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Sample records for veterans aging cohort

  1. Food insecurity and health: data from the Veterans Aging Cohort Study.

    Science.gov (United States)

    Wang, Emily A; McGinnis, Kathleen A; Goulet, Joseph; Bryant, Kendall; Gibert, Cynthia; Leaf, David A; Mattocks, Kristin; Fiellin, Lynn E; Vogenthaler, Nicholas; Justice, Amy C; Fiellin, David A

    2015-01-01

    Food insecurity may be a modifiable and independent risk factor for worse control of medical conditions, but it has not been explored among veterans. We determined the prevalence of, and factors independently associated with, food insecurity among veterans in the Veterans Aging Cohort Study (VACS). Using data from VACS from 2002-2008, we determined the prevalence of food insecurity among veterans who have accessed health care in the Veterans Health Administration (VA) as defined by "concern about having enough food for you or your family in the past month." We used multivariable logistic regression to determine factors independently associated with food insecurity and tests of trend to measure the association between food insecurity and control of hypertension, diabetes, HIV, and depression. Of the 6,709 veterans enrolled in VACS, 1,624 (24%) reported being food insecure. Food insecurity was independently associated with being African American, earning food insecure was also associated with worse control of hypertension, diabetes, HIV, and depression (pFood insecurity is prevalent and associated with worse control of medical conditions among veterans who have accessed care in the VA.

  2. Sexual Assault, Sexual Harassment, and Physical Victimization during Military Service across Age Cohorts of Women Veterans.

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    Gibson, Carolyn J; Gray, Kristen E; Katon, Jodie G; Simpson, Tracy L; Lehavot, Keren

    2016-01-01

    Exposure to sexual and physical trauma during military service is associated with adverse mental and physical health outcomes. Little is known about their prevalence and impact in women veterans across age cohorts. Data from a 2013 national online survey of women veterans was used to examine associations between age and trauma during military service, including sexual assault, sexual harassment, and physical victimization. Analyses were conducted using logistic regression, adjusting for service duration and demographic factors. In secondary analyses, the moderating role of age in the relationship between trauma and self-reported health was examined. The sample included 781 women veterans. Compared with the oldest age group (≥ 65), all except the youngest age group had consistently higher odds of reporting trauma during military service. These differences were most pronounced in women aged 45 to 54 years (sexual assault odds ratio [OR], 3.81 [95% CI, 2.77-6.71]; sexual harassment, OR, 3.99 [95% CI, 2.25-7.08]; and physical victimization, OR, 5.72 [95% CI, 3.32-9.85]). The association between trauma during military service and self-reported health status also varied by age group, with the strongest negative impact observed among women aged 45 to 54 and 55 to 64. Compared with other age groups, women in midlife were the most likely to report trauma during military service, and these experiences were associated with greater negative impact on their self-reported health. Providers should be aware that trauma during military service may be particularly problematic for the cohort of women currently in midlife, who represent the largest proportion of women who use Department of Veterans Affairs health care. Published by Elsevier Inc.

  3. Race and incarceration in an aging cohort of Vietnam veterans in treatment for post-traumatic stress disorder (PTSD).

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    Coker, Kendell L; Rosenheck, Robert

    2014-03-01

    Cross sectional studies have addressed the incarceration of Vietnam veterans with post-traumatic stress disorder (PTSD), but no studies have examined changes in incarceration as they age. This study examines patterns of incarceration among Vietnam veterans treated in specialized veterans affairs (VA) intensive PTSD programs over time. Data was drawn from admission data from the initial episode of treatment of Caucasian and African American Vietnam veterans entering VA specialized intensive PTSD programs between 1993 and 2011 (N = 31,707). Bivariate correlations and logistic regression were used to examine associations among race and incarceration over time and the potentially confounding influence of demographic and clinical covariates on this relationship. Rates of reported incarceration declined from 63 to 43%. Over time, African American veterans were 34% more likely than Caucasian veterans to have a lifetime history of incarceration while interaction analysis showed steeper declines for Caucasians than African Americans. Rates of incarceration among these Vietnam veterans declined as they aged. Furthermore, African American veterans were substantially more likely than Caucasian veterans to have been incarcerated and showed less decline as the cohort aged. While reduced, needs for clinical PTSD services remain among aging combat veterans.

  4. Incidence of cancer among UK Gulf war veterans: cohort study

    OpenAIRE

    Macfarlane, Gj; Biggs, Am; Maconochie, N; Hotopf, M; Doyle, P; Lunt, M

    2003-01-01

    Objectives To determine whether incidence rates of cancer are higher in UK service personnel who were deployed in the Gulf war than in those not deployed and whether any increased risk of cancer is related to self reported exposures to potentially hazardous material during the period of deployment. Design A cohort study with follow up from 1 April 1991 (the end of the Gulf war) to 31 July 2002. Participants 51721 Gulf war veterans and 50 755 service personnel matched for age, sex, rank, servi...

  5. Long-acting Reversible Contraception Among Homeless Women Veterans With Chronic Health Conditions: A Retrospective Cohort Study.

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    Gawron, Lori M; Redd, Andrew; Suo, Ying; Pettey, Warren; Turok, David K; Gundlapalli, Adi V

    2017-09-01

    US women Veterans are at increased risk of homelessness and chronic health conditions associated with unintended pregnancy. Veterans Health Administration (VHA) provision of long-acting reversible contraception (LARC) can assist in healthy pregnancy planning. To evaluate perinatal risk factors and LARC exposure in ever-homeless women Veterans. A retrospective cohort study of women Veterans using VHA administrative data from fiscal years 2002-2015. We included 41,747 ever-homeless women Veterans age 18-44 years and 46,391 housed women Veterans matched by military service period. A subgroup of 7773 ever-homeless and 8674 matched housed women Veterans deployed in Iraq and Afghanistan [Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND)] conflicts comprised a second analytic cohort. Descriptive statistics compared demographic, military, health conditions, and LARC exposure in ever-homeless versus housed women Veterans. Multivariable logistic regression explored factors associated with LARC exposure in the OEF/OIF/OND subgroup. All health conditions were significantly higher in ever-homeless versus housed Veterans: mental health disorder in 84.5% versus 48.7% (Phomeless women Veterans and providing LARC access. The prevalence of perinatal risk factors in ever-homeless women Veterans highlights a need for further programmatic enhancements to improve reproductive planning.

  6. Homeless Aging Veterans in Transition: A Life-Span Perspective

    OpenAIRE

    Thompson, Carla J.; Bridier, Nancy L.

    2013-01-01

    The need for counseling and career/educational services for homeless veterans has captured political and economic venues for more than 25 years. Veterans are three times more likely to become homeless than the general population if veterans live in poverty or are minority veterans. This mixed methods study emphasized a life-span perspective approach for exploring factors influencing normative aging and life-quality of 39 homeless veterans in Alabama and Florida. Seven descriptive quantitative...

  7. Depressive symptoms and other risk factors predicting suicide in middle-aged men: a prospective cohort study among Korean Vietnam War veterans.

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    Yi, Sang-Wook; Hong, Jae-Seok

    2015-01-01

    Background. Few studies have prospectively examined whether depressive symptoms and other risk factors are associated with a higher risk of suicide death in individuals other than high-risk populations such as psychiatric patients and individuals with self-harm histories. The purpose of the study is to prospectively examine whether depressive symptoms assessed by the Beck Depression Inventory (BDI) are associated with greater risk of suicide death and whether depressive symptoms and other risk factors are independent predictors of suicide in general-risk populations. Another aim is to evaluate the sensitivity of the BDI for predicting suicide death. Methods. 10,238 Korean Vietnam War veterans (mean age: 56.3 years) who participated in two surveys in 2001 were followed up for suicide mortality over 7.5 years. Results. 41 men died by suicide. Severely depressed participants had a higher adjusted hazard ratio (aHR = 3.4; 95% CI [1.5-7.7]) of suicide than non-to-moderately depressed ones. Higher suicide risk was associated with more severe depressive symptoms (p for trend = 0.009). After adjustment for depressive symptoms and other factors, very poor health, low education, and past drinking were associated with higher suicide risk, while good health, body mass index, and marital status were not associated with suicide. The sensitivity at the cut-off score of 31 for detecting suicide was higher during the earlier 3.5 years of the follow-up (75%; 95% CI [50-90]) than during the latter 4 years (60%; 95% CI [41-76]). Conclusions. Depressive symptoms are a strong independent predictor and very poor health, low education, and drinking status may be independent predictors of future suicide. The BDI may have acceptable diagnostic properties as a risk assessment tool for identifying people with depression and suicidal potential among middle-aged men.

  8. Depressive symptoms and other risk factors predicting suicide in middle-aged men: a prospective cohort study among Korean Vietnam War veterans

    Directory of Open Access Journals (Sweden)

    Sang-Wook Yi

    2015-07-01

    Full Text Available Background. Few studies have prospectively examined whether depressive symptoms and other risk factors are associated with a higher risk of suicide death in individuals other than high-risk populations such as psychiatric patients and individuals with self-harm histories. The purpose of the study is to prospectively examine whether depressive symptoms assessed by the Beck Depression Inventory (BDI are associated with greater risk of suicide death and whether depressive symptoms and other risk factors are independent predictors of suicide in general-risk populations. Another aim is to evaluate the sensitivity of the BDI for predicting suicide death.Methods. 10,238 Korean Vietnam War veterans (mean age: 56.3 years who participated in two surveys in 2001 were followed up for suicide mortality over 7.5 years.Results. 41 men died by suicide. Severely depressed participants had a higher adjusted hazard ratio (aHR = 3.4; 95% CI [1.5–7.7] of suicide than non-to-moderately depressed ones. Higher suicide risk was associated with more severe depressive symptoms (p for trend = 0.009. After adjustment for depressive symptoms and other factors, very poor health, low education, and past drinking were associated with higher suicide risk, while good health, body mass index, and marital status were not associated with suicide. The sensitivity at the cut-off score of 31 for detecting suicide was higher during the earlier 3.5 years of the follow-up (75%; 95% CI [50–90] than during the latter 4 years (60%; 95% CI [41–76].Conclusions. Depressive symptoms are a strong independent predictor and very poor health, low education, and drinking status may be independent predictors of future suicide. The BDI may have acceptable diagnostic properties as a risk assessment tool for identifying people with depression and suicidal potential among middle-aged men.

  9. Agent Orange Exposure and Monoclonal Gammopathy of Undetermined Significance: An Operation Ranch Hand Veteran Cohort Study.

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    Landgren, Ola; Shim, Youn K; Michalek, Joel; Costello, Rene; Burton, Debra; Ketchum, Norma; Calvo, Katherine R; Caporaso, Neil; Raveche, Elizabeth; Middleton, Dan; Marti, Gerald; Vogt, Robert F

    2015-11-01

    Multiple myeloma has been classified as exhibiting "limited or suggestive evidence" of an association with exposure to herbicides in Vietnam War veterans. Occupational studies have shown that other pesticides (ie, insecticides, herbicides, fungicides) are associated with excess risk of multiple myeloma and its precursor state, monoclonal gammopathy of undetermined significance (MGUS); however, to our knowledge, no studies have uncovered such an association in Vietnam War veterans. To examine the relationship between MGUS and exposure to Agent Orange, including its contaminant 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), in Vietnam War veterans. This was a prospective cohort study conducted in 2013 to 2014, testing for MGUS in serum specimens collected and stored in 2002 by the Air Force Health Study (AFHS). The relevant exposure data collected by the AFHS was also used. We tested all specimens in 2013 without knowledge of the exposure status. The AFHS included former US Air Force personnel who participated in Operation Ranch Hand (Ranch Hand veterans) and other US Air Force personnel who had similar duties in Southeast Asia during the same time period (1962 to 1971) but were not involved in herbicide spray missions (comparison veterans). Agent Orange was used by the US Air Force personnel who conducted aerial spray missions of herbicides (Operation Ranch Hand) in Vietnam from 1962 to 1971. We included 479 Ranch Hand veterans and 479 comparison veterans who participated in the 2002 follow-up examination of AFHS. Agent Orange and TCDD. Serum TCDD levels were measured in 1987, 1992, 1997, and 2002. Risk of MGUS measured by prevalence, odds ratios (ORs), and 95% CIs. The 479 Ranch Hand veterans and 479 comparison veterans had similar demographic and lifestyle characteristics and medical histories. The crude prevalence of overall MGUS was 7.1% (34 of 479) in Ranch Hand veterans and 3.1% (15 of 479) in comparison veterans. This translated into a 2.4-fold increased risk

  10. The use of VA Disability Compensation and Social Security Disability Insurance among working-aged veterans.

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    Wilmoth, Janet M; London, Andrew S; Heflin, Colleen M

    2015-07-01

    Although there is substantial disability among veterans, relatively little is known about working-aged veterans' uptake of Department of Veterans Affairs (VA) Disability Compensation and Social Security Disability Insurance (DI). This study identifies levels of veteran participation in VA disability and/or DI benefit programs, examines transitions into and out of VA and DI programs among veterans, and estimates the size and composition of the veteran population receiving VA and/or DI benefits over time. Data from the 1992, 1993, 1996, 2001, 2004, and 2008 Survey of Income and Program Participation (SIPP) are used to describe VA and DI program participation among veterans under the age of 65. The majority of working-aged veterans do not receive VA or DI benefits and joint participation is low, but use of these programs has increased over time. A higher percentage of veterans receive VA compensation, which ranges from 4.9% in 1992 to 13.2% in 2008, than DI compensation, which ranges from 2.9% in 1992 to 6.7% in 2008. The rate of joint participation ranges from less than 1% in 1992 to 3.6% in 2008. Veterans experience few transitions between VA and DI programs during the 36-48 months they are observed. The number of veterans receiving benefits from VA and/or DI nearly doubled between 1992 and 2008. There have been substantial shifts in the composition of veterans using these programs, as cohorts who served prior to 1964 are replaced by those who served after 1964. The findings suggest potential gaps in veterans' access to disability programs that might be addressed through improved coordination of VA and DI benefits. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Prevalence of Post-Traumatic Stress Disorder in Aging Vietnam-Era Veterans: Veterans Administration Cooperative Study 569: Course and Consequences of Post-Traumatic Stress Disorder in Vietnam-Era Veteran Twins.

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    Goldberg, Jack; Magruder, Kathryn M; Forsberg, Christopher W; Friedman, Matthew J; Litz, Brett T; Vaccarino, Viola; Heagerty, Patrick J; Gleason, Theresa C; Huang, Grant D; Smith, Nicholas L

    2016-03-01

    The prevalence of post-traumatic stress disorder (PTSD) among aging Vietnam-era veterans is not well characterized. In a cross-sectional study, 5,598 male Vietnam-era veterans and members of the Vietnam Era Twin Registry were assessed for PTSD using the Composite International Diagnostic Interview. Current symptoms were measured with the PTSD Checklist (PCL). PTSD was estimated according to age (aged at least 60 years was 16.9% (95% CI: 13.9%-20.5%) and higher than the 5.5% (95% CI: 4.3%-7.0%) among nontheater veterans. Among veterans younger than 60 years, the comparable prevalence was 22.0% for theater (95% CI: 16.7%-28.4%) and 15.7% for nontheater (95% CI: 13.4%-18.2%) veterans. Similar results were found for theater service and current PTSD prevalence (past 12 months). PCL scores were significantly higher in theater compared with nontheater veterans in both younger and older cohorts. In both the younger and older cohorts significant differences in lifetime and current PTSD prevalence and PCL scores persisted in theater service discordant twin pairs. Vietnam service is related to elevated PTSD prevalence and current symptom burden in aging veterans. More than 30 years after the end of the Vietnam conflict, many veterans continue to suffer from PTSD, which highlights the need for continuing outreach throughout the life course. Copyright © 2016 American Association for Geriatric Psychiatry. All rights reserved.

  12. Isoniazid Toxicity among an Older Veteran Population: A Retrospective Cohort Study.

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    Vinnard, Christopher; Gopal, Anand; Linkin, Darren R; Maslow, Joel

    2013-01-01

    our objective was to determine the incidence of toxicity among veterans initiating isoniazid therapy for latent tuberculosis infection (LTBI) and determine whether advancing age was a risk factor for toxicity. we performed a retrospective cohort study among all adults initiating isoniazid treatment for LTBI at a Veterans Medical Center from 1999 to 2005. We collected data on patient demographics, co-morbidities, site of initiation, and treatment outcome. 219 patients initiated isoniazid therapy for LTBI during the period of observation, and the completion of therapy was confirmed in 100 patients (46%). Among 18/219 patients (8%) that discontinued therapy due to a documented suspected toxicity, the median time to onset was 3 months (IQR 1-5 months). In an adjusted Cox regression model, there was no association between discontinuation due to suspected toxicity and advancing age (HR 1.03, 95% CI 0.99, 1.07). In contrast, hepatitis C infection was a significant predictor of cessation due to toxicity in the adjusted analysis (HR 3.03, 95% CI 1.08, 8.52). cessation of isoniazid therapy due to suspected toxicity was infrequently observed among a veteran population and was not associated with advancing age. Alternative LTBI treatment approaches should be further examined in the veteran population.

  13. Isoniazid Toxicity among an Older Veteran Population: A Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Christopher Vinnard

    2013-01-01

    Full Text Available Background: our objective was to determine the incidence of toxicity among veterans initiating isoniazid therapy for latent tuberculosis infection (LTBI and determine whether advancing age was a risk factor for toxicity. Methods: we performed a retrospective cohort study among all adults initiating isoniazid treatment for LTBI at a Veterans Medical Center from 1999 to 2005. We collected data on patient demographics, co-morbidities, site of initiation, and treatment outcome. Results: 219 patients initiated isoniazid therapy for LTBI during the period of observation, and the completion of therapy was confirmed in 100 patients (46%. Among 18/219 patients (8% that discontinued therapy due to a documented suspected toxicity, the median time to onset was 3 months (IQR 1–5 months. In an adjusted Cox regression model, there was no association between discontinuation due to suspected toxicity and advancing age (HR 1.03, 95% CI 0.99, 1.07. In contrast, hepatitis C infection was a significant predictor of cessation due to toxicity in the adjusted analysis (HR 3.03, 95% CI 1.08, 8.52. Conclusions: cessation of isoniazid therapy due to suspected toxicity was infrequently observed among a veteran population and was not associated with advancing age. Alternative LTBI treatment approaches should be further examined in the veteran population.

  14. Homeless Aging Veterans in Transition: A Life-Span Perspective

    Directory of Open Access Journals (Sweden)

    Carla J. Thompson

    2013-01-01

    Full Text Available The need for counseling and career/educational services for homeless veterans has captured political and economic venues for more than 25 years. Veterans are three times more likely to become homeless than the general population if veterans live in poverty or are minority veterans. This mixed methods study emphasized a life-span perspective approach for exploring factors influencing normative aging and life-quality of 39 homeless veterans in Alabama and Florida. Seven descriptive quantitative and qualitative research questions framed the investigation. Study participants completed a quantitative survey reflecting their preferences and needs with a subset of the sample (N=12 also participating in individual qualitative interview sessions. Thirty-two service providers and stakeholders completed quantitative surveys. Empirical and qualitative data with appropriate triangulation procedures provided interpretive information relative to a life-span development perspective. Study findings provide evidence of the need for future research efforts to address strategies that focus on the health and economic challenges of veterans before they are threatened with the possibility of homelessness. Implications of the study findings provide important information associated with the premise that human development occurs throughout life with specific characteristics influencing the individual’s passage. Implications for aging/homelessness research are grounded in late-life transitioning and human development intervention considerations.

  15. PTSD, Psychotropic Medication Use, and the Risk of Dementia Among US Veterans: A Retrospective Cohort Study.

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    Mawanda, Francis; Wallace, Robert B; McCoy, Kimberly; Abrams, Thad E

    2017-05-01

    To determine the associations between PTSD, psychotropic medication use, and the risk for dementia. Retrospective cohort. Nationwide sample of US veterans (N = 417,172) aged ≥56 years during fiscal year (FY) 2003 without a diagnosis of dementia or mild cognitive impairment at baseline (FY02-03) and ≥1 clinical encounter every 2 years during follow-up (FY04-12). Demographic characteristics; diagnosis of PTSD, dementia, and medical and psychiatric comorbidity (defined by ICD-9 codes); and psychotropic medication use including selective serotonin reuptake inhibitors (SSRI), serotonin-norepinephrine reuptake inhibitors (SNRI), novel antidepressants (NA), benzodiazepines (BZA), and atypical antipsychotics (AA). Cox proportional hazard models examined for associations between PTSD diagnosis, psychotropic medication use, and risk for a dementia diagnosis. PTSD diagnosis significantly increased the risk for dementia diagnosis (HR = 1.35; [95% CI = 1.27-1.43]). However, there were significant interactions between PTSD diagnosis and use of SSRIs (P dementia diagnosis. HR for dementia diagnosis among veterans diagnosed with PTSD and not using psychotropic medications was 1.55 [1.45-1.67]. Among veterans diagnosed with PTSD prescribed SSRI, SNRI, or AA, HR for dementia diagnosis varied by drug class use ranging from 1.99 for SSRI to 4.21 for AA, relative to veterans without a PTSD diagnosis and no psychotropic medication receipt. BZAs or SNRIs use at baseline was associated with a significantly increased risk for dementia diagnosis independent of a PTSD diagnosis. PTSD diagnosis is associated with an increased risk for dementia diagnosis that varied with receipt of psychotropic medications. Further research would help to delineate if these findings are due to differences in PTSD severity, psychiatric comorbidity, or independent effects of psychotropic medications on cognitive decline. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics

  16. Agent Orange exposure and cancer incidence in Korean Vietnam veterans: a prospective cohort study.

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    Yi, Sang-Wook; Ohrr, Heechoul

    2014-12-01

    During the Vietnam War, US and allied military sprayed approximately 77 million liters of tactical herbicides including Agent Orange, contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin. To the authors' knowledge, few studies to date have examined the association between Agent Orange exposure and cancer incidence among Korean veterans who were exposed to Agent Orange during the Vietnam War. An Agent Orange exposure index, based on the proximity of the veteran's military unit to the area that was sprayed with Agent Orange, was developed using a geographic information system-based model. Cancer incidence was followed for 180,251 Vietnam veterans from 1992 through 2003. After adjustment for age and military rank, high exposure to Agent Orange was found to significantly increase the risk of all cancers combined (adjusted hazards ratio [aHR], 1.08). Risks for cancers of the mouth (aHR, 2.54), salivary glands (aHR, 6.96), stomach (aHR, 1.14), and small intestine (aHR, 2.30) were found to be significantly higher in the high-exposure group compared with the low-exposure group. Risks for cancers of all sites combined (aHR, 1.02) and for cancers of the salivary glands (aHR, 1.47), stomach (aHR, 1.03), small intestine (aHR, 1.24), and liver (aHR, 1.02) were elevated with a 1-unit increase in the exposure index. Exposure to Agent Orange several decades earlier may increase the risk of cancers in all sites combined, as well as several specific cancers, among Korean veterans of the Vietnam War, including some cancers that were not found to be clearly associated with exposure to Agent Orange in previous cohort studies primarily based on Western populations. © 2014 American Cancer Society.

  17. Evidence of poorer life-course mental health outcomes among veterans of the Korean War cohort.

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    Brooks, Matthew Stephen; Fulton, Lawrence

    2010-03-01

    Comparing the outcomes of veterans who served in Korea and those who served elsewhere, we examined the treatment of post-traumatic stress disorder (PTSD), other mental health conditions, psychiatric treatment locations, and six mental health well-being measures. The analytic sample consisted of nationally representative data from the 2001 National Survey of Veterans (NSV). Analyses included multiple logistic regressions that controlled for sociodemographic characteristics. Korean era veterans in the NSV (n = 4030): 1498 served in Korea; 2532 elsewhere during the era. Veterans who served in Korea have notably poorer mental health than those who served elsewhere. These results suggest higher resource needs among aging Korean era veterans. Clinicians, policy makers and the Department of Veterans Affairs should focus on mental health services to older veterans.

  18. Successful aging among older veterans in the United States.

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    Pietrzak, Robert H; Tsai, Jack; Kirwin, Paul D; Southwick, Steven M

    2014-06-01

    To develop a unidimensional latent model of successful aging and to evaluate sociodemographic, medical, psychiatric, and psychosocial correlates of this construct in a nationally representative sample of older veterans in the United States. Data were analyzed from a cross-sectional web survey of 2,025 U.S. veterans aged 60 to 96 years who participated in the National Health and Resilience in Veterans Study. Self-report measures of sociodemographics; subjective physical, mental, and cognitive functioning; and psychosocial characteristics were used. Confirmatory factor analysis was used to construct a unidimensional latent factor of successful aging. Correlates of scores on this factor were then evaluated. Most older veterans (82.1%) rated themselves as aging successfully. A unidimensional latent factor composed of seven measures of self-rated successful aging, quality of life, and physical, mental, cognitive, and social functioning provided a good fit to the data. Physical health difficulties (β = -0.39) and current psychological distress (β = -0.33) were most strongly negatively related to scores on this latent factor of successful aging, while protective psychosocial characteristics (β = 0.22), most notably resilience, gratitude, and purpose in life, were most strongly positively related to these scores. Additional positive predictors of successful aging included White, non-Hispanic race, being married or living with partner, perceiving a positive effect of the military on one's life, active lifestyle, positive expectations regarding aging, and conscientiousness; additional negative predictors included substance abuse history. Results of this study provide a dimensional approach to characterizing components and correlates of successful aging in older veterans. Interventions and policy initiatives designed to mitigate physical health difficulties and psychological distress and to enhance protective psychosocial characteristics such as resilience, gratitude, and

  19. [Heart rhythm abnormalities in middle-aged veteran elite athletes].

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    Sharashdze, N S; Pagava, Z T; Saatashvili, G A; Agladze, R A

    2008-06-01

    Disrrhythmia is frequent finding in high competitive athletes. Majority of heart rhythm abnormalities in athletes, suggested being benign, however, prognostic value of it is not yet well established. Purpose of the present study was to investigate heart rhythm and relationship of heart rhythm abnormalities with LV mass in veteran elite athletes. 30 veteran elite athletes (16 soccer players and 14 water-polo players) aged 30-50 were studied. They formed main group. >10 years of active sports activity and >5 years after competitive sports cessation. All athletes were symptom free. Control group consists of 30 age - matched sedentary healthy individuals. In all study subjects ambulatory 24 hour ECG was recorded and, LV mass, dimensions and function by ultrasound-Doppler technique was evaluated. LV mass by Devereux formula was calculated and indexed to body surface area. Student's t-test for continuous variables, Descriptive statistics and Fisher's exact test for categorical variables were used. A P-value of conductivity abnormalities as well as complex arrhythmias were more frequent findings in athletes as compared with healthy sedentary subjects. Heart Rhythm abnormalities were associated with enhanced LV mass in Veteran athletes. Hence, veteran elite athletes may be at increased risk of life threatening arrhythmias. However, prognostic value of heart rhythm disturbances in veteran athletes has to be studied.

  20. Mortality patterns among women Vietnam-era veterans: results of a retrospective cohort study.

    Science.gov (United States)

    Cypel, Yasmin; Kang, Han

    2008-03-01

    This research compiled and analyzed the data of two cohorts of women veterans who either served in Vietnam ("Vietnam veteran" cohort, n = 4586) or served elsewhere during the Vietnam War ("non-Vietnam veteran" cohort, n = 5325). All cause and cause-specific mortality were compared between Vietnam and non-Vietnam veteran cohorts, to the U.S. population, and to earlier research. Similar analyses were performed for nurses only. Vital status was determined through December 31, 2004, using primarily the U.S. Department of Veterans Affairs beneficiary file and the Social Security Administration Death Master File. Selected data were submitted to the National Center for Health Statistics for merging with the National Death Index to obtain cause of death. Cox proportional hazard analysis modeling was used to obtain adjusted relative risks (ARR). SEER( *)Stat software was used to compute standardized mortality ratios (SMR) for comparisons to the U.S. population. Women Vietnam veterans showed a significant deficit (ARR = 0.78, 95% confidence interval [CI] 0.62-0.98) in circulatory system disease relative to non-Vietnam veterans, but significant deficits also were observed when the Vietnam and non-Vietnam cohorts were each compared with women in the U.S. population (SMR = 0.65, 95% CI 0.54-0.77; SMR=0.82, 95% CI 0.73-0.93, respectively). Vietnam veterans had significantly lower mortality than women in the U.S. population for all causes (SMR = 0.87, 95% CI 0.80-0.94). Vietnam veterans were at significantly greater risk of mortality from motor vehicle accidents than non-Vietnam veterans (ARR = 2.60, 95% CI 1.22-5.55) and this appeared to be specific to service in Vietnam based on comparisons to the U.S. population. Patterns did not differ greatly for the analysis on nurse veterans or to earlier mortality studies of these cohorts. Mortality from motor vehicle accidents was significantly associated with service in Vietnam. Mortality patterns generally resembled those reported on

  1. A descriptive analysis of medical health services utilization of Veterans living in Ontario: a retrospective cohort study using administrative healthcare data.

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    Aiken, Alice B; Mahar, Alyson L; Kurdyak, Paul; Whitehead, Marlo; Groome, Patti A

    2016-08-04

    Health services utilization by Veterans following release may be different than the general population as the result of occupational conditions, requirements and injuries. This study provides the first longitudinal overview of Canadian Veteran healthcare utilization in the Ontario public health system. This is a retrospective cohort study designed to use Ontario's provincial healthcare data to study the demographics and healthcare utilization of Canadian Armed Forces (CAF) & RCMP Veterans living in Ontario. Veterans were eligible for the study if they released between January 1, 1990 and March 31, 2013. Databases at the Institute for Clinical Evaluative Sciences were linked by a unique identifier to study non-mental health related hospitalizations, emergency department visits, and physician visits. Overall and age-stratified descriptive statistics were calculated in five-year intervals following the date of release. The cohort is comprised of 23, 818 CAF or RCMP Veterans. Following entry into the provincial healthcare system, 82.6 % (95 % CI 82.1-83.1) of Veterans saw their family physician at least once over the first five years following release, 60.7 % (95 % CI 60.0-61.3) saw a non-mental health specialist, 40.8 % (95 % CI 40.2-41.5) went to the emergency department in that same time period and 9.9 % (9.5-10.3) were hospitalized for non-mental health related complaints. Patterns of non-mental health services utilization appeared to be time and service dependant. Stratifying health services utilization by age of the Veteran at entry into the provincial healthcare system revealed significant differences in service use and intensity. This study provides the first description of health services utilization by Veterans, following release from the CAF or RCMP. This work will inform the planning and delivery of support to Veterans in Ontario.

  2. Lower urinary tract dysfunction in male Iraq and Afghanistan war veterans: association with mental health disorders: a population-based cohort study.

    Science.gov (United States)

    Breyer, Benjamin N; Cohen, Beth E; Bertenthal, Daniel; Rosen, Raymond C; Neylan, Thomas C; Seal, Karen H

    2014-02-01

    To determine the prevalence and correlates of lower urinary tract symptoms (LUTS) among returned Iraq and Afghanistan veterans; in particular its association with mental health diagnoses and medication use. We performed a retrospective cohort study of Iraq and Afghanistan veterans who were new users of U.S. Department of Veterans Affairs health care. Mental health diagnoses were defined by International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM) codes from medical records. LUTS was defined by ICD-9-CM code, use of prescription medication for LUTS, or procedure for LUTS. We determined the independent association of mental health diagnoses and LUTS after adjusting for sociodemographic and military service characteristics, comorbidities, and medications. Of 519,189 veterans, 88% were men and the mean age was 31.8 years (standard deviation ± 9.3). The overall prevalence of LUTS was 2.2% (11,237/519,189). Veterans with post-traumatic stress disorder (PTSD) were significantly more likely to have a LUTS diagnosis, prescription, or related procedure (3.5%) compared with veterans with no mental health diagnoses (1.3%) or a mental health diagnosis other than PTSD (3.1%, P <.001). In adjusted models, LUTS was significantly more common in veterans with PTSD with and without other mental health disorders vs those without mental health disorders (adjusted relative risk [ARR] = 2.04, 95% confidence interval [CI] = 1.94-2.15) and in veterans prescribed opioids (ARR = 2.46, 95% CI = 2.36-2.56). In this study of young returned veterans, mental health diagnoses and prescription for opioids were independently associated with increased risk of receiving a diagnosis, treatment, or procedure for LUTS. Provider awareness may improve the detection and treatment of LUTS, and improve patient care and quality of life. Copyright © 2014. Published by Elsevier Inc.

  3. Infertility among male UK veterans of the 1990-1 Gulf war: reproductive cohort study

    OpenAIRE

    Maconochie, N; Doyle, P; Carson, C.

    2004-01-01

    OBJECTIVES: To examine the hypothesis that, theoretically at least, exposure to toxicants of the type present in the Gulf war could affect spermatogenesis, which might be observed as increased levels of infertility. DESIGN: Retrospective reproductive cohort analysis. SETTING: Male UK Gulf war veterans and matched comparison group of non-deployed servicemen, surveyed by postal questionnaire. PARTICIPANTS: 42,818 completed questionnaires were returned, representing response rates of 53% for Gul...

  4. Risk factors associated with posttraumatic stress disorder in US veterans: A cohort study.

    Science.gov (United States)

    Müller, Jan; Ganeshamoorthy, Sarmila; Myers, Jonathan

    2017-01-01

    To assess the association between clinical and exercise test factors and the development of posttraumatic stress disorder (PTSD) in US Veterans. Exercise capacity, demographics and clinical variables were assessed in 5826 veterans (mean age 59.4 ± 11.5 years) from the Veterans Affairs Healthcare System in Palo Alto, CA. The study participants underwent routine clinical exercise testing between the years 1987 and 2011. The study end point was the development of PTSD. A total of 723 (12.9%) veterans were diagnosed with PTSD after a mean follow-up of 9.6 ± 5.6 years. Drug abuse (HR: 1.98, CI: 1.33-2.92, p = .001), current smoking (HR: 1.57, CI: 1.35-2.24, p Physical activity pattern was not associated with PTSD in either the univariate or multivariate models. In the final multivariate model, current smoking (HR: 1.30, CI: 1.10-1.53, p = .002) history of chest pain (HR: 1.37, CI: 1.15-1.63, p <.001) and younger age (HR: 0.97, CI: 0.97-0.98, p <.001) were significantly associated to PTSD. Onset of PTSD is significantly associated with current smoking, history of chest pain and younger age. Screening veterans with multiple risk factors for symptoms of PTSD should therefore be taken into account.

  5. Comparing the Age Related Mood Profile of Veteran Basketball Players

    Directory of Open Access Journals (Sweden)

    Robabeh Rostami

    2016-07-01

    Full Text Available Background: Basketball, as an exciting team sport, is very popular among athletes with disabilities. Among psychological skills, mood states as an important variable have been of special interest to researchers. Objectives: The purpose of the present study was to investigate and compare profile of mood states (BRUMS of disabled former soldiers who play basketball in different age groups. Methodology: After getting permit to conduct the research, 28 disabled basketball players completed the demographic survey and the Brunel Mood Scale (BRUMS questionnaire. BRUMS consisted of 24 items in subscales of stress, anger, depression, fatigue, confusion and vigor. The one-way analysis of variance test was used for the data analysis. The significance level was set at P≤0.05. SPSS Statistics 22.0 was used for the analysis of data. Results: The results showed that mood states become less negative with age. However, scores showed a rising trend in the 35-39 age groups (mood of anger with P=0/02 fatigue with P=0/03 and confusion with P=0/04. Conclusion: It seems that examining the psychological variables in relation to age can help develop more effective strategies in physical and mental training programs for disabled players. Keywords: Mood States, Basketball Players, veteran with disabilities, Age

  6. Generations, Age Groups and Cohorts: Conceptual Distinctions.

    Science.gov (United States)

    Marshall, Victor W.

    1983-01-01

    Calls for a return to the conceptualization of Mannheim about generations and a parallel conceptualization concerning age groups. The usefulness of this approach is discussed in terms of the political sociology of age relations. Recommends precise definition and use of the terms cohort, generation, age grade, age stratum, age group, and generation…

  7. Long-term disability associated with war-related experience among Vietnam veterans: retrospective cohort study.

    Science.gov (United States)

    Clarke, Philip M; Gregory, Robert; Salomon, Joshua A

    2015-05-01

    Recent combat operations have involved large numbers of personnel. Long-term health effects of military deployment remain largely unknown. To examine patterns and trends in long-term disability among combat veterans and to relate disability to aspects of wartime experience. A total of 60,228 Australian military personnel deployed between 1962 and 1975 during the Vietnam War, and 82,877 military personnel who were not deployed overseas. Accepted physician-assessed disability claims were evaluated over follow-up periods up to 50 years after deployment, and compared with age-matched controls. Multivariable analysis was used to examine differences by service branch, rank, age, and deployment duration. The steepest rise in disability incidence was observed among Vietnam veterans starting in the 1990s, around 20-30 years after deployment for most veterans. After 1994, when Statements of Principles were introduced to guide evaluation of disability claims, the hazard ratio for disability incidence was 1.53 (95% confidence interval, 1.32-1.77) compared with the prior period. By January 2011, after an average follow-up of 42.5 years, 69.7% (95% confidence interval, 69.4%-70.1%) of veterans had at least 1 war-related disability. Many veterans had multiple disabilities, with leading causes being eye and ear disorders (48.0%), mental health conditions (47.9%), and musculoskeletal disorders (18.4%). For specific categories of disability, relative risks for accepted claims among veterans compared with controls were highest for mental health disorders, at 22.9 (21.9-24.0) and lowest for injuries, at 1.5 (1.4-1.6) with a relative risk for any disability of 3.7 (3.7-3.8). Veterans with service of >1 year were 2.5 (2.2-2.7) times more likely to have a mental health disability than those who served war-related disability is associated with service history. If similar patterns follow from more recent conflicts, significant additional resources will be needed to prevent and treat long

  8. Purpose in Life is Associated with a Reduced Risk of Incident Physical Disability in Aging U.S. Military Veterans.

    Science.gov (United States)

    Mota, Natalie P; Tsai, Jack; Kirwin, Paul D; Sareen, Jitender; Southwick, Steven M; Pietrzak, Robert H

    2016-09-01

    The current study evaluated the incidence and determinants of physical disability in a contemporary, nationally representative sample of U.S. military veterans. Data were analyzed from the National Health and Resilience in Veterans Study, a nationally representative, prospective cohort study of 1,686 veterans aged 55 years and older. Waves 1 and 2 were conducted in 2011 and 2013, respectively. Potential determinants of incident disability in activities of daily living (ADL; e.g., bathing, dressing) and instrumental activities of daily living (IADL; e.g., food preparation, medication adherence) were assessed at Wave 1, and included sociodemographic characteristics, and risk (e.g., medical conditions, psychiatric distress), and protective psychosocial (e.g., psychological resilience, purpose in life) factors. The two-year incidence of any physical disability (ADL or IADL) among veterans aged 55 years and older was 11.5%, and the incidence of ADL and IADL disability was 3.0% and 11.4%, respectively. Older age, being married/cohabiting, and number of medical conditions-specifically, diabetes, heart attack, and chronic pain-were associated with an increased risk of any incident physical disability and incident IADL disability (adjusted odds ratio [AOR] range: 1.10-3.10). Retirement was associated with an increased risk of incident ADL disability (AOR: 7.53, 95% CI: 1.37-41.51). Purpose in life was found to be protective for incident IADL disability (AOR: 0.93, 95% CI: 0.87-0.99). Although greater medical burden is associated with increased incidence of physical disability in U.S. veterans, results of this study suggest that initiatives designed to foster greater purpose in life may help protect against the development of physical disability in this rapidly growing segment of the population. Copyright © 2016 American Association for Geriatric Psychiatry. All rights reserved.

  9. A retrospective cohort study of comorbidity trajectories associated with traumatic brain injury in veterans of the Iraq and Afghanistan wars.

    Science.gov (United States)

    Pugh, Mary Jo; Finley, Erin P; Wang, Chen-Pin; Copeland, Laurel A; Jaramillo, Carlos A; Swan, Alicia A; Elnitsky, Christine A; Leykum, Luci K; Mortensen, Eric M; Eapen, Blessen A; Noel, Polly H; Pugh, Jacqueline A

    2016-01-01

    To identify and validate trajectories of comorbidity associated with traumatic brain injury in male and female Iraq and Afghanistan war Veterans (IAV). Derivation and validation cohorts were compiled of IAV who entered the Department of Veterans Affairs (VA) care and received 3 years of VA care between 2002-2011. Chronic disease and comorbidities associated with deployment including TBI were identified using diagnosis codes. A latent class analysis (LCA) of longitudinal comorbidity data was used to identify trajectories of comorbidity. LCA revealed five trajectories that were similar for women and men: (1) Healthy, (2) Chronic Disease, (3) Mental Health, (4) Pain and (5) Polytrauma Clinical Triad (PCT: pain, mental health and TBI). Two additional classes found in men were 6) Minor Chronic and 7) PCT with chronic disease. Among these gender-stratified trajectories, it was found that women were more likely to experience headache (Pain trajectory) and depression (Mental Health trajectory), while men were more likely to experience lower back pain (Pain trajectory) and substance use disorder (Mental Health trajectory). The probability of TBI was highest in the PCT-related trajectories, with significantly lower probabilities in other trajectories. It was found that TBI was most common in PCT-related trajectories, indicating that TBI is commonly comorbid with pain and mental health conditions for both men and women. The relatively young age of this cohort raises important questions regarding how disease burden, including the possibility of neurodegenerative sequelae, will accrue alongside normal age-related decline in individuals with TBI. Additional 'big data' methods and a longer observation period may allow the development of predictive models to identify individuals with TBI that are at-risk for adverse outcomes.

  10. Mediation of smoking-associated postoperative mortality by perioperative complications in veterans undergoing elective surgery: data from Veterans Affairs Surgical Quality Improvement Program (VASQIP)?a cohort study

    OpenAIRE

    Singh, Jasvinder A; Hawn, Mary; Campagna, Elizabeth J; Henderson, William G; Richman, Joshua; Houston, Thomas K

    2013-01-01

    Objective To assess the mediation of smoking-associated postoperative mortality by postoperative complications. Design Observational cohort study. Setting Using data from the Veterans Affairs (VA) Surgical Quality Improvement Programme, a quality assurance programme for major surgical procedures in the VA healthcare system, we assessed the association of current smoking at the time of the surgery with 6-month and 1-year mortality. Primary and secondary outcome measures Using mediation analyse...

  11. Cohort profile: the ages 2003 cohort study in Aichi, Japan.

    Science.gov (United States)

    Nishi, Akihiro; Kondo, Katsunori; Hirai, Hiroshi; Kawachi, Ichiro

    2011-01-01

    The longevity of Japanese is thought to be associated with psychosocial factors such as sense of coherence, social support, and social capital. However, the actual factors responsible and the extent of their contribution to individual health status are not known. The Aichi Gerontological Evaluation Study (AGES) 2003 Cohort Study is a prospective cohort study of community-dwelling, activities of daily living-independent people aged 65 or older living in 6 municipalities in Chita peninsula, Aichi Prefecture, Japan. Information on psychosocial factors and other individual- and community-level factors was collected in the second half of 2003 using a baseline questionnaire. Vital status and physical and cognitive decline have been followed using data derived from long-term care insurance certification. Geographical information on the study participants was also obtained. A total of 13 310 (6508 men; 6802 women) study participants were registered in the study. For an interim report, we followed the cohort for 48 months, yielding 24 753 person-years of observation among men and 26 456 person-years among women. The AGES 2003 Cohort Study provides useful evidence for research in social epidemiology, gerontology, and health services.

  12. The mortality and cancer experience of New Zealand Vietnam war veterans: a cohort study.

    Science.gov (United States)

    McBride, David; Cox, Brian; Broughton, John; Tong, Darryl

    2013-09-03

    The aim was to observe the patterns of mortality and cancer incidence in New Zealand Vietnam veterans. The objectives were to assess whether the patterns of disease observed were consistent with those associated with military service in Vietnam, and similar to the patterns identified in other groups of Vietnam veterans. A historical cohort study. Veterans, identified from service records, with Vietnam service between 1964 and 1972. Of the 3322 survivors of Vietnam service, we followed up 2783 (84%). Standardised mortality and incidence ratios (SMRs and SIRs, respectively) were calculated based on the number of deaths and cancer registrations observed, those expected being based on New Zealand national rates. All cause mortality was significantly reduced (SMR 0.85, 95% CI 0.77 to 0.94) and cancer incidence non-significantly increased (SIR 1.06, 95% CI 0.97 to 1.16). The risk of mortality from cancers of the head and neck (SMR 2.20, 95% CI 1.09 to 3.93); oral cavity pharynx and larynx (SMR 2.13, 95% CI 1.06 to 3.81) and the incidence of chronic lymphatic leukaemia (CLL) (SIR 1.91, 95% CI 1.04 to 3.20) were, however, significantly increased. Other lymphohaematopoietic disorders, specifically multiple myeloma and Hodgkin disease, showed non-significant mortality excesses, reflected by a similar increase in incidence. Service in the Vietnam war was associated with defoliant herbicide exposure, including 2,4,5-trichlorophenoxyacetic acid, 2,4-dichlorophenoxyacetic acid, picloram and cacodylic acid. Subsequent reviews of mechanistic, animal and epidemiological evidence led to certain conditions being deemed compensable. The pattern of mortality and cancer incidence is not at odds with the list of compensable conditions and consistent with that found in Australian veterans serving in the same area of Vietnam, but also consistent with smoking and the healthy soldier effect. In common with the Australian experience, this is the only veterans group to show a significant

  13. Age Differences in the Association of Social Support and Mental Health in Male U.S. Veterans: Results From the National Health and Resilience in Veterans Study.

    Science.gov (United States)

    Weiner, Melissa R; Monin, Joan K; Mota, Natalie; Pietrzak, Robert H

    2016-04-01

    To examine the associations between multiple aspects of social support-perceived support, structural support, and community integration-and mental health difficulties in younger and older male veterans. Drawing from Socioemotional Selectivity Theory (SST), we hypothesized that greater support would be more strongly negatively related to mental health difficulties in older than younger veterans. Cross-sectional Web survey of younger and older male veterans recruited from a contemporary, nationally representative sample of veterans residing in the United States. Data were drawn from the National Health and Resilience in Veterans Study. Participants were 290 younger male veterans (mean age: 37.0 years, SD: 6.9, range: 21-46) and 326 older male veterans (mean age: 81.7 years, SD: 3.2, range: 78-96). Participants completed measures of sociodemographic and military characteristics, perceived and structural social support, community integration, and mental health difficulties. In contrast to SST, higher perceived support was associated with fewer mental health difficulties in younger but not older veterans. In line with SST, community integration was associated with fewer mental health difficulties in older but not younger veterans. Structural support was not associated with mental health difficulties in either group. Results of this study provide mixed support for SST and suggest that different aspects of social support may help promote the mental health of younger and older male U.S. veterans. Promotion of community engagement may help promote mental health in older veterans, whereas promotion of functional social support may help promote mental health in younger veterans. Copyright © 2016 American Association for Geriatric Psychiatry. All rights reserved.

  14. Age-Related Concerns of Male Veteran Callers to a Suicide Crisis Line

    Science.gov (United States)

    King, Deborah A.; O’Riley, Alisa A.; Thompson, Caitlin; Conwell, Yeates; He, Hua; Kemp, Janet

    2015-01-01

    In July 2007, the United States Department of Veterans Affairs (VA) partnered with the Department of Health and Human Services’ Substance Abuse and Mental Health Service Administration (SAMHSA) to create the Veterans Crisis Line (VCL) in order to meet the unique needs of Veterans in distress. The current study utilized a mixed methods design to examine characteristics of male callers to the VCL. Results from qualitative analyses demonstrated that the majority of callers between April 1 and August 31, 2008 contacted the VCL with concerns related to mental health issues, suicide ideation, and substance abuse issues. Quantitative analyses demonstrated age differences associated with concerns presented by callers such that middle-aged and older callers were more likely to present with loneliness and younger callers were more likely to present with mental health concerns. The results of this study will help to inform future research designed to optimize the effectiveness of the VCL for suicide prevention in Veterans. PMID:24810270

  15. Racial differences in the evaluation and treatment of hepatitis C among veterans: a retrospective cohort study.

    Science.gov (United States)

    Rousseau, Christine M; Ioannou, George N; Todd-Stenberg, Jeffrey A; Sloan, Kevin L; Larson, Meaghan F; Forsberg, Christopher W; Dominitz, Jason A

    2008-05-01

    We examined the association between race and hepatitis C virus (HCV) evaluation and treatment of veterans in the Northwest Network of the Department of Veterans Affairs (VA). In our retrospective cohort study, we used medical records to determine antiviral treatment of 4263 HCV-infected patients from 8 VA medical centers. Secondary outcomes included specialty referrals, laboratory evaluation, viral genotype testing, and liver biopsy. Multiple logistic regression was used to adjust for clinical (measured through laboratory results and International Classification of Diseases, Ninth Revision, codes) and sociodemographic factors. Blacks were less than half as likely as Whites to receive antiviral treatment (odds ratio [OR]=0.38; 95% confidence interval [CI]=0.23, 0.63). Both had similar odds of referral and liver biopsy. However, Blacks were significantly less likely to have complete laboratory evaluation (OR=0.67; 95% CI=0.52, 0.88) and viral genotype testing (OR=0.68; 95% CI=0.51, 0.90). Race is associated with receipt of medical care for various medical conditions. Further investigation is warranted to help understand whether patient preference or provider bias may explain why HCV-infected Blacks were less likely to receive medical care than Whites.

  16. Hysterectomy risk in premenopausal-aged military veterans: associations with sexual assault and gynecologic symptoms.

    Science.gov (United States)

    Ryan, Ginny L; Mengeling, Michelle A; Summers, Karen M; Booth, Brenda M; Torner, James C; Syrop, Craig H; Sadler, Anne G

    2016-03-01

    Several gynecological conditions associated with hysterectomy, including abnormal bleeding and pelvic pain, have been observed at increased rates in women who have experienced sexual assault. Previous findings have suggested that one of the unique health care needs for female military veterans may be an increased prevalence of hysterectomy and that this increase may partially be due to their higher risk of sexual assault history and posttraumatic stress disorder (PTSD). Although associations between trauma, PTSD, and gynecological symptoms have been identified, little work has been done to date to directly examine the relationship between sexual assault, PTSD, and hysterectomy within the rapidly growing female veteran population. The objective of the study was to assess the prevalence of hysterectomy in premenopausal-aged female veterans, compare with general population prevalence, and examine associations between hysterectomy and sexual assault, PTSD, and gynecological symptoms in this veteran population. We performed a computer-assisted telephone interview between July 2005 and August 2008 of 1004 female Veterans Affairs (VA)-enrolled veterans ≤ 52 years old from 2 Midwestern US Veterans Affairs medical centers and associated community-based outreach clinics. Within the veteran study population, associations between hysterectomy and sexual assault, PTSD, and gynecological symptoms were assessed with bivariate analyses using χ(2), Wilcoxon-Mann-Whitney, and Student t tests; multivariate logistic regression analyses were used to look for independent associations. Hysterectomy prevalence and ages were compared with large civilian populations represented in the Behavioral Risk Factor Surveillance System and American College of Surgeons National Surgical Quality Improvement Program databases from similar timeframes using χ(2) and Student t tests. Prevalence of hysterectomy was significantly higher (16.8% vs 13.3%, P = .0002), and mean age at hysterectomy was

  17. Combat exposure, social relationships, and subjective well-being among middle-aged and older Veterans.

    Science.gov (United States)

    Yang, Mai See; Burr, Jeffrey A

    2016-01-01

    This study described the association of subjective well-being with combat exposure and social relationships among middle-aged and older Veteran men in the USA. The stress-buffering hypothesis, which predicts social relationships may moderate the association between combat exposure and subjective well-being, was also examined. Data from the 2008 Health and Retirement Study (N = 2961) were used to estimate logistic regression models, focusing on three measures of subjective well-being: depression, life satisfaction, and self-reported health. In the fully adjusted models, there were no statistically significant relationships between combat exposure and the three indicators of subjective well-being. However, compared to Veterans who had lower scores on the social relationship index, Veterans who had higher scores were less likely to be depressed and less likely to report poor or fair health. Veterans who had higher scores on the social relationships index reported higher levels of life satisfaction than those Veterans who had lower scores. There was no evidence for a social relationships buffering effect. The results of this study demonstrated that combat exposure did not have a long-term relationship with subjective well-being. Longitudinal research designs with more comprehensive indicators of combat exposure may help researchers better understand some of the underlying complexity of this relationship. Complementary research with samples of women Veterans, as well as samples of Hispanic, and non-Black, non-White Veterans, is also needed.

  18. THE LEVEL AND AGE DYNAMICS OF SPORTS ACHIEVEMENTS OF ATHLETES-VETERANS OF THE HAMMER THROW

    Directory of Open Access Journals (Sweden)

    Ivanova Natalya Dmitrievna

    2013-03-01

    Full Text Available The article presents the records of the world and Russian athletes veterans in the hammer throw, starting with the age group 35-39 years and up to age group 100-104 years, and a comparison of the records of veterans subject to an age factor and of the high scores of athletes in the current sports. The aim of the work is to analyze the level and dynamics of the records of the world and Russian athletes, veterans in the hammer throw in each five-year group starting with the age group 35-39 years and up to age group 100-104 years. The novelty of the work consists in comparison of the records of the world and Russia in the hammer throw active athletes and records of veterans with the amendment to the age factor. Analysis of the level and age dynamics of sports achievements of domestic and foreign athletes-throwers older age groups. In the course of the research it is established, that in the throwing hammer, decreasing absolute (without regard to the age factor results, which is largely due to the natural age-related changes in the organism of athletes. Records of the world athletes-veterans compared with the records of active athletes and the transition from each of the five-year group in the following, decline on average in men by 10,0%, among women by 19,3%, in spite of the fact that the weight of the shells in the hammer throw with age decreases. Presented the reasons for the backwardness of Russian athletes older than 35 years of foreign veterans.

  19. Cardiovascular pathology in veterans of Great Patriotic War and aged patients: spectrum and clinical pattern

    Directory of Open Access Journals (Sweden)

    Denisova Т.Р.

    2011-09-01

    Full Text Available Cardiovascular pathology spectrum and dynamics in veterans of Great Patriotic War and aged patients of Volga agricultural and industrial region were studied. Clinical signs and course of cardiovascular pathology in aged patients were determined. A «dissolution» phenomenon of chronic cardiovascular pathology was revealed in patients aged over 100 years

  20. Benzodiazepine prescribing patterns and deaths from drug overdose among US veterans receiving opioid analgesics: case-cohort study.

    Science.gov (United States)

    Park, Tae Woo; Saitz, Richard; Ganoczy, Dara; Ilgen, Mark A; Bohnert, Amy S B

    2015-06-10

    To study the association between benzodiazepine prescribing patterns including dose, type, and dosing schedule and the risk of death from drug overdose among US veterans receiving opioid analgesics. Case-cohort study. Veterans Health Administration (VHA), 2004-09. US veterans, primarily male, who received opioid analgesics in 2004-09. All veterans who died from a drug overdose (n=2400) while receiving opioid analgesics and a random sample of veterans (n=420,386) who received VHA medical services and opioid analgesics. Death from drug overdose, defined as any intentional, unintentional, or indeterminate death from poisoning caused by any drug, determined by information on cause of death from the National Death Index. During the study period 27% (n=112,069) of veterans who received opioid analgesics also received benzodiazepines. About half of the deaths from drug overdose (n=1185) occurred when veterans were concurrently prescribed benzodiazepines and opioids. Risk of death from drug overdose increased with history of benzodiazepine prescription: adjusted hazard ratios were 2.33 (95% confidence interval 2.05 to 2.64) for former prescriptions versus no prescription and 3.86 (3.49 to 4.26) for current prescriptions versus no prescription. Risk of death from drug overdose increased as daily benzodiazepine dose increased. Compared with clonazepam, temazepam was associated with a decreased risk of death from drug overdose (0.63, 0.48 to 0.82). Benzodiazepine dosing schedule was not associated with risk of death from drug overdose. Among veterans receiving opioid analgesics, receipt of benzodiazepines was associated with an increased risk of death from drug overdose in a dose-response fashion. © Park et al 2015.

  1. The comparative effectiveness of hydrochlorothiazide and chlorthalidone in an observational cohort of veterans.

    Science.gov (United States)

    Lund, Brian C; Ernst, Michael E

    2012-09-01

    Indirect evidence suggests that chlorthalidone may be more effective than hydrochlorothiazide (HCTZ), but direct comparisons are lacking. Using national Veterans Administrative pharmacy data from 2003 to 2008, the authors performed a retrospective cohort study examining the effectiveness of chlorthalidone and HCTZ among new thiazide users. For 1 year following the thiazide start, rates of persistence of thiazide use, adequacy of response (defined as the absence of additional new antihypertensive medications following thiazide initiation), and an overall composite of treatment effectiveness incorporating both outcomes were examined. In this cohort of >125,000 individuals, persistence of thiazide use was higher for HCTZ than chlorthalidone (72.0% vs 62.0%; Pcompared with chlorthalidone (76.4% vs 70.1%; Padvantage for HCTZ over chlorthalidone (50.7% vs 47.4%; P=.002). These findings remained consistent after adjustment using multivariable logistic regression. This study provides real-world clinical data supporting a potential efficacy advantage of chlorthalidone among patients who tolerate the drug and remain persistent with treatment; however, strategies to optimize the way chlorthalidone is prescribed in clinical practice are necessary to increase its overall effectiveness relative to HCTZ. © 2012 Wiley Periodicals, Inc.

  2. Perceived age as clinically useful biomarker of ageing: cohort study

    DEFF Research Database (Denmark)

    Christensen, Kaare; Thinggaard, Mikael; McGue, Matt

    2009-01-01

    OBJECTIVE: To determine whether perceived age correlates with survival and important age related phenotypes. DESIGN: Follow-up study, with survival of twins determined up to January 2008, by which time 675 (37%) had died. SETTING: Population based twin cohort in Denmark. PARTICIPANTS: 20 nurses, 10...... increased with increasing discordance in perceived age within the twin pair-that is, the bigger the difference in perceived age within the pair, the more likely that the older looking twin died first. Twin analyses suggested that common genetic factors influence both perceived age and survival. Perceived...

  3. Metformin vs sulfonylurea use and risk of dementia in US veterans aged ≥65 years with diabetes.

    Science.gov (United States)

    Orkaby, Ariela R; Cho, Kelly; Cormack, Jean; Gagnon, David R; Driver, Jane A

    2017-10-31

    To determine whether metformin is associated with a lower incidence of dementia than sulfonylureas. This was a retrospective cohort study of US veterans ≥65 years of age with type 2 diabetes who were new users of metformin or a sulfonylurea and had no dementia. Follow-up began after 2 years of therapy. To account for confounding by indication, we developed a propensity score (PS) and used inverse probability of treatment weighting (IPTW) methods. Cox proportional hazards models estimated the hazard ratio (HR) of incident dementia. We identified 17,200 new users of metformin and 11,440 new users of sulfonylureas. Mean age was 73.5 years and mean HbA1c was 6.8%. Over an average follow-up of 5 years, 4,906 cases of dementia were diagnosed. Due to effect modification by age, all analyses were conducted using a piecewise model for age. Crude hazard ratio [HR] for any dementia in metformin vs sulfonylurea users was 0.67 (95% confidence interval [CI] 0.61-0.73) and 0.78 (95% CI 0.72-0.83) for those metformin was associated with a lower risk of subsequent dementia than sulfonylurea use in veterans metformin for the prevention of dementia. © 2017 American Academy of Neurology.

  4. Health and functioning among four war eras of U.S. veterans: examining the impact of war cohort membership, socioeconomic status, mental health, and disease prevalence.

    Science.gov (United States)

    Villa, Valentine M; Harada, Nancy D; Washington, Donna; Damron-Rodriguez, JoAnn

    2002-09-01

    This analysis examines the self-rated health and functioning of World War II, Vietnam era, Korean Conflict, and Persian Gulf War veterans participating in the Veteran Identity Program Survey 2001. The results indicate that although World War II veterans are more likely to report poor health status and functioning, Vietnam-era veterans report more difficulty with specific activities of daily living and instrumental activities of daily living than any other era of veterans. These relationships remain when controlling for race/ethnicity, socioeconomic status, disease prevalence, and mental health status. These findings suggest that there are characteristics unique to the Vietnam experience that negatively affect this cohort of veterans. We suggest that further analysis examine the specific pathways through which the experience of being a Vietnam veteran affects health. In the meantime, health and social service planning within the Department of Veterans Affairs should explore the services that should be developed and targeted to this cohort of veterans so that they may remain independent in the community.

  5. Lifestyle and health-related risk factors and risk of cognitive aging among older veterans.

    Science.gov (United States)

    Yaffe, Kristine; Hoang, Tina D; Byers, Amy L; Barnes, Deborah E; Friedl, Karl E

    2014-06-01

    Lifestyle and health-related factors are critical components of the risk for cognitive aging among veterans. Because dementia has a prolonged prodromal phase, understanding effects across the life course could help focus the timing and duration of prevention targets. This perspective may be especially relevant for veterans and health behaviors. Military service may promote development and maintenance of healthy lifestyle behaviors, but the period directly after active duty has ended could be an important transition stage and opportunity to address some important risk factors. Targeting multiple pathways in one intervention may maximize efficiency and benefits for veterans. A recent review of modifiable risk factors for Alzheimer's disease estimated that a 25% reduction of a combination of seven modifiable risk factors including diabetes, hypertension, obesity, depression, physical inactivity, smoking, and education/cognitive inactivity could prevent up to 3 million cases worldwide and 492,000 cases in the United States. Lifestyle interventions to address cardiovascular health in veterans may serve as useful models with both physical and cognitive activity components, dietary intervention, and vascular risk factor management. Although the evidence is accumulating for lifestyle and health-related risk factors as well as military risk factors, more studies are needed to characterize these factors in veterans and to examine the potential interactions between them. Published by Elsevier Inc.

  6. Veterans Crisis Line

    Data.gov (United States)

    Department of Veterans Affairs — The caring responders at the Veterans Crisis Line are specially trained and experienced in helping Veterans of all ages and circumstances. Some of the responders are...

  7. Risk factors for hepatitis C infection among Vietnam era veterans versus nonveterans: results from the Chronic Hepatitis Cohort Study (CHeCS).

    Science.gov (United States)

    Boscarino, Joseph A; Sitarik, Alexandra; Gordon, Stuart C; Rupp, Loralee B; Nerenz, David R; Vijayadeva, Vinutha; Schmidt, Mark A; Henkle, Emily; Lu, Mei

    2014-10-01

    Research suggests that Vietnam era veterans have a higher prevalence of hepatitis C virus (HCV) than other veterans and nonveterans. However, the reasons for this are unclear, since this research has been conducted among Department of Veterans Affairs (VA) patients and most veterans do not use the VA. The current study compares HCV risk factors between the Vietnam era veterans and nonveterans seen in 4 large non-VA systems to explain this disparity. A total of 4,636 HCV patients completed surveys in 2011-2012. Vietnam era veterans were defined as those who served in the military any time between 1964 and 1975. Bivariate tests followed by logistic regressions, and multivariable modeling were conducted to study risk factors among Vietnam era veterans and nonveterans. Since few veterans were female (~2 %), they were excluded. Among male respondents (N = 2,638), 22.5 % were classified as Vietnam era veterans. Compared to nonveterans, these patients were older (p risk factor differences for HCV infection by veteran status suggested that while injection drug use approached statistical significance (nonveterans = 46.1 % vs. Vietnam era veterans = 41.4 %, p = 0.06), only reported sex with men was significant (nonveterans = 2.4 % vs. Vietnam era veterans = 0.6 %, p = 0.013). In multivariate logistic regression controlling for age, education, country of birth, marital status and study site, no HCV risk factor was associated with Vietnam era veteran status. However, veterans were more likely to report "other" exposures were the source of infection than nonveterans (p Vietnam era veterans seen in non-VA facilities do not report a higher prevalence of common HCV risk factors, such as injection drug use, they are more likely to report "other" exposures, typically associated with military service, as the source of HCV infection.

  8. Immunological and infectious risk factors for lung cancer in US veterans with HIV: a longitudinal cohort study.

    Science.gov (United States)

    Sigel, Keith; Wisnivesky, Juan; Crothers, Kristina; Gordon, Kirsha; Brown, Sheldon T; Rimland, David; Rodriguez-Barradas, Maria C; Gibert, Cynthia; Goetz, Matthew Bidwell; Bedimo, Roger; Park, Lesley S; Dubrow, Robert

    2017-02-01

    HIV infection is independently associated with risk of lung cancer, but few data exist for the relation between longitudinal measurements of immune function and lung-cancer risk in people living with HIV. We followed up participants with HIV from the Veterans Aging Cohort Study for a minimum of 3 years between Jan 1, 1998, and Dec 31, 2012, and used cancer registry data to identify incident cases of lung cancer. The index date for each patient was the later of the date HIV care began or Jan 1, 1998. We excluded patients with less than 3 years' follow-up, prevalent diagnoses of lung cancer, or incomplete laboratory data. We used Cox regression models to investigate the relation between different time-updated lagged and cumulative exposures (CD4 cell count, CD8 cell count, CD4/CD8 ratio, HIV RNA, and bacterial pneumonia) and risk of lung cancer. Models were adjusted for age, race or ethnicity, smoking, hepatitis C virus infection, alcohol use disorders, drug use disorders, and history of chronic obstructive pulmonary disease and occupational lung disease. We identified 277 cases of incident lung cancer in 21 666 participants with HIV. In separate models for each time-updated 12 month lagged, 24 month simple moving average cumulative exposure, increased risk of lung cancer was associated with low CD4 cell count (p trend=0·001), low CD4/CD8 ratio (p trend=0·0001), high HIV RNA concentration (p=0·004), and more cumulative bacterial pneumonia episodes (12 month lag only; p trend=0·0004). In a mutually adjusted model including these factors, CD4/CD8 ratio and cumulative bacterial pneumonia episodes remained significant (p trends 0·003 and 0·004, respectively). In our large HIV cohort in the antiretroviral therapy era, we found evidence that dysfunctional immune activation and chronic inflammation contribute to the development of lung cancer in the setting of HIV infection. These findings could be used to target lung-cancer prevention measures to high-risk groups

  9. Cardiovascular function is better in veteran football players than age-matched untrained elderly healthy men

    DEFF Research Database (Denmark)

    Schmidt, Jakob Friis; Andersen, Thomas Rostgaard; Andersen, Lars Juel

    2015-01-01

    The aim of the study was to determine whether lifelong football training may improve cardiovascular function, physical fitness, and body composition. Our subjects were 17 male veteran football players (VPG; 68.1 ± 2.1 years) and 26 healthy age-matched untrained men who served as a control group (CG......, microvascular function, and a healthier body composition. Overall, VPG have better cardiovascular function compared with CG, which may reduce their cardiovascular morbidity and mortality....

  10. Seroprevalence of Strongyloides stercoralis in a South Australian Vietnam veteran cohort.

    Science.gov (United States)

    Rahmanian, Hany; MacFarlane, Alexander C; Rowland, Karen E; Einsiedel, Lloyd J; Neuhaus, Susan J

    2015-08-01

    Strongyloides stercoralis is a parasitic roundworm causing chronic infection that is endemic in Southeast Asia. Vietnam veterans are considered to be at high risk of Strongyloides infection. The prevalence of persistent infection in this group is unknown. This study aimed to establish the seropositivity rate of Strongyloides antibodies in South Australian Vietnam veterans and to identify the most reported symptoms within the seropositive group. This cross-sectional study recruited 309 veterans who had served in Vietnamese territory between 1962 and 1975 and were currently resident in South Australia. Participants completed a self-administered questionnaire examining demographics, deployment, somatic symptoms and depression. Venous blood was collected for Strongyloides serology and eosinophil count. Participants who demonstrated positive Strongyloides serology underwent faecal microscopy for parasites. A total of 309 participants were recruited and 256 completed the questionnaire. Strongyloides seropositivity was demonstrated in 29 of 249 participants (11.6%). No participant had Strongyloides larvae detected by faecal microscopy. On multivariate analysis, only dermatological symptoms were associated with positive serology (OR 4.84, 95%CI 1.31-17.92, p-value 0.01). This study found a high seroprevalence (11.6%) of Strongyloides antibodies within the Vietnam veteran community in South Australia. Seropositivity was associated with increased likelihood of dermatological symptoms. Post-deployment screening and eradication therapy for Strongyloides should be offered to ADF staff after service in Strongyloides-endemic areas. This should include those veterans who left the service many years ago. © 2015 Public Health Association of Australia.

  11. Assessment of biological age and "quantity of health" of judoists-veterans at the exit stage from elite sport

    Directory of Open Access Journals (Sweden)

    Volodymyr Perebeynos

    2016-12-01

    Full Text Available Purpose: the assessment of biological age and "quantity of health" of judoists-veterans that allows estimating the level of functionality of their organism at the exit stage from elite sport and to construct correctly their training and competitive processes. Material & Methods: the systemic-functional approach is applied. The biological age and "quantity of health" of judoists-veterans decided with the help of tests. The group of 28 men and 19 women – judoists-veterans is tested for this purpose. Results: it is proved that the research of biological age of veterans of judo at the exit stage from elite sport, continuing systematic trainings, is of great importance for sports medicine, physical therapy, gerontology, neurology, and also for professional selection in respect of age rationing of intellectual and exercise stresses, assessment of influence of the motive mode on the rate of aging; the carried-out tests allowed to estimate "quantity of health" of judoists-veterans, giving the idea of the level of functionality of their organism. Conclusions: it is proved that judo classes, the correct and positive image of life positively influence health of judoists-veterans.

  12. Prediction of changes in self-stigma among veterans participating in partial psychiatric hospitalization: The role of disability status and military cohort.

    Science.gov (United States)

    Harris, J Irene; Farchmin, Leah; Stull, Laura; Boyd, Jennifer; Schumacher, Marianne; Drapalski, Amy L

    2015-06-01

    Interventions addressing internalized stigma are a new area of research, and it is important to identify the types of clientele who derive benefit from existing interventions. Information was provided by 235 veterans attending a partial psychiatric hospitalization program, regarding their levels of internalized stigma on admission and discharge from a 3-week program that included interventions targeting internalized stigma. Upon discharge, veterans receiving disability benefits demonstrated less reduction in internalized stigma than those not receiving disability benefits. Time of service moderated the relationship between disability status and change in internalized stigma, such that veterans serving in the more recent Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) cohort who received disability benefits had a more difficult time resolving internalized stigma. Further analyses suggested that OEF/OIF/OND cohort veterans receiving disability benefits have more difficulty developing effective stigma resistance, and more difficulty resolving stigma-related alienation, than other veterans. Based on this research, particular attention should be devoted to internalized stigma among OEF/OIF/OND veterans. (c) 2015 APA, all rights reserved).

  13. Understanding, Predicting, and Preventing Life Changing and Life Threatening Health Changes among Aging Veterans and Civilians with Spinal Cord Injury

    Science.gov (United States)

    2017-10-01

    Veterans and Civilians with Spinal Cord Injury PRINCIPAL INVESTIGATOR: James S Krause, PhD RECIPIENT: Medical University of South Carolina Charleston...Threatening Health Changes among Aging Veterans and Civilians with Spinal Cord Injury 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-16-1-0629 5c. PROGRAM...STATEMENT Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Spinal cord injury (SCI) is associated with secondary

  14. Race and Other Risk Factors for Incident Proteinuria in a National Cohort of HIV-infected Veterans

    Science.gov (United States)

    Banerjee, Tanushree; Scherzer, Rebecca; Powe, Neil R.; Steffick, Diane; Shahinian, Vahakn; Saran, Rajiv; Pavkov, Meda E.; Saydah, Sharon; Shlipak, Michael G.

    2014-01-01

    Background Proteinuria in HIV-infected individuals has been associated with poorer outcomes. We examined risk factors associated with the development of proteinuria in a national registry of HIV-infected veterans. Methods 21,129 HIV-infected veterans of black and white race without pre-existing kidney disease were receiving health care in the Veterans’ Health Administration (VHA) medical system between 1997 and 2011. Using the VHA electronic record system, we identified kidney-related risk factors (hypertension, diabetes, cardiovascular disease), and HIV-related risk factors (CD4 lymphocyte count, HIV RNA level, hepatitis C virus, and hepatitis B virus) for developing proteinuria. Proteinuria was defined by 2 consecutive dipstick measures of 1+ or higher. The Fine-Gray competing risk model was used to estimate association between clinical variables and incident proteinuria, while accounting for intervening mortality events. Results During follow-up (median=5.3 years), 7,031 patients developed proteinuria. Overall, black race compared with white race was associated with a higher risk of proteinuria (HR[95% CI]=1.51[1.43–1.59]), but the association was stronger at younger ages (p interactionproteinuria for blacks relative to whites was greatest amongst veterans60 years). We found the race difference to be stronger for the outcome of 2+ or higher proteinuria (2.13[1.89–2.39]). Both HIV-related and traditional risk factors were also associated with incident proteinuria (pproteinuria was higher in black veterans with HIV-infection, particularly at younger ages. In both races, HIV and kidney-related risk factors were associated with higher proteinuria risk. PMID:25072613

  15. Smoking mediates the effect of conscientiousness on mortality: The Veterans Affairs Normative Aging Study.

    Science.gov (United States)

    Turiano, Nicholas A; Hill, Patrick L; Roberts, Brent W; Spiro, Avron; Mroczek, Daniel K

    2012-12-01

    This study examined the relationship between conscientiousness and mortality over 18 years and whether smoking behavior mediated this relationship. We utilized data from the Veterans Affairs Normative Aging Study on 1349 men who completed the Goldberg (1992) adjectival markers of the Big Five. Over the 18-year follow-up, 547 (41%) participants died. Through proportional hazards modeling in a structural equation modeling framework, we found that higher levels of conscientiousness significantly predicted longer life, and that this effect was mediated by current smoking status at baseline. Methodologically, we also demonstrate the effectiveness of using a structural equation modeling framework to evaluate mediation when using a censored outcome such as mortality.

  16. Korean War Veterans by State

    Data.gov (United States)

    Department of Veterans Affairs — The spreadsheet of Korean War Veterans by State includes the total Korean War Veteran population for each state and broken out by age and gender. It also includes...

  17. Epidemiology of multiple sclerosis in US veterans. 4. Age at onset.

    Science.gov (United States)

    Kurtzke, J F; Page, W F; Murphy, F M; Norman, J E

    1992-01-01

    Age at onset of multiple sclerosis (MS) symptoms was ascertained for subsets of some 4,400 veterans of World War II who had been adjudged 'service-connected' for this condition. Average age at onset was 27.0 years for white men, 27.7 for white women, and 27.5 for black men. The unexpectedly older age for women is attributed to their older age at entry into service. When the coterminous United States was divided into three horizontal tiers of states, we found a strong effect of geography on age at onset. By state of residence at entry into active duty (EAD), white men had an average age at onset of 26.4 years in the northern tier, 27.3 years in the middle, and 28.8 years in the south. Trends were similar for white women and black men. Migrants, defined as those whose birth and EAD tiers differed, showed increasing ages at onset with southward moves. A statistical model used to discriminate between the influence of birth and EAD tiers on age at onset confirmed the significant effect of EAD alone. These data are compatible with the theses that the cause of MS is less common (or less efficient) in locations where the clinical disease is less common, and that its acquisition therefore occurs at an older age in those locales.

  18. Patterns of alcohol use and abuse among aging Civil War veterans, 1865-1920.

    Science.gov (United States)

    Achenbaum, W A; Howell, J D; Parker, M

    1993-01-01

    Given the extent of alcoholism among elderly people, it is remarkable how little is known about the biomedical and social dimensions of alcohol use and abuse in late life. In the absence of compelling longitudinal data drawn from contemporary sources, a historical perspective may help to illuminate the incidence and consequences of alcohol abuse among the elderly. Based on a study of 370 case histories drawn from the National Military Home in Dayton, Ohio, which around the turn of the century was the nation's largest old-age home, it appears that alcohol's social ramifications were more important than its pathological or physiological manifestations in late 19th-century America. Drinking habits among aging Civil War veterans varied considerably: moderate consumption was acceptable; too much of a good thing caused problems.

  19. Longitudinal changes in hearing sensitivity among men: the Veterans Affairs Normative Aging Study.

    Science.gov (United States)

    Echt, Katharina V; Smith, Sherri L; Burridge, Andrea Backscheider; Spiro, Avron

    2010-10-01

    Over 35 years (1962-1996), participants of the Veterans Affairs Normative Aging Study (NAS), a study of healthy aging in men, completed up to eight audiometric assessments. This report describes the age-related hearing trajectories of screened men (n=953) aged 23 to 81 years at enrollment, estimates the typical rate of change per decade in hearing sensitivity, and compares longitudinal and cross-sectional estimates of change in hearing sensitivity. The men were followed 14 years on average. The hearing trajectories, based on a mixed-effects model analytical approach to the data, provide converging evidence that hearing loss in aging is pervasive and progressive even among men initially selected for good physical health. Typically the men accrued early losses (>25 dB HL) in hearing sensitivity at the higher frequencies beginning in the early 40s, but maintained hearing thresholds better than 25 dB HL for lower frequencies into old age. The average rate of change per year across frequencies and age was 0.69 dB. Predicted cross-sectional estimates of change in hearing sensitivity reliably approximated longitudinal trajectories, with slight misestimations in the 8th decade.

  20. Dental service rates: age, period, and cohort effects.

    Science.gov (United States)

    Brennan, D S; Ryan, P; Spencer, A J; Szuster, F S

    2000-06-01

    Variation in dental service provision over time has been related to changes in factors such as oral health and demographics. Dentist factors such as age and cohort effects are also potential sources of influence. The aim of the study was to examine the operation of age, period, and cohort factors on variation in service rates. data were collected by a mailed survey of a random sample of 10% of male and 40% of female dentists from each state/territory of Australia in 1983-84, 1988-89. and 1993-94 with response rates of 73, 75 and 74% respectively. Data on main areas of service were obtained from a log of service items provided on a typical day. Poisson regressions of rates for the 10 main areas of service over time showed increased rates over the study period for diagnostic, preventive, endodontic, crown and bridge, general/miscellaneous and orthodontic services, and decreased rates of prosthodontic services. Goodness-of-fit tests indicated that models for periodontal and endodontic services had a good fit. However, only endodontic services were readily interpretable in terms of descriptive trends. While the age-period-cohort model was preferred, age-period and age-cohort models were also examined because of problems of identification with age-period-cohort models. Endodontic rates were higher among younger dentist birth cohorts, and increased over the 10-year study period for most cohorts of dentists. If these effects for dentist cohorts were extrapolated over the next 10-year interval, the distribution of services would alter, with endodontic services emerging as a dominant area behind restorative, diagnostic, and preventive services.

  1. Risk factors for becoming homeless among a cohort of veterans who served in the era of the Iraq and Afghanistan conflicts.

    Science.gov (United States)

    Metraux, Stephen; Clegg, Limin X; Daigh, John D; Culhane, Dennis P; Kane, Vincent

    2013-12-01

    In this population-based cohort study, we assessed baseline risk factors for homelessness, including the role of service in the Iraq or Afghanistan conflicts, among a large cohort of recent veterans. Data for this study came from administrative records for 310,685 veterans who separated from active military duty from July 1, 2005, to September 30, 2006. We used survival analysis methods to determine incidence rates and risk factors for homelessness, based on baseline data for military factors, demographic characteristics, and diagnoses of behavioral health disorders and traumatic brain injury. Service in Iraq or Afghanistan and, more specifically, posttraumatic stress disorder among veterans deployed there, were significant risk factors of modest magnitude for homelessness, and socioeconomic and behavioral health factors provided stronger indicators of risk. Gender was not a significant indicator of differential risk. Although service in Iraq and Afghanistan was significant, socioeconomic and behavioral health indicators show more promise in efforts to use administrative data to inform prevention efforts by identifying veterans who are at elevated risk for becoming homeless upon their return to civilian life.

  2. Trajectories of posttraumatic growth among US military veterans: a 4-year nationally representative, prospective cohort study.

    Science.gov (United States)

    Tsai, J; Pietrzak, R H

    2017-11-01

    This study examined the nature and determinants of predominant trajectories of posttraumatic growth (PTG) over time. Using data from a prospective, nationally representative survey of 2718 US veterans assessed in 2011, 2013, and 2015, we used latent growth mixture modeling to identify PTG trajectories, and to examine key determinants of PTG trajectories from a comprehensive set of sociodemographic, military, health, and psychosocial variables. Three PTG trajectories were identified, labeled as Low and Decreasing PTG (74.0%), Consistently Moderate PTG (12.0%), and High and Increasing PTG (14.0%). Greater severity of posttraumatic stress disorder symptoms, specifically re-experiencing and avoidance symptoms, at baseline predicted Consistently Moderate and High and Increasing PTG trajectories. Compared to the Low and Decreasing PTG trajectory, the High and Increasing PTG trajectory scored higher on baseline measures of gratitude, purpose in life, Spirituality, and social support. Posttraumatic growth is a dynamic process with divergent trajectories. Developing interventions that target certain psychosocial factors may help trauma survivors maintain PTG over time. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  3. International Variation in Ageing and Economic Dependency: A Cohort Perspective

    Directory of Open Access Journals (Sweden)

    Elke Loichinger

    2016-08-01

    Full Text Available Within this analysis of demographic and economic dependency ratios for 45 countries around the world, we reiterate the importance of age- and gender-specific employment levels as well as their determinants when discussing the economic challenges associated with population ageing. Building upon existing research on economic dependency, we portray and discuss cohort variation in employment and its possible effect on the challenges of population ageing, focusing on the implications of high youth unemployment, the role of changes in female employment and the evolution of retirement patterns across cohorts. The insights from our analysis reaffirm findings elsewhere that younger populations may not be as well off in the light of demographic change as an analysis of their demographic structure alone would suggest and stress the importance of considering the cohort dimension of employment in this discussion.

  4. Bayesian Age-Period-Cohort Model of Lung Cancer Mortality

    Directory of Open Access Journals (Sweden)

    Bhikhari P. Tharu

    2015-09-01

    Full Text Available Background The objective of this study was to analyze the time trend for lung cancer mortality in the population of the USA by 5 years based on most recent available data namely to 2010. The knowledge of the mortality rates in the temporal trends is necessary to understand cancer burden.Methods Bayesian Age-Period-Cohort model was fitted using Poisson regression with histogram smoothing prior to decompose mortality rates based on age at death, period at death, and birth-cohort.Results Mortality rates from lung cancer increased more rapidly from age 52 years. It ended up to 325 deaths annually for 82 years on average. The mortality of younger cohorts was lower than older cohorts. The risk of lung cancer was lowered from period 1993 to recent periods.Conclusions The fitted Bayesian Age-Period-Cohort model with histogram smoothing prior is capable of explaining mortality rate of lung cancer. The reduction in carcinogens in cigarettes and increase in smoking cessation from around 1960 might led to decreasing trend of lung cancer mortality after calendar period 1993.

  5. Bayesian Age-Period-Cohort Modeling and Prediction - BAMP

    Directory of Open Access Journals (Sweden)

    Volker J. Schmid

    2007-10-01

    Full Text Available The software package BAMP provides a method of analyzing incidence or mortality data on the Lexis diagram, using a Bayesian version of an age-period-cohort model. A hierarchical model is assumed with a binomial model in the first-stage. As smoothing priors for the age, period and cohort parameters random walks of first and second order, with and without an additional unstructured component are available. Unstructured heterogeneity can also be included in the model. In order to evaluate the model fit, posterior deviance, DIC and predictive deviances are computed. By projecting the random walk prior into the future, future death rates can be predicted.

  6. Multiple Mild Traumatic Brain Injuries Are Associated with Increased Rates of Health Symptoms and Gulf War Illness in a Cohort of 1990–1991 Gulf War Veterans

    Directory of Open Access Journals (Sweden)

    Megan K. Yee

    2017-07-01

    Full Text Available Recent research demonstrated a relation between traumatic brain injury (TBI, health symptoms and diagnosis of Gulf War Illness (GWI in Gulf War Veterans, but no study has examined the impact of multiple mild TBIs (mTBIs. A total of 229 male Gulf War Veterans from the Ft Devens Cohort were categorized by a number of mTBIs reported. One-way ANOVA and chi-square test of independence were used to test for differences in total reported health symptoms and diagnosis of chronic multisymptom illness (CMI or Kansas GWI criteria, two of the most common case definitions of GWI. A total of 72 veterans reported no mTBIs (31.4%, 26 reported one mTBI (11.4%, 25 reported two mTBIs (10.9%, and 106 veterans reported sustaining three or more mTBIs (46.3%. Veterans reporting two or more mTBIs (p < 0.01 or three or more mTBIs (p < 0.001 endorsed significantly higher rates of health symptoms than Veterans reporting no mTBIs. Significantly higher rates of CMI (p = 0.035 and Kansas GWI criteria (p < 0.001 were seen in the three or more mTBI group. Results suggest two mTBIs increase risk of health symptoms, but three mTBIs may be the threshold needed to sustain chronic symptom reporting needed for a formal diagnosis. These findings highlight the importance of implementing policies and procedures monitoring head injuries in military personnel.

  7. Age-period-cohort models for the Lexis diagram.

    Science.gov (United States)

    Carstensen, B

    2007-07-10

    Analysis of rates from disease registers are often reported inadequately because of too coarse tabulation of data and because of confusion about the mechanics of the age-period-cohort model used for analysis. Rates should be considered as observations in a Lexis diagram, and tabulation a necessary reduction of data, which should be as small as possible, and age, period and cohort should be treated as continuous variables. Reporting should include the absolute level of the rates as part of the age-effects. This paper gives a guide to analysis of rates from a Lexis diagram by the age-period-cohort model. Three aspects are considered separately: (1) tabulation of cases and person-years; (2) modelling of age, period and cohort effects; and (3) parametrization and reporting of the estimated effects. It is argued that most of the confusion in the literature comes from failure to make a clear distinction between these three aspects. A set of recommendations for the practitioner is given and a package for R that implements the recommendations is introduced. Copyright 2006 John Wiley & Sons, Ltd.

  8. Happiness and social determinants across age cohorts in Taiwan.

    Science.gov (United States)

    Hsu, Hui-Chuan; Chang, Wen-Chiung; Chong, Young-Sook; An, Jeong Shin

    2016-09-01

    The purpose of this study was to examine happiness and social determinants across age cohorts in Taiwan. The data were obtained from the 2011 Taiwan Social Change Survey (aged 18 +, n = 2,199). The social determinants of happiness included socioeconomic status and social connection. Happiness was not different across the age groups. Receiving less family support, less formal support, more social trust and more control over life were significant for the younger group. Being married and having more social participation were significant for the middle-aged. Receiving less family support and having a higher economic status were significant for the older group. © The Author(s) 2015.

  9. Correlated Poisson models for age-period-cohort analysis.

    Science.gov (United States)

    Chernyavskiy, Pavel; Little, Mark P; Rosenberg, Philip S

    2017-10-04

    Age-period-cohort (APC) models are widely used to analyze population-level rates, particularly cancer incidence and mortality. These models are used for descriptive epidemiology, comparative risk analysis, and extrapolating future disease burden. Traditional APC models have 2 major limitations: (1) they lack parsimony because they require estimation of deviations from linear trends for each level of age, period, and cohort; and (2) rates observed at similar ages, periods, and cohorts are treated as independent, ignoring any correlations between them that may lead to biased parameter estimates and inefficient standard errors. We propose a novel approach to estimation of APC models using a spatially correlated Poisson model that accounts for over-dispersion and correlations in age, period, and cohort, simultaneously. We treat the outcome of interest as event rates occurring over a grid defined by values of age, period, and cohort. Rates defined in this manner lend themselves to well-established approaches from spatial statistics in which correlation among proximate observations may be modeled using a spatial random effect. Through simulations, we show that in the presence of spatial dependence and over-dispersion: (1) the correlated Poisson model attains lower AIC; (2) the traditional APC model produces biased trend parameter estimates; and (3) the correlated Poisson model corrects most of this bias. We illustrate our approach using brain and breast cancer incidence rates from the Surveillance Epidemiology and End Results Program of the United States. Our approach can be easily extended to accommodate comparative risk analyses and interpolation of cells in the Lexis with sparse data. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  10. The Gulf War era multiple sclerosis cohort: age and incidence rates by race, sex and service.

    Science.gov (United States)

    Wallin, Mitchell T; Culpepper, William J; Coffman, Parisa; Pulaski, Sarah; Maloni, Heidi; Mahan, Clare M; Haselkorn, Jodie K; Kurtzke, John F

    2012-06-01

    We characterize here a new nationwide incident cohort of multiple sclerosis from the US military-veteran population. This cohort provides an update to the only other US nationwide incidence study of multiple sclerosis performed during the 1970s. Medical records and data from the Department of Defense and Department of Veterans Affairs for cases of multiple sclerosis who served in the military between 1990, the start of the Gulf War era, and 2007 and who were service-connected for this disorder by the Department of Veterans Affairs from 1990 on, were reviewed. A total of 2691 patients were confirmed as having multiple sclerosis: 2288 definite, 190 possible, 207 clinically isolated syndrome and six neuromyelitis optica. Overall racial categories were White, Black and other, which included all Hispanics. There were 1278 White males and 556 females; 360 Black males and 296 females; and 200 others, 153 (77%) of whom were Hispanic. Mean age at onset of 30.7 years did not differ significantly by race or sex. Age at onset was 17-50 years in 99%, the same age range as 99% of the military. Average annual age specific (age 17-50 years) incidence rates per 100 000 for the entire series were 9.6 with 95% confidence interval of 9.3-10.0. Rates for Blacks were highest at 12.1 with confidence interval 11.2-13.1, Whites were 9.3 (interval 8.9-9.8) and others 6.9 (interval 6.0-7.9). For 83 Hispanics defined for 2000-07, the rate was 8.2 (interval 6.5-10.1). Much smaller numbers gave rates of 3.3 for Asian/Pacific Islanders and 3.1 for native Americans. Rates by sex for Whites were 7.3 and 25.8 male and female, respectively, for Blacks 8.4 and 26.3, and for Hispanics 6.6 and 17.0. Rates by service were high for Air Force (10.9) and Army (10.6), medium for Navy (9.1) and Coast Guard (7.9), and low for Marines (5.3). Relative risk of multiple sclerosis was 3.39 female:male and 1.27 Black:White. These new findings indicate that females of all races now have incidence rates for multiple

  11. All-cause mortality and risk factors in a cohort of retired military male veterans, Xi'an, China: an 18-year follow up study

    Directory of Open Access Journals (Sweden)

    Li Liang S

    2007-10-01

    Full Text Available Abstract Background Risk factors of all-cause mortality have not been reported in Chinese retired military veterans. The objective of the study was to examine the risk factors and proportional mortality in a Chinese retired military male cohort. Methods A total of 1268 retired military men aged 55 or older were examined physically and interviewed using a standard questionnaire in 1987. The cohort was followed up every two years and the study censored date was June30, 2005 with a follow-up of up to 18 years. Death certificates were obtained from hospitals and verified by two senior doctors. Data were entered (double entry by Foxbase, and analysis was carried out by SAS for Windows 8.2. Multivariate Cox proportional hazard regression model was used to compute hazard ratio (HR and 95% confidence interval (CI. Results The total person-years of follow-up was 18766.28. Of the initial cohort of 1268 men, 491 had died, 748 were alive and 29 were lost to follow up. Adjusted mortality (adjusted for age, blood pressure, body mass index, cholesterol, triglycerides, alcohol, exercise, and existing disease was 2,616 per 100,000 person years. The proportional mortality of cancer, vascular disease and Chronic Obstructive Pulmonary Disease (COPD were 39.71%, 28.10% and 16.90% respectively. Multivariate analysis showed that age, cigarettes per day, systolic blood pressure, triglyceride, family history of diseases (hypertension, stroke and cancer, existing diseases (stroke, diabetes and cancer, body mass index, and age of starting smoking were associated with all-cause mortality, HR (95%CI was1.083(1.062–1.104, 1.026(1.013–1.039, 1.009(1.003–1.015, 1.002(1.001–1.003, 1.330(1.005–1.759, 1.330(1.005–1.759, 1.444(1.103–1.890, 2.237(1.244–4.022, 1.462(1.042–2.051, 2.079(1.051–4.115, 0.963(0.931–0.996and 0.988(0.978–0.999respectively. Compared with never-smokers, current smokers had increased risks of total mortality [HR 1.369(1.083–1

  12. Do cherished children age successfully? Longitudinal findings from the Veterans Affairs Normative Aging Study.

    Science.gov (United States)

    Lee, Lewina O; Aldwin, Carolyn M; Kubzansky, Laura D; Chen, Edith; Mroczek, Daniel K; Wang, Joyce M; Spiro, Avron

    2015-12-01

    Although early adversity has been linked to worse mental and physical health in adulthood, few studies have investigated the pathways through which positive and negative dimensions of early experiences can jointly influence psychological well-being in later life. This study examined: (a) profiles of early experiences across multiple domains, (b) the relations of these profiles to hedonic and eudaimonic well-being in later life, and (c) whether midlife social support mediated these relations. We first conducted latent class analysis of early experiences using data from 1,076 men in the VA Normative Aging Study who completed the Childhood Experiences Scale (age: M = 69, SD = 7). Analyses yielded 3 profiles of early experiences, labeled as cherished (strong support and some losses), harshly disciplined (harsh parental discipline, low positive reinforcement, and nonnormative stressors), and ordinary (few stressors and low parental attention). Next, we applied structural equation modeling to data on a subset of this sample assessed 7 years later on hedonic and eudaimonic well-being (n = 496; age: M = 76, SD = 7). In general, the cherished group reported stronger qualitative social support in midlife than the harshly disciplined and ordinary groups, which in turn was related to greater hedonic (life satisfaction, positive affect) and eudaimonic (competence, positive relations with others) well-being in later life. The cherished group also reported higher autonomy than the ordinary group, but this association was independent of midlife social support. Our findings suggest that experiencing adversity in the context of a nurturing early environment can promote successful aging through the maintenance of supportive relationships in midlife. (c) 2015 APA, all rights reserved).

  13. Mood disorders and risk of lung cancer in the EAGLE case-control study and in the U.S. Veterans Affairs inpatient cohort.

    Directory of Open Access Journals (Sweden)

    David E Capo-Ramos

    Full Text Available Mood disorders may affect lung cancer risk. We evaluated this hypothesis in two large studies.We examined 1,939 lung cancer cases and 2,102 controls from the Environment And Genetics in Lung cancer Etiology (EAGLE case-control study conducted in Italy (2002-2005, and 82,945 inpatients with a lung cancer diagnosis and 3,586,299 person-years without a lung cancer diagnosis in the U.S. Veterans Affairs Inpatient Cohort (VA study, composed of veterans with a VA hospital admission (1969-1996. In EAGLE, we calculated odds ratios (ORs and 95% confidence intervals (CI, with extensive adjustment for tobacco smoking and multiple lifestyle factors. In the VA study, we estimated lung cancer relative risks (RRs and 95% CIs with time-dependent Poisson regression, adjusting for attained age, calendar year, hospital visits, time within the study, and related previous medical diagnoses. In EAGLE, we found decreased lung cancer risk in subjects with a personal history of mood disorders (OR: 0.59, 95% CI: 0.44-0.79, based on 121 lung cancer incident cases and 192 controls and family history of mood disorders (OR: 0.62, 95% CI: 0.50-0.77, based on 223 lung cancer cases and 345 controls. The VA study analyses yielded similar results (RR: 0.74, 95% CI: 0.71-0.77, based on 2,304 incident lung cancer cases and 177,267 non-cancer person-years in men with discharge diagnoses for mood disorders. History of mood disorders was associated with nicotine dependence, alcohol and substance use and psychometric scales of depressive and anxiety symptoms in controls for these studies.The consistent finding of a relationship between mood disorders and lung cancer risk across two large studies calls for further research into the complex interplay of risk factors associated with these two widespread and debilitating diseases. Although we adjusted for smoking effects in EAGLE, residual confounding of the results by smoking cannot be ruled out.

  14. Mortality in Danish women: age, period and cohort analysis

    DEFF Research Database (Denmark)

    Lindahl-Jacobsen, Rune

    smokers throughout their adult life, suggesting that these smoking habits may be an important factor for their increased mortality. Study aim 3 The analysis of causes of death suggested an increased risk for deaths associated with the respiratory system and from causes traditionally associated....... Smoking was suggested as the reason for the high mortality of middle-aged Danish women. The analysis focussed on the age-period effects. However, calculations based only on age and period may lead to erroneous conclusions, as the birth cohort may be an important factor for understanding trends...... with that of women in Norway and Sweden can therefore partly be regarded as a transitional phenomenon caused by excessive death rates for women born between the two World Wars. The trends in smoking prevalence for women in Denmark, Norway and indicated that a high percentage of Danish women in these cohorts were...

  15. Cohort profile: the lidA Cohort Study-a German Cohort Study on Work, Age, Health and Work Participation.

    Science.gov (United States)

    Hasselhorn, Hans Martin; Peter, Richard; Rauch, Angela; Schröder, Helmut; Swart, Enno; Bender, Stefan; du Prel, Jean-Baptist; Ebener, Melanie; March, Stefanie; Trappmann, Mark; Steinwede, Jacob; Müller, Bernd Hans

    2014-12-01

    The lidA Cohort Study (German Cohort Study on Work, Age, Health and Work Participation) was set up to investigate and follow the effects of work and work context on the physical and psychological health of the ageing workforce in Germany and subsequently on work participation. Cohort participants are initially employed people subject to social security contributions and born in either 1959 (n = 2909) or 1965 (n = 3676). They were personally interviewed in their homes in 2011 and will be visited every 3 years. Data collection comprises socio-demographic data, work and private exposures, work ability, work and work participation attitudes, health, health-related behaviour, personality and attitudinal indicators. Employment biographies are assessed using register data. Subjective health reports and physical strength measures are complemented by health insurance claims data, where permission was given. A conceptual framework has been developed for the lidA Cohort Study within which three confirmatory sub-models assess the interdependencies of work and health considering age, gender and socioeconomic status. The first set of the data will be available to the scientific community by 2015. Access will be given by the Research Data Centre of the German Federal Employment Agency at the Institute for Employment Research (http://fdz.iab.de/en.aspx). © The Author 2014. Published by Oxford University Press on behalf of the International Epidemiological Association.

  16. Spatiotemporal study of elderly suicide in Korea by age cohort.

    Science.gov (United States)

    Joo, Y

    2017-01-01

    This study analyzed the spatiotemporal pattern and spatial diffusion of elderly suicide by age cohort, in Korea. The research investigated the elderly suicide rates of the 232 municipal units in South Korea between 2001 and 2011. The Gi* score, which is a spatially weighted indicator of area attributes, was used to identify hot spots and the spatiotemporal pattern of elderly suicide in the nation during the last 10 years. The spatial Markov matrix and spatial dynamic panel data model were employed to identify and estimate the diffusion effect. The suicide rate among elderly individuals 75 years and older was substantially higher than the rate for those between 65 and 74 years of age; however, the spatial patterns of the suicide clusters were similar between the two groups. From 2001 to 2011, the spatial distribution of elderly suicide hot spots differed each year. For both age cohorts, elderly suicide hot spots developed around the north area of South Korea in 2001 and moved to the mid-east area and the mid-western coastal area over 10 years. The spatial Markov matrix indicates that the change in the suicide rate of one area was affected by the suicide rates of neighbouring areas from the previous year, which suggests that suicide increase in one area inflates a neighbouring area's suicide rate over time. Using a spatial dynamic panel data model, elderly suicide diffusion effects were found to be statistically significant for both age cohorts even after economic and demographic indicators and a time variable are included. For individuals 75 years and older, the diffusion effect appeared to be larger. This study demonstrates that elderly suicide can spread spatially over time in both age cohorts. Thus, it is necessary to design a place-based and age-differentiated intervention policy that precisely considers the spatial diffusion of elderly suicide. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  17. Physical Health Conditions Among a Population-Based Cohort of Vietnam-Era Women Veterans: Agreement Between Self-Report and Medical Records.

    Science.gov (United States)

    Kilbourne, Amy M; Schumacher, Karen; Frayne, Susan M; Cypel, Yasmin; Barbaresso, Michelle M; Nord, Kristina M; Perzhinsky, Juliette; Lai, Zongshan; Prenovost, Katherine; Spiro, Avron; Gleason, Theresa C; Kimerling, Rachel; Huang, Grant D; Serpi, Tracey B; Magruder, Kathryn M

    2017-11-01

    Little is known about medical morbidity among women Vietnam-era veterans, or the long-term physical health problems associated with their service. This study assessed agreement comparing data on physical health conditions from self-report and medical records from a population-based cohort of women Vietnam-era Veterans from the Health of Vietnam Era Women's Study (HealthViEWS). Women Vietnam-era veterans (n = 4219) self-completed a survey and interview on common medical conditions. A subsample (n = 900) were contacted to provide permission to obtain medical records from as many as three of their providers. Medical record reviews were conducted using a standardized checklist. Agreement and kappa (agreement beyond chance) were calculated for physical health condition groups. Of the 900, 449 had medical records returned, and of those, 412 had complete surveys/interviews. The most commonly reported conditions based on self-report or medical record review included hypertension, hyperlipidemia, or arthritis. Kappa scores between self-reported conditions and medical record documentation were 0.75-0.91 for hypertension, diabetes, most cancers, and neurological conditions, but lower (k = 0.29-0.55) for cardiovascular diseases, musculoskeletal, and gastrointestinal conditions. Generally, agreement did not significantly vary by different sociodemographic groups. There was relatively high agreement for physical health conditions when self-report was compared with medical record review. As more women are increasingly represented in the military and more veterans in general seek care outside the Veterans Health Administration, accurate measurement of physical health conditions among population-based samples is crucial.

  18. Danish Gulf War Veterans Revisited

    DEFF Research Database (Denmark)

    Nissen, Lars Ravnborg; Stoltenberg, Christian; Nielsen, Anni B Sternhagen

    2016-01-01

    OBJECTIVE: To examine the assumption that postdeployment incidence of sickness and other absence from work are higher among Gulf War Veterans compared with nonveterans. METHODS: A prospective registry study including a cohort of 721 Danish Gulf War Veterans and a control cohort of 3,629 nonvetera...

  19. Traffic density as a surrogate measure of environmental exposures in studies of air pollution health effects: Long-term mortality in a cohort of US veterans

    Science.gov (United States)

    Lipfert, F. W.; Wyzga, R. E.; Baty, J. D.; Miller, J. P.

    Vehicular traffic is an ubiquitous source of air pollution in developed nations, yet relatively few epidemiology studies have considered its long-term health effects. This paper uses an areal measure of traffic density as a surrogate index of exposure to vehicular traffic. We present associations between county-level traffic density (annual vehicle-km traveled km -2), ambient air quality, and mortality in a cohort of about 70,000 male US veterans (the Washington University-EPRI Veterans Cohort) who were enrolled in 1976 and followed through 2001. Traffic density is seen to be a significant and robust predictor of survival in this cohort, more so than ambient air quality, with the possible exception of ozone. Stronger effects of traffic density are seen in the counties that have ambient air quality monitoring data, which also tend to have higher levels of traffic density. These proportional-hazard modeling results indicate only modest changes in traffic-related mortality risks over time, from 1976-2001, despite the decline in regulated tailpipe emissions per vehicle since the mid-1970s. This suggests that other environmental effects may be involved, such as particles from brake, tire, and road wear, traffic noise, psychological stress, and spatial gradients in socioeconomic status.

  20. Posttraumatic stress disorder symptoms in Korean conflict and World War II combat veterans seeking outpatient treatment.

    Science.gov (United States)

    McCranie, E W; Hyer, L A

    2000-07-01

    Given important differences in the Korean conflict and World War II, samples of treatment-seeking combat veterans from these wars (30 Korea, 83 World War II) were compared on the prevalence and severity of posttraumatic stress disorder (PTSD). With age, ethnicity, and combat exposure taken into account, the Korean veterans reported significantly more severe symptoms on both interview and self-report PTSD measures. Group differences in the prevalence of current PTSD were in a similar direction but not significant. These results are generally consistent with other studies that have found Korean combat veterans to exhibit higher rates of psychosocial maladjustment than World War II combat veterans. Based on related research with Vietnam veterans, one direction for future investigation is to examine what role stressful postmilitary homecoming experiences may have played in influencing the development and course of combat-related PTSD in the aging cohort of "forgotten" Korean conflict veterans.

  1. Life satisfaction and age : Dealing with underidentification in age-period-cohort models

    NARCIS (Netherlands)

    de Ree, Joppe; Alessie, Rob

    Recent literature typically finds a U shaped relationship between life satisfaction and age. Age profiles, however, are not identified without forcing arbitrary restrictions on the cohort and/or time profiles. In this paper we report what can be identified about the relationship between life

  2. The Relationship between Health and Community across Aging Cohorts

    Directory of Open Access Journals (Sweden)

    Julie Norstrand

    2014-01-01

    Full Text Available Research is needed to examine the connection between older adults and their community as they age. This is important as increasing numbers of older adults wish to age in place. Regression models were examined across 3 cohorts testing relationships among social capital indicators (neighborhood trust, neighborhood support, neighborhood cohesion, neighborhood participation, and telephone interaction with health outcomes (self-rated health, activities of daily living (ADL, and instrumental activities of daily living (IADL. Results showed that most social capital indicators remained significant for all health outcomes into very old age. Development of tools for individual and community interventions to ensure optimal fit between the aging individual and their environment is discussed, along with recommendations for enhancing social work theory and practice.

  3. Occupational Characteristics and Cognitive Aging in the Glostrup 1914 Cohort

    DEFF Research Database (Denmark)

    Gow, Alan J; Avlund, Kirsten; Mortensen, Erik L

    2014-01-01

    ). In growth curve models, intellectual challenge continued to be associated with cognitive ability, controlling for sex, education, and social class. However, the association was reversed after accounting for cognitive ability at age 50; of 2 individuals with the same baseline level of cognitive ability...... change between age 60 and 80.Discussion.Notwithstanding the reversal of the effect of occupational intellectual challenge on cognitive ability level after accounting for pre-exiting cognitive differences, there was no evidence for long-term effects of occupational characteristics on cognitive change......Objectives.The effect of occupational characteristics on cognitive change over 20 years was examined.Method.Occupational characteristics-intellectual challenge, physical hazards, and psychological demands-were assessed in the Glostrup 1914 Cohort when aged 60 years, and cognitive ability...

  4. An R package for fitting age, period and cohort models

    Directory of Open Access Journals (Sweden)

    Adriano Decarli

    2014-11-01

    Full Text Available In this paper we present the R implementation of a GLIM macro which fits age-period-cohort model following Osmond and Gardner. In addition to the estimates of the corresponding model, owing to the programming capability of R as an object oriented language, methods for printing, plotting and summarizing the results are provided. Furthermore, the researcher has fully access to the output of the main function (apc which returns all the models fitted within the function. It is so possible to critically evaluate the goodness of fit of the resulting model.

  5. Comment: Distinguishing Cohort Effects from Age*Period Effects on Non-Marital Fertility

    Science.gov (United States)

    Martin, Steve

    2009-01-01

    In the article "Cohort Effects on Non-marital Fertility," in this issue of "Social Forces," Jean Stockard employs a novel strategy for disentangling cohort, period, and age effects on the non-marital fertility ratio. In a model with fixed-effect controls for age and for time period, the author documents evidence for three cohort-specific factors…

  6. Obesity and Associated Adverse Health Outcomes Among U.S. Military Members and Veterans: Findings from the Millennium Cohort Study

    Science.gov (United States)

    2016-06-27

    I. Conceptual framework and item selection. Med Care 1992;30:473-483. 20. LeardMann CA, Smith TC, Smith B, Wells TS, Ryan MA. Baseline self reported...veterans (14%–32%). Participants with obesity were significantly more likely to be male, older, less educated, in the Army or Navy, and sep- arated/ retired ...to completing the 2007 survey. Military separation/ retirement was determined using official military personnel files provided by Defense Man- power

  7. Aging, Depression, and Wisdom: A Pilot Study of Life-Review Intervention and PTSD Treatment With Two Groups of Vietnam Veterans.

    Science.gov (United States)

    Daniels, Lori R; Boehnlein, James; McCallion, Phillip

    2015-01-01

    Vietnam War veterans are a sometimes overlooked subgroup of the aging baby boomer generation. Forty years after the war ended, war veterans still seek out VA or Vet Center counselors to assist with traumatic stress symptoms. However, there currently are no specific age-related protocols for treating older war veterans suffering from posttraumatic stress disorder (PTSD), nor have established PTSD interventions incorporated gerontology content for these older trauma survivors. This pilot study juxtaposed life review within regular PTSD group counseling for 12 Vietnam veterans at a community-based Vet Center using a partial crossover design. The Life Review and Experiencing Form (LREF) structured the delivery of the life review component. T-tests and repeated measures ANOVA were used to examine depression and self-assessed wisdom outcomes using measures previously tested with older adults. Findings suggest that life review prior to PTSD group therapy has clinical benefits for reducing symptoms of depression and increasing self-assessed wisdom. The study illuminates the possible relationship of traumatic stress symptom effects on the natural reminiscing process for older veterans and provides insights into methods for more age-appropriate treatment for trauma survivors participating in Vet Center and VA programs nationwide.

  8. Deserving Veterans' Disability Compensation: A Qualitative Study of Veterans' Perceptions.

    Science.gov (United States)

    MacGregor, Casey; Heilemann, MarySue V

    2017-05-01

    Veterans recently returned from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) experience many health and mental health problems after deployment. These OEF/OIF veterans are applying and appealing for veterans' disability compensation (VDC) at rapidly increasing rates, often for "invisible conditions" such as posttraumatic stress disorder. Little is known about how veterans experience the process of applying and receiving VDC. In-depth qualitative interviews were conducted with OEF/OIF veterans ages 35 and younger (N = 18). This article addresses how veterans perceive themselves, and other veterans, of being deserving and undeserving of VDC. Veterans' rationales can be categorized into four primary areas: (1) risking and suffering, (2) the cause of the condition, (3) intentions to become self-sufficient, and (4) putting VDC to "good use." © 2017 National Association of Social Workers.

  9. Use of the Adaptive LASSO Method to Identify PM2.5 Components Associated with Blood Pressure in Elderly Men: The Veterans Affairs Normative Aging Study.

    Science.gov (United States)

    Dai, Lingzhen; Koutrakis, Petros; Coull, Brent A; Sparrow, David; Vokonas, Pantel S; Schwartz, Joel D

    2016-01-01

    PM2.5 (particulate matter ≤ 2.5 μm) has been associated with adverse cardiovascular outcomes, but it is unclear whether specific PM2.5 components, particularly metals, may be responsible for cardiovascular effects. We aimed to determine which PM2.5 components are associated with blood pressure in a longitudinal cohort. We fit linear mixed-effects models with the adaptive LASSO penalty to longitudinal data from 718 elderly men in the Veterans Affairs Normative Aging Study, 1999-2010. We controlled for PM2.5 mass, age, body mass index, use of antihypertensive medication (ACE inhibitors, non-ophthalmic beta blockers, calcium channel blockers, diuretics, and angiotensin receptor antagonists), smoking status, alcohol intake, years of education, temperature, and season as fixed effects in the models, and additionally applied the adaptive LASSO method to select PM2.5 components associated with blood pressure. Final models were identified by the Bayesian Information Criterion (BIC). For systolic blood pressure (SBP), nickel (Ni) and sodium (Na) were selected by the adaptive LASSO, whereas only Ni was selected for diastolic blood pressure (DBP). An interquartile range increase (2.5 ng/m3) in 7-day moving-average Ni was associated with 2.48-mmHg (95% CI: 1.45, 3.50 mmHg) increase in SBP and 2.22-mmHg (95% CI: 1.69, 2.75 mmHg) increase in DBP, respectively. Associations were comparable when the analysis was restricted to study visits with PM2.5 below the 75th percentile of the distribution (12 μg/m3). Our study suggested that exposure to ambient Ni was associated with increased blood pressure independent of PM2.5 mass in our study population of elderly men. Further research is needed to confirm our findings, assess generalizability to other populations, and identify potential mechanisms for Ni effects. Dai L, Koutrakis P, Coull BA, Sparrow D, Vokonas PS, Schwartz JD. 2016. Use of the adaptive LASSO method to identify PM2.5 components associated with blood pressure in

  10. Chronic diseases in male veterans with multiple sclerosis.

    Science.gov (United States)

    Lavela, Sherri L; Prohaska, Thomas R; Furner, Sylvia; Weaver, Frances M

    2012-01-01

    Chronic disease risk may be high in people with multiple sclerosis (MS). Our objective was to identify chronic health conditions that may disproportionately affect male veterans with MS. We collected primary survey data for male veterans with MS (n = 1,142) in 2003 and 2004 and compared the data with 2003 Behavioral Risk Factor Surveillance System secondary data for comparison groups without MS (veteran population, n = 31,500; general population = 68,357). We compared disease prevalence by group and identified variables associated with chronic diseases in male veterans with MS. Overall, veterans with MS had a high prevalence of hypercholesterolemia (49%), hypertension (47%), diabetes (16%), coronary heart disease (11%), and stroke (7%). Overall and for the subset of people aged 50 years or older, diabetes, hypertension, hypercholesterolemia, coronary heart disease, and stroke were significantly more prevalent among male veterans with MS than among the general population. Diabetes, hypertension, hypercholesterolemia, and stroke were more prevalent overall among male veterans with MS than among the general veteran population; however, except for stroke, differences were not significant for the group aged 50 or older. Explanatory variables (eg, age, education, race) and dynamic associations between conditions (higher odds for each when ≥ 1 of the other conditions were present) for chronic disease in men with MS were similar to findings in the general population literature for select conditions. These findings raise awareness of chronic disease in a veteran cohort and help bridge a gap in the literature on chronic disease epidemiology in men with MS. We identified chronic disease priorities that may benefit from focused interventions to reduce disparities.

  11. Age, time period, and birth cohort differences in self-esteem: Reexamining a cohort-sequential longitudinal study.

    Science.gov (United States)

    Twenge, Jean M; Carter, Nathan T; Campbell, W Keith

    2017-05-01

    Orth, Trzesniewski, and Robins (2010) concluded that the nationally representative Americans' Changing Lives (ACL) cohort-sequential study demonstrated moderate to large age differences in self-esteem, and no birth cohort (generational) differences in the age trajectory. In a reanalysis of these data using 2 different statistical techniques, we find significant increases in self-esteem that could be attributed to birth cohort or time period. First, hierarchical linear modeling analyses with birth cohort as a continuous variable (vs. the multiple group formulation used by Orth et al.) find that birth cohort has a measurable influence on self-esteem through its interaction with age. Participants born in later years (e.g., 1960) were higher in self-esteem and were more likely to increase in self-esteem as they aged than participants born in earlier years (e.g., 1920). However, the estimated age trajectory up to age 60 is similar in Orth et al.'s results and in the results from our analyses including cohort. Second, comparing ACL respondents of the same age in 1986 versus 2002 (a time-lag design) yields significant birth cohort differences in self-esteem, with 2002 participants of the same age higher in self-esteem than those in 1986. Combined with some previous studies finding significant increases in self-esteem and positive self-views over time, these results suggest that cultural change in the form of cohort and time period cannot be ignored as influences in cross-sectional and longitudinal studies. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Gender and the use of Veterans Health Administration homeless services programs among Iraq/Afghanistan veterans.

    Science.gov (United States)

    Blackstock, Oni J; Haskell, Sally G; Brandt, Cynthia A; Desai, Rani A

    2012-04-01

    Female Veterans comprise 12% of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans, the largest proportion of women to serve of any prior cohort. We sought to determine the sex-specific risk of using a Veterans Health Administration (VHA) homeless program among OEF/OIF Veterans and to identify factors associated with increased risk of program use for women compared with men. We included OEF/OIF Veterans with at least 1 VHA clinical visit between October 1, 2001, and September 30, 2009. The study's outcome was the time to first use of a VHA homeless program. Cox proportional-hazards regression was used to estimate the relative risk of using a homeless program by sex, adjusting for relevant sociodemographic and clinical variables. Exploratory analyses examined interactions between sex and all covariates. Of 445,319 Veterans, 7431 (1.7%) used a VHA homeless program, of which 961 were females (1.8%), and 6470 were males (1.7%) during a median follow-up period of 3.20 years. Women were as likely as men to use a homeless program (adjusted hazard ratio, 1.02; 95% confidence interval, 0.95-1.09); median time to first use was similar for female and male Veterans (1.88 vs. 1.88 y, respectively, P=0.53). In exploratory analyses, we found increased risk of program use for women compared with men for the following subgroups: ages 26-35 years, 100% service-connected disability rating, posttraumatic stress disorder diagnosis, and northeast location. Overall, there was no substantial difference in the sex-specific risk of using a VHA homeless program. In light of this finding, VHA homeless programs must be prepared to recognize and address the unique needs of female OEF/OIF Veterans.

  13. Traumatic war stressors and psychiatric symptoms among World War II, Korean, and Vietnam War veterans.

    Science.gov (United States)

    Fontana, A; Rosenheck, R

    1994-03-01

    Three hypotheses regarding symptoms of war-related posttraumatic stress disorder and general psychiatric distress were tested: that symptoms are more severe the more severe the traumatic exposure, regardless of the war in question; that symptoms are less severe the older the veterans' age; and that symptom levels differ across sociocultural cohorts. A total of 5,138 war zone veterans who were seeking treatment from specialized Veterans Affairs outpatient clinical teams made up the sample: 320 World War II, 199 Korean War, and 4,619 Vietnam War veterans. All hypotheses were supported significantly. The similarity of relationships between traumatic exposure and symptoms across wars testifies to the generality of these experiences. Furthermore, the results suggest the operation of significant effects due both to aging and to cohort differences in sociocultural attitudes toward the stigma of mental illness and the popularity of the wars.

  14. Activity participation and cognitive aging from age 50 to 80 in the glostrup 1914 cohort.

    Science.gov (United States)

    Gow, Alan J; Mortensen, Erik L; Avlund, Kirsten

    2012-10-01

    To examine the cognitively protective effect of leisure and physical activities while accounting for prior cognitive ability, a rarely considered confounder of the previously reported associations between activity and cognitive aging. Longitudinal cohort study. Glostrup, Denmark. Community-dwelling sample of adults recruited into the Glostrup 1914 Cohort (baseline N = 802). All were born in 1914 and were assessed at ages 50, 60, 70, and 80. New participants were recruited during the study to counter attrition. On each occasion, cognitive ability was assessed using four tests, which defined a general cognitive ability score. Self-reported participation in leisure and physical activities was also collected. In general, physical activity was summarized on a 3- or 4-point scale, and leisure activity as none versus some (ages 50 and 60) or according to participation in a list of common activities (age 70). The effect of activity-leisure and physical-on the level of cognitive ability and cognitive change over time from age 60 to 80 was examined in growth curve models. Greater activity (leisure or physical) was consistently associated with a higher level of cognitive ability. Adjusting for baseline cognitive ability (age 50) attenuated these associations, suggesting that associations between activity and cognition reported in old age are largely a consequence of preserved differentiation. A small but significant association remained between greater physical activity at age 60 or 70 and less cognitive decline. The association between more-frequent leisure activity and less cognitive decline mainly reflects the positive cross-sectional association between activity and cognition, although the link that remains between greater physical activity and a more-successful cognitive aging trajectory is of particular relevance to those who are developing interventions. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  15. Role of BMI and age in predicting pathologic vertebral fractures in newly diagnosed multiple myeloma patients: A retrospective cohort study.

    Science.gov (United States)

    Chen, Yi-Lun; Liu, Yao-Chung; Wu, Chia-Hung; Yeh, Chiu-Mei; Chiu, Hsun-I; Lee, Gin-Yi; Lee, Yu-Ting; Hsu, Pei; Lin, Ting-Wei; Gau, Jyh-Pyng; Hsiao, Liang-Tsai; Chiou, Tzeon-Jye; Liu, Jin-Hwang; Liu, Chia-Jen

    2017-11-06

    Vertebral fractures affect approximately 30% of myeloma patients and lead to a poor impact on survival and life quality. In general, age and body mass index (BMI) are reported to have an important role in vertebral fractures. However, the triangle relationship among age, BMI, and vertebral fractures is still unclear in newly diagnosed multiple myeloma (NDMM) patients. This study recruited consecutive 394 patients with NDMM at Taipei Veterans General Hospital between January 1, 2005 and December 31, 2015. Risk factors for vertebral fractures in NDMM patients were collected and analyzed. The survival curves were demonstrated using Kaplan-Meier estimate. In total, 301 (76.4%) NDMM patients were enrolled in the cohort. In the median follow-up period of 18.0 months, the median survival duration in those with vertebral fractures ≥ 2 was shorter than those with vertebral fracture BMI BMI ≥ 24.0 kg/m(2) (adjusted RR, 2.79; 95% CI, 1.44-5.43). In multivariable logistic regression, BMI BMI ≥ 24.0 kg/m(2) (adjusted OR, 6.05; 95% CI, 2.43-15.08). Among age stratifications, patients with both old age and low BMI were at a greater risk suffering from increased vertebral fractures, especially in patients > 75 years and BMI BMI. Elder patients with low BMI should consider to routinely receive spinal radiographic examinations and regular follow-up. Copyright © 2017 John Wiley & Sons, Ltd.

  16. Heart matters: Gender and racial differences cardiovascular disease risk factor control among veterans.

    Science.gov (United States)

    Goldstein, Karen M; Melnyk, S Dee; Zullig, Leah L; Stechuchak, Karen M; Oddone, Eugene; Bastian, Lori A; Rakley, Susan; Olsen, Maren K; Bosworth, Hayden B

    2014-01-01

    Cardiovascular disease (CVD) is the leading cause of mortality for U.S. women. Racial minorities are a particularly vulnerable population. The increasing female veteran population has an higher prevalence of certain cardiovascular risk factors compared with non-veteran women; however, little is known about gender and racial differences in cardiovascular risk factor control among veterans. We used analysis of variance, adjusting for age, to compare gender and racial differences in three risk factors that predispose to CVD (diabetes, hypertension, and hyperlipidemia) in a cohort of high-risk veterans eligible for enrollment in a clinical trial, including 23,955 men and 1,010 women. Low-density lipoprotein (LDL) values were higher in women veterans than men with age-adjusted estimated mean values of 111.7 versus 97.6 mg/dL (p LDL values, and hemoglobin A1c levels, although the differences were only significant among men. Female veterans have higher LDL cholesterol levels than male veterans and African-American veterans have higher BP, LDL cholesterol, and A1c levels than Whites after adjusting for age. Further examination of CVD gender and racial disparities in this population may help to develop targeted treatments and strategies applicable to the general population. Published by Elsevier Inc.

  17. Long-term risks after splenectomy among 8,149 cancer-free American veterans: a cohort study with up to 27 years follow-up

    Science.gov (United States)

    Kristinsson, Sigurdur Y.; Gridley, Gloria; Hoover, Robert N; Check, David; Landgren, Ola

    2014-01-01

    Although preservation of the spleen following abdominal trauma and spleen-preserving surgical procedures have become gold standards, about 22,000 splenectomies are still conducted annually in the USA. Infections, mostly by encapsulated organisms, are the most well-known complications following splenectomy. Recently, thrombosis and cancer have become recognized as potential adverse outcomes post-splenectomy. Among more than 4 million hospitalized USA veterans, we assessed incidence and mortality due to infections, thromboembolism, and cancer including 8,149 cancer-free veterans who underwent splenectomy with a follow-up of up to 27 years. Relative risk estimates and 95% confidence intervals were calculated using time-dependent Poisson regression methods for cohort data. Splenectomized patients had an increased risk of being hospitalized for pneumonia, meningitis, and septicemia (rate ratios=1.9–3.4); deep venous thrombosis and pulmonary embolism (rate ratios=2.2); certain solid tumors: buccal, esophagus, liver, colon, pancreas, lung, and prostate (rate ratios =1.3–1.9); and hematologic malignancies: non-Hodgkin lymphoma, Hodgkin lymphoma, multiple myeloma, acute myeloid leukemia, chronic lymphocytic leukemia, chronic myeloid leukemia, and any leukemia (rate ratios =1.8–6.0). They also had an increased risk of death due to pneumonia and septicemia (rate ratios =1.6–3.0); pulmonary embolism and coronary artery disease (rate ratios =1.4–4.5); any cancer: liver, pancreas, and lung cancer, non-Hodgkin lymphoma, Hodgkin lymphoma, and any leukemia (rate ratios =1.3–4.7). Many of the observed risks were increased more than 10 years after splenectomy. Our results underscore the importance of vaccination, surveillance, and thromboprophylaxis after splenectomy. PMID:24056815

  18. Military veteran mortality following a survived suicide attempt

    Directory of Open Access Journals (Sweden)

    Conigliaro Joseph

    2011-05-01

    Full Text Available Abstract Background Suicide is a global public health problem. Recently in the U.S., much attention has been given to preventing suicide and other premature mortality in veterans returning from Iraq and Afghanistan. A strong predictor of suicide is a past suicide attempt, and suicide attempters have multiple physical and mental comorbidities that put them at risk for additional causes of death. We examined mortality among U.S. military veterans after hospitalization for attempted suicide. Methods A retrospective cohort study was conducted with all military veterans receiving inpatient treatment during 1993-1998 at United States Veterans Affairs (VA medical facilities following a suicide attempt. Deaths occurring during 1993-2002, the most recent available year at the time, were identified through VA Beneficiary and Records Locator System data and National Death Index data. Mortality data for the general U.S. adult population were also obtained from the National Center for Health Statistics. Comparisons within the veteran cohort, between genders, and against the U.S. population were conducted with descriptive statistics and standardized mortality ratios. The actuarial method was used estimate the proportion of veterans in the cohort we expect would have survived through 2002 had they experienced the same rate of death that occurred over the study period in the U.S. population having the age and sex characteristics. Results During 1993-1998, 10,163 veterans were treated and discharged at a VA medical center after a suicide attempt (mean age = 44 years; 91% male. There was a high prevalence of diagnosed alcohol disorder or abuse (31.8%, drug dependence or abuse (21.8%, psychoses (21.2%, depression (18.5%, and hypertension (14.2%. A total of 1,836 (18.1% veterans died during follow up (2,941.4/100,000 person years. The cumulative survival probability after 10 years was 78.0% (95% CI = 72.9, 83.1. Hence the 10-year cumulative mortality risk was 22

  19. A comparison of HAART outcomes between the US military HIV Natural History Study (NHS and HIV Atlanta Veterans Affairs Cohort Study (HAVACS.

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    Jodie L Guest

    Full Text Available INTRODUCTION: The Department of Defense (DoD and the Department of Veterans Affairs (VA provide comprehensive HIV treatment and care to their beneficiaries with open access and few costs to the patient. Individuals who receive HIV care in the VA have higher rates of substance abuse, homelessness and unemployment than individuals who receive HIV care in the DoD. A comparison between individuals receiving HIV treatment and care from the DoD and the VA provides an opportunity to explore the impact of individual-level characteristics on clinical outcomes within two healthcare systems that are optimized for clinic retention and medication adherence. METHODS: Data were collected on 1065 patients from the HIV Atlanta VA Cohort Study (HAVACS and 1199 patients from the US Military HIV Natural History Study (NHS. Patients were eligible if they had an HIV diagnosis and began HAART between January 1, 1996 and June 30, 2010. The analysis examined the survival from HAART initiation to all-cause mortality or an AIDS event. RESULTS: Although there was substantial between-cohort heterogeneity and the 12-year survival of participants in NHS was significantly higher than in HAVACS in crude analyses, this survival disparity was reduced from 21.5% to 1.6% (mortality only and 26.8% to 4.1% (combined mortality or AIDS when controlling for clinical and demographic variables. CONCLUSION: We assessed the clinical outcomes for individuals with HIV from two very similar government-sponsored healthcare systems that reduced or eliminated many barriers associated with accessing treatment and care. After controlling for clinical and demographic variables, both 12-year survival and AIDS-free survival rates were similar for the two study cohorts who have open access to care and medication despite dramatic differences in socioeconomic and behavioral characteristics.

  20. Influence of birth cohort on age of onset cluster analysis in bipolar I disorder

    DEFF Research Database (Denmark)

    Bauer, M; Glenn, T; Alda, M

    2015-01-01

    Purpose: Two common approaches to identify subgroups of patients with bipolar disorder are clustering methodology (mixture analysis) based on the age of onset, and a birth cohort analysis. This study investigates if a birth cohort effect will influence the results of clustering on the age of onse...

  1. Empirical Bayes Age-Period-Cohort Analysis of Retrospective Incidence Data

    DEFF Research Database (Denmark)

    Ogata, Yosihiko; Katsura, Koichi; Keiding, Niels

    2000-01-01

    ABIC, age-period-cohort decomposition, anisotropic smoothness prior, B-spline, detection rate, diabetes incidence, integrated likelihood, intensity function, Lexis diagram, random deletion......ABIC, age-period-cohort decomposition, anisotropic smoothness prior, B-spline, detection rate, diabetes incidence, integrated likelihood, intensity function, Lexis diagram, random deletion...

  2. Synergistic effects of cognitive impairment on physical disability in all-cause mortality among men aged 80 years and over: Results from longitudinal older veterans study.

    Directory of Open Access Journals (Sweden)

    Wan-Chen Yu

    Full Text Available We evaluated effects of the interrelationship between physical disability and cognitive impairment on long-term mortality of men aged 80 years and older living in a retirement community in Taiwan.This prospective cohort study enrolled older men aged 80 and older living in a Veterans Care Home. Those with confirmed diagnosis of dementia were excluded. All participants received comprehensive geriatric assessment, including sociodemographic data, Charlson's Comorbidity Index (CCI, geriatric syndromes, activities of daily living (ADL using the Barthel index and cognitive function using the Mini-Mental State Examination (MMSE. Subjects were categorized into normal cognitive function, mild cognitive deterioration, and moderate-to-severe cognitive impairment and were further stratified by physical disability status. Kaplan-Meier log-rank test was used for survival analysis. After adjusting for sociodemographic characteristics and geriatric syndromes, Cox proportional hazards model was constructed to examine associations between cognitive function, disability and increased mortality risk.Among 305 male subjects aged 85.1 ± 4.1 years, 89 subjects died during follow-up (mean follow-up: 1.87 ± 0.90 years. Kaplan-Meier unadjusted analysis showed reduced survival probability associated with moderate-to-severe cognitive status and physical disability. Mortality risk increased significantly only for physically disabled subjects with simultaneous mild cognitive deterioration (adjusted HR 1.951, 95% CI 1.036-3.673, p = 0.038 or moderate-to-severe cognitive impairment (aHR 2.722, 95% CI 1.430-5.181, p = 0.002 after adjusting for age, BMI, education levels, smoking status, polypharmacy, visual and hearing impairment, urinary incontinence, fall history, depressive symptoms and CCI. Mortality risk was not increased among physically independent subjects with or without cognitive impairment, and physically disabled subjects with intact cognition.Physical disability

  3. Evaluation of US Veterans Nutrition Education for Diabetes Prevention.

    Science.gov (United States)

    Erickson, Megan; Braun, Katie; List, Riesa; Utech, Anne; Moore, Carolyn; White, Donna L; Garcia, Jose M

    2016-09-01

    Evaluate the effectiveness of nutrition education interventions for diabetes prevention. Retrospective cohort design. Tertiary-care US Veterans' Hospital, July 2007 to July 2012, using pre-existing database. Prediabetic, adult veterans (n = 372), mostly men (94.4%, n = 351). Visits with existing nutrition education classes were collected. diabetes status; predictors: visits/encounters, age, body mass index, weight change, and hemoglobin A1c. Cox proportional hazards method, χ(2) test, and logistic regression. In this sample, prediabetic veterans who received nutrition education were less likely to develop diabetes when compared with prediabetic veterans who did not receive nutrition education (hazard ratio, 0.71; 95% confidence interval, 0.55-0.92; P Nutrition education was significantly associated with preventing the progression from prediabetes to diabetes in US Veterans participating in a nutrition education intervention at the Michael E. DeBakey Veterans Affairs Medical Center. Copyright © 2016 Society for Nutrition Education and Behavior. All rights reserved.

  4. Injuries and Falls in an Aging Cohort with Spinal Cord Injury: SCI Aging Study.

    Science.gov (United States)

    Saunders, Lee L; Krause, James S

    2015-01-01

    Limited research suggests that additional "subsequent" injuries occur frequently among persons with an existing spinal cord injury (SCI), which may result in further significant complications and added disability. The purpose of this study was to (a) report the 12-month incidence of injuries by age in an aging SCI cohort, (b) report the 12-month incidence of falls, (c) assess the impact of injuries on participation by age, and (d) assess the relationship of age with injuries and falls while controlling for potential confounding factors. Participants (N = 759) responded to questions about injuries and falls resulting in injury in the past year. Demographic and SCI characteristics, binge drinking, and prescription medication use were measured. A total of 19.2% reported 1 or more injuries in the past year, and 10.4% reported a fall resulting in an injury in the past year. Among those who sustained 1 or more injuries, 22.8% had at least 1 hospitalization for an injury within the past 12 months. Additionally, 47.6% were limited in their normal daily activities for a week or more due to injury. Prescription medication use was associated with injury in the past year and falls resulting in injury. Equal time between walking and wheelchair use as the primary mode of locomotion was also associated with falls in the past year. Future research should investigate circumstances surrounding subsequent injuries to aid in prevention efforts. Additionally, information is needed on whether subsequent injuries further contribute to physical disability.

  5. Predictors of Mortality in Older Homeless Veterans.

    Science.gov (United States)

    Schinka, John A; Curtiss, Glenn; Leventhal, Katherine; Bossarte, Robert M; Lapcevic, William; Casey, Roger

    2017-10-01

    In this analysis of a cohort of older homeless veterans, we examined psychosocial, health, housing, and employment characteristics to identify predictors of mortality. Our sample of 3,620 older veterans entered Veteran Affairs homeless programs in years 2000-2003. Fifteen variables from a structured interview described this sample and served as predictors. National Death Index data for years 2000-2011 were used to ascertain death. Survival table analyses were conducted to estimate and plot cumulative survival functions. To determine predictors and estimate hazard functions, Cox proportional hazards regression analysis was conducted. Five variables (presence of a serious health issue, hospitalization for alcohol abuse, alcohol dependency, unemployment for 3 years, and age 60+) were associated with increased risk of death; three (non-White, drug dependency, and dental problems) were associated with reduced risk. A risk score, based on total unit-weighted risk for all eight predictors, was used to identify three groups that were found to differ significantly in mortality. These analyses underline the jeopardy faced by older homeless veterans in terms of early death. We were able to identify several variables associated with mortality; more importantly, we were able to show that a risk score based on status for these variables was significantly related to survival.

  6. Five-year trends in women veterans' use of VA maternity benefits, 2008-2012.

    Science.gov (United States)

    Mattocks, Kristin M; Frayne, Susan; Phibbs, Ciaran S; Yano, Elizabeth M; Zephyrin, Laurie; Shryock, Holly; Haskell, Sally; Katon, Jodie; Sullivan, J Cherry; Weinreb, Linda; Ulbricht, Christine; Bastian, Lori A

    2014-01-01

    An increasing number of young women veterans are returning from war and military service and are seeking reproductive health care from the Veterans Health Administration (VHA). Many of these women seek maternity benefits from the VHA, and yet little is known regarding the number of women veterans utilizing VHA maternity benefits nor the characteristics of pregnant veterans using these benefits. In May 2010, VHA maternity benefits were expanded to include 7 days of infant care, which may serve to entice more women to use VHA maternity benefits. Understanding the changing trends in women veterans seeking maternity benefits will help the VHA to improve the quality of reproductive care over time. The goal of this study was to examine the trends in delivery claims among women veterans receiving VHA maternity benefits over a 5-year period and the characteristics of pregnant veterans utilizing VHA benefits. We undertook a retrospective, national cohort study of pregnant veterans enrolled in VHA care with inpatient deliveries between fiscal years (FY) 2008 and 2012. We included pregnant veterans using VHA maternity benefits for delivery. Measures included annualized numbers and rates of inpatient deliveries and delivery-related costs, as well as cesarean section rates as a quality indicator. During the 5-year study period, there was a significant increase in the number of deliveries to women veterans using VHA maternity benefits. The overall delivery rate increased by 44% over the study period from 12.4 to 17.8 deliveries per 1,000 women veterans. A majority of women using VHA maternity benefits were age 30 or older and had a service-connected disability. From FY 2008 to 2012, the VHA paid more than $46 million in delivery claims to community providers for deliveries to women veterans ($4,993/veteran). Over a 5-year period, the volume of women veterans using VHA maternity benefits increased by 44%. Given this sizeable increase, the VHA must increase its capacity to care

  7. Social Origin and Graduation Age: A Cohort Comparison of Danish University Students

    Science.gov (United States)

    Klausen, Trond Beldo

    2016-01-01

    This paper investigates whether social origin has an impact on graduation age among university students. A large number of social background factors are applied on a large data set of 4 successive cohorts of Danish university graduates born 1960-1975. These are cohorts for whom university attendance increased steeply. Contrary to recent findings…

  8. Childhood Risk Factors for Lifetime Anorexia Nervosa by Age 30 Years in a National Birth Cohort

    Science.gov (United States)

    Nicholls, Dasha E.; Viner, Russell M.

    2009-01-01

    Whether previously identified childhood risk factors for anorexia nervosa (AN) predict self-reported lifetime AN by age 30 is examined. The cohort confirmed four risk and two protective factors out of the 22 suggested risk factors. The study used data from the 1970 British Cohort Study.

  9. Mode of Delivery and Asthma at School Age in 9 European Birth Cohorts

    DEFF Research Database (Denmark)

    Rusconi, Franca; Zugna, Daniela; Annesi-Maesano, Isabella

    2017-01-01

    Evidence on the association between mode of delivery and asthma at school age is inconclusive. We assessed the associations between specific modes of delivery and asthma in children from 9 European birth cohorts that enrolled participants between 1996 and 2006. Cohort-specific crude and adjusted ...

  10. Correlates of Initiation of Treatment for Chronic Hepatitis C Infection in United States Veterans, 2004-2009.

    Directory of Open Access Journals (Sweden)

    Adi V Gundlapalli

    Full Text Available We describe the rates and predictors of initiation of treatment for chronic hepatitis C (HCV infection in a large cohort of HCV positive Veterans seen in U.S. Department of Veterans Affairs (VA facilities between January 1, 2004 and December 31, 2009. In addition, we identify the relationship between homelessness among these Veterans and treatment initiation. Univariate and multivariable Cox Proportional Hazards regression models with time-varying covariates were used to identify predictors of initiation of treatment with pegylated interferon alpha plus ribavirin. Of the 101,444 HCV treatment-naïve Veterans during the study period, rates of initiation of treatment among homeless and non-homeless Veterans with HCV were low and clinically similar (6.2% vs. 7.4%, p<0.0001. For all U.S. Veterans, being diagnosed with genotype 2 or 3, black or other/unknown race, having Medicare or other insurance increased the risk of treatment. Veterans with age ≥50 years, drug abuse, diabetes, and hemoglobin < 10 g/dL showed lower rates of treatment. Initiation of treatment for HCV in homeless Veterans is low; similar factors predicted initiation of treatment. Additionally, exposure to treatment with medications for diabetes predicted lower rates of treatment. As newer therapies become available for HCV, these results may inform further studies and guide strategies to increase treatment rates in all U.S. Veterans and those who experience homelessness.

  11. Childcare before age 6 and body mass index at age 7 years in a cohort of Danish children

    DEFF Research Database (Denmark)

    Benjamin Neelon, S E; Schmidt Morgen, C; Kamper-Jørgensen, M

    2017-01-01

    BACKGROUND: Previous studies show inconsistent associations between childcare and obesity. AIMS: Our prior work demonstrated that childcare in infancy was associated with higher weight in a cohort of Danish children. Here, we extend this work and examine childcare through 6 years and body mass in...... index (BMI) at age 7 years. MATERIALS AND METHODS: We examined 24 714 children in the Danish National Birth Cohort who were also in the Childcare Database. We conducted multivariable linear regressions examining children prior to age 6, overall and by type (daycare, crèche, age...

  12. Separating the effects of age, period and birth cohort on seafood consumption in Norway

    DEFF Research Database (Denmark)

    Scholderer, Joachim; Trondsen, Torbjørn; Lund, Eiliv

    Effects of age, period and birth cohort on consumption of fat fish, lean fish and processed fish were estimated based on panel data from the Norwegian Women and Seafood Consumption Study (NOWAC). Cohorts selected for the present analysis were women born between 1951 and 1966. Survey questionnaires......, the relative size of the effects suggests that either (a) a positive effect of period is neutralized by a negative effect of birth cohort, resulting in a zero net effect for the period under investigation, or (b) that both effects are peripheral, caused by an underlying biological-ageing effect. Total...

  13. Lifetime Sexual Assault and Sexually Transmitted Infections Among Women Veterans.

    Science.gov (United States)

    Goyal, Vinita; Mengeling, Michelle A; Booth, Brenda M; Torner, James C; Syrop, Craig H; Sadler, Anne G

    2017-07-01

    Women veterans report a high prevalence of sexual assault. Unfortunately, there are limited data on the reproductive health sequelae faced by these women. Our objective was to evaluate the association between completed lifetime sexual assault (LSA) and sexually transmitted infections (STIs) among a cohort of women veterans, adjusting for sexual risk behaviors. We conducted a retrospective study among women veterans aged 51 years or younger who enrolled for care at two Veterans Administration (VA) healthcare sites between 2000 and 2008. Participants completed a telephone interview assessing reproductive health and sexual violence history. We compared the frequencies of past STI diagnoses among those who had and had not experienced LSA. We used logistic regression to assess the effect of sexual assault with history of an STI diagnosis after adjusting for age, sexual risk behaviors, and substance abuse treatment. Among 996 women veterans, a history of STIs was reported by 32%, including a lifetime history of gonorrhea (5%), chlamydia (15%), genital herpes infection (8%), and human papillomavirus infection (15%), not mutually exclusive; 51% reported LSA. Women with a history of LSA were significantly more likely to report a history of STIs (unadjusted odds ratio [OR] 1.91, 95% confidence interval [CI] 1.45-2.50; adjusted OR 1.49, 95% CI 1.07-2.08). Women veterans who have experienced LSA are at increased risk for lifetime STI diagnoses. To adequately address the reproductive health needs of the growing population of women veterans, STI risk assessments should include queries of military service and LSA histories.

  14. AN AGE-PERIOD-COHORT ANALYSIS OF CANCER INCIDENCE AMONG THE OLDEST OLD

    Science.gov (United States)

    Hanson, Heidi A.; Smith, Ken R.; Stroup, Antoinette M.; Harrell, C. Janna

    2014-01-01

    Separating and understanding the effects of age, period, and cohort on major health conditions in the population over eighty-five, the oldest-old, will lead to better population projections of morbidity and mortality. We used age-period-cohort (APC) analyses to describe the simultaneous effects of age, period and cohort on cancer incidence rates in an attempt to understand the population dynamics underlying their patterns. Data from the Utah Cancer Registry (UCR), the US Census, the National Center for Health Statistics (NCHS) and the National Cancer Institute’s Surveillence Epidemiology and End Results (SEER) program were used to generate age-specific estimates of cancer incidence for ages 65–99 from 1973–2002 for Utah. Our results showed increasing cancer incidence rates up to the 85–89 age group followed by declines for ages 90–99 when not confounded by the distinct influence of period and cohort effects. We found significant period and cohort effects, suggesting the role of environmental mechanisms in cancer incidence trends between the ages of 85 and 100. PMID:25396304

  15. Materialism across the lifespan : An age-period-cohort analysis

    NARCIS (Netherlands)

    Jaspers, Esther; Pieters, Rik

    This research examined the development of materialism across the lifespan. Two initial studies revealed that: 1) lay beliefs were that materialism declines with age; and 2) previous research findings also implied a modest, negative relationship between age and materialism. Yet, previous research has

  16. ECONOMIC STRESSORS AND ALCOHOL-RELATED OUTCOMES: EXPLORING AGE COHORT DIFFERENCES

    Science.gov (United States)

    Brown, Robyn Lewis; Richman, Judith A.; Rospenda, Kathleen M.

    2015-01-01

    Objectives This study examined processes linking age cohort, economic stressors, coping strategies and two drinking-related outcomes (i.e., past-month drinking and problematic drinking). Methods Structural equation models were conducted utilizing data from a national survey. Results Findings revealed the associations between economic stressors and both past-month drinking and problematic drinking were significantly greater for members of the millennial cohort compared to baby boomers. These effects are partly explained by the lesser tendency of members of the millennial cohort to use collective, politically-focused coping strategies. Discussion These findings clarify the circumstances in which age matters most for the associations among economy-related stressors, coping strategies and drinking-related outcomes. They highlight how difficult economic circumstances influence the availability of coping strategies and, in turn, alcohol consumption – and differently for younger and older age cohorts. PMID:26291290

  17. Effects of low-level sarin and cyclosarin exposure on hippocampal subfields in Gulf War Veterans.

    Science.gov (United States)

    Chao, Linda L; Kriger, Stephen; Buckley, Shannon; Ng, Peter; Mueller, Susanne G

    2014-09-01

    More than 100,000 US troops were potentially exposed to chemical warfare agents sarin (GB) and cyclosarin (GF) when an ammunition dump at Khamisiyah, Iraq was destroyed during the 1991 Gulf War (GW). We previously reported reduced hippocampal volume in GW veterans with suspected GB/GF exposure relative to matched, unexposed GW veterans estimated from 1.5T magnetic resonance images (MRI). Here we investigate, in a different cohort of GW veterans, whether low-level GB/GF exposure is associated with structural alterations in specific hippocampal subfields, estimated from 4T MRI. The Automatic Segmentation of Hippocampal Subfields (ASHS) technique was used to quantify CA1, CA2, CA3 and dentate gyrus (DG), and subiculum (SUB) subfields volumes from high-resolution T2-weighted images acquired on a 4T MR scanner in 56 GW veterans with suspected GB/GF exposure and 56 "matched" unexposed GW veterans (mean age 49±7 years). GB/GF exposed veterans had smaller CA2 (p=0.003) and CA3/DG (p=0.01) subfield volumes compared to matched, unexposed GW veterans. There were no group difference in total hippocampal volume, quantified with FreeSurfer, and no dose-response relationship between estimated levels of GB/GF exposure and total hippocampal or subfield volume. These findings extend our previous report of structural alterations in the hippocampi of GW veterans with suspected GB/GF exposure to volume changes in the CA2, CA3, and DG hippocampal subfields in a different cohort of GW veterans with suspected GB/GF exposure. Published by Elsevier B.V.

  18. Age-period-cohort analysis of suicide mortality rates in Spain, 1959-1991.

    Science.gov (United States)

    Granizo, J J; Guallar, E; Rodríguez-Artalejo, F

    1996-08-01

    Although there is evidence that suicide rates may be increasing in Spain, formal epidemiological studies have been limited to specific cities or counties. The objective of this study was to investigate nationwide trends in suicide mortality from 1959 to 1991 in Spain, with emphasis on age, period, and cohort effects. Age- and sex-specific suicide mortality rates from 1959 until 1991 were obtained from official vital statistics tables from the Instituto Nacional de Estadística, the official registry of vital statistics in Spain. Poisson regression and graphical methods were used to model and estimate age, period and cohort effects. Suicide mortality rates increased with age, with a proportional increment for each decade of life of 45% (95% confidence interval: 45-46%). In both males and females, age-adjusted suicide mortality rates decreased from 1959 until the late 1970s and early 1980s. In 1982, trends started to increase, returning to the levels of 1959 in less than 6 years. Cohort effects were small for cohorts born prior to 1940. For cohorts born after 1950, suicide rates increased markedly. The increase in suicide mortality in younger cohorts and the high rates of suicide in the elderly demand further investigation to establish causal mechanisms and preventive strategies.

  19. Age, period and cohort effects on suicide mortality in Russia, 1956-2005.

    Science.gov (United States)

    Jukkala, Tanya; Stickley, Andrew; Mäkinen, Ilkka Henrik; Baburin, Aleksei; Sparén, Pär

    2017-03-07

    Russian suicide mortality rates changed rapidly over the second half of the twentieth century. This study attempts to differentiate between underlying period and cohort effects in relation to the changes in suicide mortality in Russia between 1956 and 2005. Sex- and age-specific suicide mortality data were analyzed using an age-period-cohort (APC) approach. Descriptive analyses and APC modeling with log-linear Poisson regression were performed. Strong period effects were observed for the years during and after Gorbachev's political reforms (including the anti-alcohol campaign) and for those following the break-up of the Soviet Union. After mutual adjustment, the cohort- and period-specific relative risk estimates for suicide revealed differing underlying processes. While the estimated period effects had an overall positive trend, cohort-specific developments indicated a positive trend for the male cohorts born between 1891 and 1931 and for the female cohorts born between 1891 and 1911, but a negative trend for subsequent cohorts. Our results indicate that the specific life experiences of cohorts may be important for variations in suicide mortality across time, in addition to more immediate effects of changes in the social environment.

  20. Timing of Initiation of Maintenance Dialysis: A Qualitative Analysis of the Electronic Medical Records of a National Cohort of Patients From the Department of Veterans Affairs.

    Science.gov (United States)

    Wong, Susan P Y; Vig, Elizabeth K; Taylor, Janelle S; Burrows, Nilka R; Liu, Chuan-Fen; Williams, Desmond E; Hebert, Paul L; O'Hare, Ann M

    2016-02-01

    There is often considerable uncertainty about the optimal time to initiate maintenance dialysis in individual patients and little medical evidence to guide this decision. To gain a better understanding of the factors influencing the timing of initiation of dialysis in clinical practice. A qualitative analysis was conducted using the electronic medical records from the Department of Veterans Affairs (VA) of a national random sample of 1691 patients for whom the decision to initiate maintenance dialysis occurred in the VA between January 1, 2000, and December 31, 2009. Data analysis took place from June 1 to November 30, 2014. Central themes related to the timing of initiation of dialysis as documented in patients' electronic medical records. Of the 1691 patients, 1264 (74.7%) initiated dialysis as inpatients and 1228 (72.6%) initiated dialysis with a hemodialysis catheter. Cohort members met with a nephrologist during an outpatient clinic visit a median of 3 times (interquartile range, 0-6) in the year prior to initiation of dialysis. The mean (SD) estimated glomerular filtration rate at the time of initiation for cohort members was 10.4 (5.7) mL/min/1.73 m(2). The timing of initiation of dialysis reflected the complex interplay of at least 3 interrelated and dynamic processes. The first was physician practices, which ranged from practices intended to prepare patients for dialysis to those intended to forestall the need for dialysis by managing the signs and symptoms of uremia with medical interventions. The second process was sources of momentum. Initiation of dialysis was often precipitated by clinical events involving acute illness or medical procedures. In these settings, the imperative to treat often seemed to override patient choice. The third process was patient-physician dynamics. Interactions between patients and physicians were sometimes adversarial, and physician recommendations to initiate dialysis sometimes seemed to conflict with patient priorities

  1. Are non-allergic drug reactions commonly documented as medication "allergies"? A national cohort of Veterans' admissions from 2000 to 2014.

    Science.gov (United States)

    McConeghy, Kevin W; Caffrey, Aisling R; Morrill, Haley J; Trivedi, Amal N; LaPlante, Kerry L

    2017-04-01

    Adverse drug reactions (ADRs) including medication allergies are not well-described among large national cohorts. This study described the most common documented medication allergies and their reactions among a national cohort of Veterans Affairs (VA) inpatients. We evaluated inpatient admissions in any VA Medical Center from 1 January 2000 to 31 December 2014. Each admission was linked with allergy history preceding or upon admission. Individual drugs were aggregated into drug class category including: penicillins, sulfonamides, angiotensin converting enzyme (ACE) inhibitors, opiates, HMG-CoA reductase inhibitors ("statins") and non-steroidal anti-inflammatory inhibitors (NSAID). Results were reported in aggregate and over time. Approximately ~10.8 million inpatient admissions occurred from 2000 to 2014. We found the most commonly reported allergy drug classes were penicillins (13%, n = 1 410 080), opiates (9.1%, n = 984 978), ACE inhibitors (5.7%, n = 618 075) sulfonamides (5.1%, n = 558 653), NSAIDs (5.1%, n = 551 216) and statins (3.6%, n = 391 983). Several allergy histories increased over time including opiates (6.2 to 11.2%), ACE inhibitors (1.3 to 10.2%), statins (0.3 to 7.3%) and NSAIDs (3.9 to 6.0%). Rash was the most commonly documented reaction on reports for penicillins (25.5%, n = 371 825), sulfonamides (25.6%, n = 165 954) and NSAIDs (10.3%, n = 65 741). The most common reaction for opiates was nausea/vomiting (17.9%, n = 211 864), cough/coughing for ACE inhibitors (41.0%, n = 270 537) and muscle pain/myalgia for statins (34.1%, n = 186 565). We report that penicillins and opiates are the most commonly documented drug allergies among VA inpatients, but other drug classes such as ACE inhibitors, statins and NSAIDs are becoming increasingly common. Clinicians also commonly document non-allergic ADRs in the allergy section such as cough or myalgia. Copyright © 2016 John Wiley

  2. Trends in Dementia Incidence in a Birth Cohort Analysis of the Einstein Aging Study.

    Science.gov (United States)

    Derby, Carol A; Katz, Mindy J; Lipton, Richard B; Hall, Charles B

    2017-11-01

    Trends in dementia incidence rates have important implications for planning and prevention. To better understand incidence trends over time requires separation of age and cohort effects, and few prior studies have used this approach. To examine trends in dementia incidence and concomitant trends in cardiovascular comorbidities among individuals aged 70 years or older who were enrolled in the Einstein Aging Study between 1993 and 2015. In this birth cohort analysis of all-cause dementia incidence in persons enrolled in the Einstein Aging Study from October 20, 1993, through November 17, 2015, a systematically recruited, population-based sample of 1348 participants from Bronx County, New York, who were 70 years or older without dementia at enrollment and at least one annual follow-up was studied. Poisson regression was used to model dementia incidence as a function of age, sex, educational level, race, and birth cohort, with profile likelihood used to identify the timing of significant increases or decreases in incidence. Birth year and age. Incident dementia defined by consensus case conference based on annual, standardized neuropsychological and neurologic examination findings, using criteria from the DSM-IV. Among 1348 individuals (mean [SD] baseline age, 78.5 [5.4] years; 830 [61.6%] female; 915 [67.9%] non-Hispanic white), 150 incident dementia cases developed during 5932 person-years (mean [SD] follow-up, 4.4 [3.4] years). Dementia incidence decreased in successive birth cohorts. Incidence per 100 person-years was 5.09 in birth cohorts before 1920, 3.11 in the 1920 through 1924 birth cohorts, 1.73 in the 1925 through 1929 birth cohorts, and 0.23 in cohorts born after 1929. Change point analyses identified a significant decrease in dementia incidence among those born after July 1929 (95% CI, June 1929 to January 1930). The relative rate for birth cohorts before July 1929 vs after was 0.13 (95% CI, 0.04-0.41). Prevalence of stroke and myocardial infarction

  3. Age, period and cohort effects on first-child fertility in Danish men

    DEFF Research Database (Denmark)

    Kamper-Jørgensen, Mads; Keiding, Niels; Knudsen, Lisbeth B.

    patterns. The model was fitted to fertility data on Danish men aged 15 to 49 years in the calendar period from 1960 to 1994. We found the classical age-period-cohodt model to be an appropriate model for describing male first-child fertility patterns in Denmark. Fluctuations in age-specific male first......Demographic studies of fertility are most often based solely on information about women, leaving out characteristics of men. Thereby valuable information may be lost. The present note intends to explore the potential of the classical age-period-cohort model for describing male first-child fertility......-child fertility rates over period were found,  with a nadir in the mid-1980s. Furthermore, age-specific first-child fertility rates were found to be lower in men from younger cirth cohorts than in men from older birth cohorts....

  4. Veterans' homecomings

    DEFF Research Database (Denmark)

    Sørensen, Birgitte Refslund

    2015-01-01

    social identity and find a meaningful life in the civilian world. When doing so, they need to navigate an ambiguous political environment and emergent public imaginaries of the veteran while also wrestling with their own military socialization and personal experiences of war. The certainty previously...... experiences, present conditions, and future ambitions are embedded in webs of concealment, disclosure, exposure, deception, lying, silence, and so forth, only partially controlled by the veterans themselves. The intricacies and anxieties associated with secrecy work are discussed in relation to three veteran...

  5. Age cohort differences in the developmental milestones of gay men.

    Science.gov (United States)

    Drasin, Harry; Beals, Kristin P; Elliott, Marc N; Lever, Janet; Klein, David J; Schuster, Mark A

    2008-01-01

    As the social context in which gay men live changes due to greater visibility, greater acceptance, and easier access to gay subculture, gay males may self-identify and take part in gay social activities at earlier ages than in the past. This study examined whether developmental milestones associated with sexual orientation for gay men have changed over the past several decades. A large and diverse sample of 2,402 gay men who responded to a 1994 survey published in a national magazine provided retrospective information on the age at which they reached individual psychological, social, and sexual behavior developmental milestones. We found evidence that individual psychological and sexual behavior milestones (e.g., awareness of attraction to males, having an orgasm with other male) are slowly moving toward earlier chronological ages (by 1 year of age every 8-25 years, p milestones (e.g., coming out) are moving more rapidly in a similar direction (by 1 year of age every 2-5 years, p < 0.001). The authors perform an innovative sensitivity test to demonstrate the persistence of the finding after correcting for the bias attributable to underrepresentation of those who have not yet self-identified as gay in such samples.

  6. Colleges' Experiences: Integrating Support Services for Military Veterans

    Science.gov (United States)

    Karp, Melinda Mechur; Klempin, Serena

    2017-01-01

    To improve the educational experiences and outcomes of student veterans, the Kisco Foundation developed the Kohlberg Prize in 2015. Two cohorts of colleges were awarded competitive grants to enhance their veterans services. This piece examines the process of creating integrated services for student veterans through the institutionalization of…

  7. The marriage boom and marriage bust in the United States: An age-period-cohort analysis.

    Science.gov (United States)

    Schellekens, Jona

    2017-03-01

    In the 1950s and 1960s there was an unprecedented marriage boom in the United States. This was followed in the 1970s by a marriage bust. Some argue that both phenomena are cohort effects, while others argue that they are period effects. The study reported here tested the major period and cohort theories of the marriage boom and bust, by estimating an age-period-cohort model of first marriage for the years 1925-79 using census microdata. The results of the analysis indicate that the marriage boom was mostly a period effect, although there were also cohort influences. More specifically, the hypothesis that the marriage boom was mostly a response to rising wages is shown to be consistent with the data. However, much of the marriage bust can be accounted for by unidentified cohort influences, at least until 1980.

  8. Exceptional Brain Aging in a Rural Population-Based Cohort

    Science.gov (United States)

    Kaye, Jeffrey; Michael, Yvonne; Calvert, James; Leahy, Marjorie; Crawford, Debbie; Kramer, Patricia

    2009-01-01

    Context: The 2000 US Census identified 50,454 Americans over the age of 100. Increased longevity is only of benefit if accompanied by maintenance of independence and quality of life. Little is known about the prevalence of dementia and other disabling conditions among rural centenarians although this information is important to clinicians caring…

  9. Long-term trends in major cardiovascular risk factors in cohorts in aging men in the European cohorts of the Seven countries study

    NARCIS (Netherlands)

    Lanti, M.; Nedeljkovic, S.; Nissinen, A.; Kafatos, A.; Kromhout, D.

    2005-01-01

    ACKGROUND AND AIMS: Time trends in major cardiovascular risk factors are described in cohorts of middle-aged men followed for 35 years in 9 European cohorts of Finland, The Netherlands, Italy, Serbia and Greece. METHODS: Men aged 40 to 59 years at entry in the early 1960s were repeatedly re-examined

  10. Age-period-cohort modelling of breast cancer incidence in the Nordic countries

    DEFF Research Database (Denmark)

    Rostgaard, K; Vaeth, M; Holst, H

    2001-01-01

    The Nordic countries have experienced a steady increase in breast cancer incidence throughout the past 35 years. We analysed the incidence in Denmark, Finland, Norway and Sweden during the period 1958 to 1992 using age-period-cohort models and taking the systematic mammography screening...... in breast cancer incidence seen in the Nordic countries. The widespread practice of neglecting the period effects in age-period-cohort analysis of time trends in breast cancer incidence therefore probably needs reconsideration. A key finding was that Danish women born in the 20th century seem to have been...... into account. Assuming the age dependency of the incidence pattern in old age to be common for the Nordic countries, an internal comparison could be made among the four countries of the cohort effects and the period effects. The study indicated that the period effects have been of importance for the increase...

  11. The Effects of Age, Period, and Cohort on Mortality from Ischemic Heart Disease in China.

    Science.gov (United States)

    Chang, Jie; Li, Boyang; Li, Jingjing; Sun, Yang

    2017-01-07

    In contrast with most developed countries, mortality due to ischemic heart disease (IHD) continues to rise in China. We examined the effects of age, period, and cohort on IHD mortality in urban and rural populations from 1987 to 2013 to identify the drivers of this trend. Region-specific data on annual IHD mortality among adults aged 20 to 84 years and corresponding population statistics were collected. We then tested for age, period, and cohort effects using the Intrinsic Estimator approach. Our results indicated that IHD mortality in China increased significantly over the three decades studied. There was a log-linear increase in the age effect on IHD mortality as those aged 80-84 showed 277 and 161 times greater IHD mortality risk than those aged 20-24 in urban and rural populations, respectively. While there was an upward trend in the period effect in both populations, the influence of the cohort effect on mortality decreased over time for those born from 1904 to 1993. The age, period, and cohort effects on mortality in China were generally comparable between urban and rural populations. The results suggest that population aging is a major driver behind the rapid rise in IHD mortality. Increased exposure to air pollution may also have played a role in driving the period effect.

  12. Women Veteran Report

    Data.gov (United States)

    Department of Veterans Affairs — This report summarizes the history of women Veterans in the military and as Veterans. It profiles the characteristics of women Veterans in 2015, and illustrates how...

  13. Veterans Health Administration

    Science.gov (United States)

    ... code here VA » Veterans Health Administration Veterans Health Administration Veterans – Here's how to Avoid Getting the Flu ... Read more » VA Medical Centers The Veterans Health Administration is home to the United States’ largest integrated ...

  14. Description of cervical cancer mortality in Belgium using Bayesian age-period-cohort models

    Science.gov (United States)

    2009-01-01

    Objective To correct cervical cancer mortality rates for death cause certification problems in Belgium and to describe the corrected trends (1954-1997) using Bayesian models. Method Cervical cancer (cervix uteri (CVX), corpus uteri (CRP), not otherwise specified (NOS) uterus cancer and other very rare uterus cancer (OTH) mortality data were extracted from the WHO mortality database together with population data for Belgium and the Netherlands. Different ICD (International Classification of Diseases) were used over time for death cause certification. In the Netherlands, the proportion of not-otherwise specified uterine cancer deaths was small over large periods and therefore internal reallocation could be used to estimate the corrected rates cervical cancer mortality. In Belgium, the proportion of improperly defined uterus deaths was high. Therefore, the age-specific proportions of uterus cancer deaths that are probably of cervical origin for the Netherlands was applied to Belgian uterus cancer deaths to estimate the corrected number of cervix cancer deaths (corCVX). A Bayesian loglinear Poisson-regression model was performed to disentangle the separate effects of age, period and cohort. Results The corrected age standardized mortality rate (ASMR) decreased regularly from 9.2/100 000 in the mid 1950s to 2.5/100,000 in the late 1990s. Inclusion of age, period and cohort into the models were required to obtain an adequate fit. Cervical cancer mortality increases with age, declines over calendar period and varied irregularly by cohort. Conclusion Mortality increased with ageing and declined over time in most age-groups, but varied irregularly by birth cohort. In global, with some discrete exceptions, mortality decreased for successive generations up to the cohorts born in the 1930s. This decline stopped for cohorts born in the 1940s and thereafter. For the youngest cohorts, even a tendency of increasing risk of dying from cervical cancer could be observed, reflecting

  15. Analysis of age-period-cohort effects on overall mortality in Andalusia (Southern Spain).

    Science.gov (United States)

    Ocaña-Riola, R; Mayoral-Cortés, J M; Sánchez-Cantalejo, C

    2013-10-01

    To evaluate the age-period-cohort effects on overall mortality in Andalusia (Spain). An ecological study was implemented with a Lexis diagram triangle comprising each annual age group, year of death and year of birth as the unit of analysis. In all 1,384,899 deaths from all causes were analysed for individuals between the ages of 1 and 84 years who died in Andalusia in the period 1981-2008. A non-linear regression model was estimated for each gender group and geographical area. The effects of age, year of death and birth cohort were parameterized using B-spline smoothing functions. There is a downward trend in mortality by age to around the age of 15 years, from which point the trend turned upwards. For cohorts born between 1945 and 1965, the rate climbed steadily. From 1965, the rate turned downwards. Death rates increased between 1995 and 2000, only to turn down again until the end of the period. Broadly, these results were similar for both men and women, in all the provinces of Andalusia and for Andalusia as a whole. This study points to an age-period-cohort effect on deaths from all causes in all the geographic areas studied. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  16. Suicide Mortality in Canada and Quebec, 1926-2008: An Age-Period-Cohort Analysis

    Directory of Open Access Journals (Sweden)

    Lise Thibodeau

    2015-09-01

    Full Text Available Suicide rates raise with age has remained consistent for more than 150 years but over the last 50 years major changes occurred. We examined Age-Period-Cohort (APC effects on suicide mortality rate by gender in Canada and in Quebec from 1926 to 2008. Durkheim theoretical framework is used to interpret our findings. Descriptive analysis and APC models relating to the Intrinsic Estimator (IE were used to assess these effects. IE model shows suicide net age effect for men in Canada and Quebec as death rate increased until 25 years old before reaching a plateau. For women it’s an inverted "U" shape peaking at mid-adulthood. While period effect differs, a net cohort effect is found for men born in 1941, and women in 1981 until most recent cohorts.

  17. Veterans and Homelessness

    Science.gov (United States)

    2013-11-29

    health care and rehabilitation services for homeless veterans (the Health Care for Homeless Veterans and Domiciliary Care for Homeless Veterans...Health Care for Homeless Veterans ................................................................................... 19 Domiciliary Care for Homeless...for Homeless Veterans (HCHV), Domiciliary Care for Homeless Veterans (DCHV), the Compensated Work Therapy/Therapeutic Residences Program, and the

  18. Support for Marijuana (Cannabis) Legalization: Untangling Age, Period, and Cohort Effects

    OpenAIRE

    Campbell, William; Twenge, Jean; Carter, Nathan

    2017-01-01

    In three large, nationally representative surveys of U.S. 12th graders, college students, and adults (N = 9 million) conducted 1968–2015, Americans became significantly more supportive of legal marijuana (cannabis) starting in the mid-1980’s. Hierarchical models using age-period-cohort analysis on the adult (General Social Survey) sample showed that the increased support for legalization is primarily a time period effect rather than generational or age effect; thus, Americans of all ages beca...

  19. Age, Period, and Cohort Differences in Work Centrality and Work Values

    Directory of Open Access Journals (Sweden)

    Gábor Hajdu

    2018-02-01

    Full Text Available In this paper, we analyze whether work values differ between three dimensions of time (age, birth cohort, period. Using data of five waves of the World Values Survey and the European Values Study from more than forty countries and hierarchical age-period-cohort regression models, we did not find relevant gaps between birth cohorts with respect to the relative importance of work or with respect to work values. Thus, we claim that, in European and Euro-Atlantic countries, birth cohorts, on average, do not differ significantly with regard to their work values. Our results suggest, however, that the relative importance of work is significantly higher in the middle-age groups than among the younger or older groups. Regarding work values, we found that the importance of having an interesting job, good pay, and good hours decreases with age, and that job security is equally important at every age, whereas the importance of having a useful job increases with age.

  20. Access to Care Among Nonelderly Veterans.

    Science.gov (United States)

    Bernard, Didem M; Selden, Thomas M

    2016-03-01

    Veteran access to care is an important policy issue that has not previously been examined with population-based survey data. This study compares access to care for nonelderly adult Veterans versus comparable non-Veterans, overall and within subgroups defined by simulated eligibility for health care from the Veterans Health Administration and by insurance status. We use household survey data from the Medical Expenditure Panel Survey from 2006 to 2011. We use iterative proportional fitting to standardize (control for) differences in age, sex, income, medical conditions, disability, Census region, and Metropolitan Statistical Area. Nonelderly Veterans and comparable non-Veterans. For medical, dental, and prescription medicine treatments, we use 4 access measures: delaying care, inability to obtain care, perceiving delay as a big problem, and perceiving inability to obtain care as a big problem. We also examine having a usual source of care. Frequencies of access barriers are similar for nonelderly Veterans and comparable non-Veterans for dental and prescription medicine treatments. For medical treatment, we find that Veterans eligible for VA health care and Veterans with VA use who are uninsured report fewer access problems than the comparable non-Veteran populations for 2 measures: inability to obtain care and reporting inability to obtain care as a big problem. Our results show that uninsured Veterans, the most policy-relevant group, have better access to care than comparable non-Veterans. Our results highlight the importance of adjusting Veteran and non-Veteran comparisons to account for the higher than average health care needs of Veterans.

  1. Materialism across the life span: An age-period-cohort analysis.

    Science.gov (United States)

    Jaspers, Esther D T; Pieters, Rik G M

    2016-09-01

    This research examined the development of materialism across the life span. Two initial studies revealed that (a) lay beliefs were that materialism declines with age and (b) previous research findings also implied a modest, negative relationship between age and materialism. Yet, previous research has considered age only as a linear control variable, thereby precluding the possibility of more intricate relationships between age and materialism. Moreover, prior studies have relied on cross-sectional data and thus confound age and cohort effects. To improve on this, the main study used longitudinal data from 8 waves spanning 9 years of over 4,200 individuals (16 to 90 years) to examine age effects on materialism while controlling for cohort and period effects. Using a multivariate multilevel latent growth model, it found that materialism followed a curvilinear trajectory across the life span, with the lowest levels at middle age and higher levels before and after that. Thus, in contrast to lay beliefs, materialism increased in older age. Moreover, age effects on materialism differed markedly between 3 core themes of materialism: acquisition centrality, possession-defined success, and acquisition as the pursuit of happiness. In particular, acquisition centrality and possession-defined success were higher at younger and older age. Independent of these age effects, older birth cohorts were oriented more toward possession-defined success, whereas younger birth cohorts were oriented more toward acquisition centrality. The economic downturn since 2008 led to a decrease in acquisition as the pursuit of happiness and in desires for personal growth, but to an increase in desires for achievement. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. Epigenetic age acceleration predicts cancer, cardiovascular, and all-cause mortality in a German case cohort.

    Science.gov (United States)

    Perna, Laura; Zhang, Yan; Mons, Ute; Holleczek, Bernd; Saum, Kai-Uwe; Brenner, Hermann

    2016-01-01

    Previous studies have developed models predicting methylation age from DNA methylation in blood and other tissues (epigenetic clock) and suggested the difference between DNA methylation and chronological ages as a marker of healthy aging. The goal of this study was to confirm and expand such observations by investigating whether different concepts of the epigenetic clocks in a population-based cohort are associated with cancer, cardiovascular, and all-cause mortality. DNA methylation age was estimated in a cohort of 1863 older people, and the difference between age predicted by DNA methylation and chronological ageage) was calculated. A case-cohort design and weighted proportional Cox hazard models were used to estimate associations of Δage with cancer, cardiovascular, and all-cause mortality. Hazard ratios for Δage (per 5 years) calculated using the epigenetic clock developed by Horvath were 1.23 (95 % CI 1.10-1.38) for all-cause mortality, 1.22 (95 % CI 1.03-1.45) for cancer mortality, and 1.19 (95 % CI 0.98-1.43) for cardiovascular mortality after adjustment for batch effects, age, sex, educational level, history of chronic diseases, hypertension, smoking status, body mass index, and leucocyte distribution. Associations were similar but weaker for Δage calculated using the epigenetic clock developed by Hannum. These results show that age acceleration in terms of the difference between age predicted by DNA methylation and chronological age is an independent predictor of all-cause and cause-specific mortality and may be useful as a general marker of healthy aging.

  3. Age, Period, and Cohort Effects on Mortality From Ischemic Heart Disease in Southern Spain.

    Science.gov (United States)

    Ocaña-Riola, Ricardo; Mayoral-Cortés, José María; Fernández-Ajuria, Alberto; Sánchez-Cantalejo, Carmen; Martín-Olmedo, Piedad; Blanco-Reina, Encarnación

    2015-05-01

    Ischemic heart disease is the leading cause of death and one of the top 4 causes of burden of disease worldwide. The aim of this study was to evaluate age-period-cohort effects on mortality from ischemic heart disease in Andalusia (southern Spain) and in each of its 8 provinces during the period 1981-2008. A population-based ecological study was conducted. In all, 145 539 deaths from ischemic heart disease were analyzed for individuals aged between 30 and 84 years who died in Andalusia in the study period. A nonlinear regression model was estimated for each sex and geographical area using spline functions. There was an upward trend in male and female mortality rate by age from the age of 30 years. The risk of death for men and women showed a downward trend for cohorts born after 1920, decreasing after 1960 with a steep slope among men. Analysis of the period effect showed that male and female death risk first remained steady from 1981 to 1990 and then increased between 1990 and 2000, only to decrease again until 2008. There were similar age-period-cohort effects on mortality in all the provinces of Andalusia and for Andalusia as a whole. If the observed cohort and period effects persist, male and female mortality from ischemic heart disease will continue to decline. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  4. Analyzing age-specific genetic effects on human extreme age survival in cohort-based longitudinal studies

    DEFF Research Database (Denmark)

    Tan, Qihua; Jacobsen, Rune; Sørensen, Mette

    2013-01-01

    The analysis of age-specific genetic effects on human survival over extreme ages is confronted with a deceleration pattern in mortality that deviates from traditional survival models and sparse genetic data available. As human late life is a distinct phase of life history, exploring the genetic...... effects on extreme age survival can be of special interest to evolutionary biology and health science. We introduce a non-parametric survival analysis approach that combines population survival information with individual genotype data in assessing the genetic effects in cohort-based longitudinal studies...

  5. Loneliness of older people aged 70: a comparison of two Finnish cohorts born 20 years apart.

    Science.gov (United States)

    Eloranta, Sini; Arve, Seija; Isoaho, Hannu; Lehtonen, Aapo; Viitanen, Matti

    2015-01-01

    This study aimed to examine loneliness among two birth cohorts, born 20 years apart, when they were 70 years of age, and to identify factors explaining loneliness. The cohorts consisted of older home-dwelling residents of Turku, Finland, from the birth cohort 1920 in 1991 (N=1530) and the birth cohort 1940 in 2011 (N=1307). Suffering from loneliness was assessed with the question: 'Do you suffer from loneliness?' Cross-tabulations with chi-square test, general linear model (GLM) and multiple regression analysis were used in statistical testing and modeling. In the 1940 cohort, around one-fifth (18%) of the respondents suffered from loneliness at least sometimes, while the corresponding figure in the 1920 cohort was around one-fourth (26%). Our analyses indicated that the effect of cohort was not a statistically significant explanatory factor of loneliness. Living status, self-rated health and memory compared to age peers were statistically significant explanatory factors for suffering from loneliness. When we controlled the effect of depressiveness on the experience of loneliness, it was shown that the effects of living status and self-rated health remained statistically significant, whereas memory compared to age peers did not. Depressiveness itself was highly important. The combined effect of living status and self-rated health emerged as the most significant explanatory factor for loneliness. Older people with poor self-rated health who lived alone were most likely to suffer from loneliness. The findings give healthcare professionals an opportunity to plan for interventions aimed at combating loneliness among home-dwelling older people. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. PTSD and Use of Outpatient General Medical Services Among Veterans of the Vietnam War.

    Science.gov (United States)

    Schlenger, William E; Mulvaney-Day, Norah; Williams, Christianna S; Kulka, Richard A; Corry, Nida H; Mauch, Danna; Nagler, Caryn F; Ho, Chia-Lin; Marmar, Charles R

    2016-05-01

    The primary goal of this analysis was to assess whether recent use of outpatient services for general medical concerns by Vietnam veterans varies according to level of posttraumatic stress disorder (PTSD) symptomatology over time. Another goal was to determine whether PTSD symptomatology was associated with veterans' reports of discussing behavioral health issues as part of a general medical visit. Self-reported service use data and measures of PTSD were from a nationally representative sample of 848 male and female Vietnam theater veterans (individuals who were deployed to the Vietnam theater of operations) who participated in the National Vietnam Veterans Longitudinal Study, a 25-year follow-up of a cohort of veterans originally interviewed from 1984-1988 as part of the National Vietnam Veterans Readjustment Study. Four categories of PTSD symptomatology course over 25 years were defined, and logistic regression models were used to assess their relationship with recent use of outpatient general medical services. Male and female theater veterans with high or increasing PTSD symptomatology over the period were more likely than those with low symptomatology to report recent VA outpatient visits. Males in the increasing and high categories were also more likely to discuss behavioral health issues at general medical visits. Vietnam veterans with high and increasing PTSD symptomatology over time were likely to use VA outpatient general health services. Attention to stressors of the aging process and to persistence of PTSD symptoms is important for Vietnam veterans, as is addressing PTSD with other psychiatric and medical comorbidities within the context of outpatient general medical care.

  7. Food-addiction scale measurement in 2 cohorts of middle-aged and older women123

    Science.gov (United States)

    Gearhardt, Ashley N; Corbin, William R; Brownell, Kelly D; Field, Alison E; Rimm, Eric B

    2014-01-01

    Background: Excess weight is a major threat to public health. An addiction-like tendency toward certain foods may contribute to overeating. Objective: We aimed to describe the prevalence and associated characteristics in relation to a food-addiction scale in middle-aged and older women. Design: We examined the prevalence and associated characteristics of a food-addiction scale measure in a cross-sectional analysis of 134,175 women participating in 2 ongoing prospective cohort studies of US nurses. Results: Overall, 7839 (5.8%) of the women surveyed met the criteria for food addiction measured by using the modified Yale Food Addiction Scale. The prevalence of food addiction was 8.4% in the younger cohort of women aged 45–64 y and 2.7% in the older cohort of women aged 62–88 y. In the multivariate model, body mass index (BMI; in kg/m2) ≥35.0 (compared with 18.5–22.9) was associated with food addiction, a prevalence ratio (PR) of 15.83 (95% CI: 12.58, 19.91) in the younger cohort of women, and a PR of 18.41 (95% CI: 11.63, 29.14) in the older cohort of women. Several other demographic characteristics and other factors were associated with the food-addiction measure in both cohorts of women. Conclusions: To our knowledge, for the first time in a large, US-based population of women, we documented the prevalence of food addiction by using a novel measurement scale in middle-aged and older women. The results may provide insight into the strong association between behavioral attributes of food consumption and the development of obesity. PMID:24452236

  8. MTHFR polymorphisms and cognitive ageing in the ninth decade: the Lothian Bith Cohort 1921

    NARCIS (Netherlands)

    Schiepers, Olga; Van Boxtel, Martin; Harris, Sarah; Gow, Alan; Pattie, Alison; Brett, Caroline; De Groot, Renate; Jolles, Jelle; Starr, John; Deary, Ian

    2012-01-01

    Schiepers, O. J. G., Van Boxtel, M. P. J., Harris, S. E., Gow, A. J., Pattie, A., Brett, C. E., De Groot, R. H. M., Jolles, J., Starr, J. M., & Deary, I. J. (2011). MTHFR polymorphisms and cognitive ageing in the ninth decade: the Lothian Birth Cohort 1921. Genes Brain and Behavior, 10, 354-364.

  9. Optimal timing of delivery in small for gestational age fetuses near term: a national cohort study

    NARCIS (Netherlands)

    Kazemier, B. M.; Voskamp, B. J.; Ravelli, A. C. J.; Pajkrt, E.; de Groot, C. J. M.; Mol, B. W. J.

    2015-01-01

    Our aim was to study the competing risks of antepartum versus intrapartum/neonatal death in small for gestational age (SGA) and non-SGA fetuses. We performed a national cohort study using all singletons delivered between 36 and 42(6/7) weeks without hypertension, preeclampsia, diabetes, congenital

  10. Age, period, or birth cohort: What determines demographic differences in seafood consumption?

    DEFF Research Database (Denmark)

    Scholderer, Joachim; Lund, Eiliv; Trondsen, Torbjørn

    , the relative size of the effects suggests that either (a) a positive effect of period is neutralized by a negative effect of birth cohort, resulting in a zero net effect for the period under investigation, or (b) that both effects are peripheral, caused by an underlying biological-ageing effect. Total...

  11. Menarcheal Age and Risk of Type 2 Diabetes: A Community-Based Cohort Study

    OpenAIRE

    Farahmand, Maryam; Tehrani, Fahimeh Ramezani; Dovom, Marzieh Rostami; Azizi, Fereidoun

    2017-01-01

    Objective: It has been reported that early menarche is associated with higher risk for type 2 diabetes. We aimed to explore the association between age at menarche and risk of type 2 diabetes in a population-based cohort study. Methods: For the purpose of the present study, 5191 subjects of reproductive age who were participants of the Tehran Lipid and Glucose Study and also met the eligibility criteria were selected. Demographic, lifestyle, reproductive, and anthropometric data as well as ri...

  12. Evolution of obesity prevalence in France: an age-period-cohort analysis

    Science.gov (United States)

    Diouf, Ibrahima; Charles, Marie Aline; Ducimetière, Pierre; Basdevant, Arnaud; Eschwege, Evelyne; Heude, Barbara

    2010-01-01

    Background A rapid increase in the prevalence of obesity has been reported in France since 1990. We investigated the impact of birth cohort on the changes in obesity prevalence after taking into account age and survey period. Methods We analyzed data from four national surveys in 1997, 2000, 2003 and 2006. For each survey, self-reported data on weight and height were recorded on mailed questionnaires sent to a sample of 20 000 households, representative of the French population. Obesity was defined according to WHO criteria, BMI ≥ 30 kg/m2. We modeled the prevalence of obesity using logistic regression with age, cohort and period as explanatory variables. As these variables are linearly dependent, only nonlinear effects can be estimated uniquely and interpreted, after including specific chosen constraints in the models. Results There was a progressive increase in the prevalence of obesity between 1997 and 2006, attributable either to a period or to a cohort effect. There was a substantial departure from a linear trend for the cohort effect only, which appeared to be stronger in women: there was an acceleration in the prevalence of obesity with birth cohort for individuals born after the mid-1960s, in both sexes. Conclusions Our results are consistent with previous studies in other countries. Compared with older generations, men and women born in the late 1960s may have been subject to early exposures that increased their lifelong susceptibility to obesity. PMID:20375843

  13. Is hypertension in adult age related to unemployment at a young age? Results from the Northern Swedish Cohort.

    Science.gov (United States)

    Nygren, Karina; Gong, Weidan; Hammarström, Anne

    2015-02-01

    The aim of this study was to analyse the relationship between early unemployment (ages 16-21 years) and adult hypertension after controlling for earlier hypertension, unemployment in adult life, risk factors for hypertension and confounders. A cohort of 927 (86.6% of the original cohort) 9th grade school-leavers was followed from 1981 until 2008. Data were collected through questionnaires, health examinations, and national registers. Univariate and multivariate logistic regression were used as primary statistical methods. At ages 21 and 43, hypertension was significantly more prevalent among men than women (p Unemployment between the ages of 16 and 21 was related to hypertension at age 43 among women but not men. The odds ratio (OR) was persistently high (OR 3.16 [95% confidence interval 1.45-6.89]) after controlling for late unemployment, hypertension at age 16, risk factors for hypertension and confounders. There was no significant relationship between exposure to early unemployment and hypertension at age 21 for women or men. From a public health perspective, youth unemployment is a societal problem in need of more attention and intervention in order to prevent long-term adverse health outcomes. © 2014 the Nordic Societies of Public Health.

  14. Generational cohorts, age at arrival, and access to health services among Asian and Latino immigrant adults.

    Science.gov (United States)

    Kao, Dennis T

    2009-05-01

    Recent immigrant assimilation literature has highlighted the tremendous heterogeneity that exists within foreign-born and U.S.-born second generation populations-and thus, the importance of a broader generational cohort framework that encompasses nativity, immigrant generation, age at arrival, and parental nativity. Using data from the 2003 California Health Interview Survey, this paper examines generational cohort differences in access to health services among Asian and Latino immigrant adults. Results showed that immigrants arriving in the U.S. as children had better access to services, one exception being middle-aged and older Asians. Individuals arriving in the U.S. as adults were significantly less likely than the third-and-later generation to have a usual source of care, and also had fewer physician visits. Across all cohorts, Latinos fared worse than both Asians and Whites. This study highlights the value of a generational cohort framework-specifically, the importance of age at arrival-in examining health access among immigrants.

  15. Economic Stressors and Psychological Distress: Exploring Age Cohort Variation in the Wake of the Great Recession.

    Science.gov (United States)

    Brown, Robyn Lewis; Richman, Judith A; Rospenda, Kathleen M

    2017-08-01

    This study examined processes linking age cohort, economic stressors, coping strategies and two indicators of psychological distress (i.e. depressive symptoms and anxiety symptoms). Structural equation models were conducted utilizing data from a national survey that was undertaken in order to understand life change consequences of the period of economic downturn from 2007 to 2009 known as the Great Recession. Findings revealed that the associations between economic stressors and symptoms of both depression and anxiety were significantly greater for members of the millennial cohort compared with baby boomers. These effects are partly explained by the greater tendency of members of the baby boomer cohort to use active coping strategies. These findings clarify the circumstances in which age matters most for the associations among economy-related stressors, coping strategies and psychological well-being. They highlight how difficult economic circumstances influence the availability of coping strategies and, in turn, psychological well-being-and differently for younger and older age cohorts. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  16. Cohort Study of Severe Bronchiolitis during Infancy and Risk of Asthma by Age 5 Years.

    Science.gov (United States)

    Balekian, Diana S; Linnemann, Rachel W; Hasegawa, Kohei; Thadhani, Ravi; Camargo, Carlos A

    Severe bronchiolitis (ie, bronchiolitis requiring hospital admission) is thought to markedly increase asthma risk, with 30%-50% developing asthma by age 5 years. To date, studies of this association are small, and most are from outside the United States. The objective of this study was to investigate the association between severe bronchiolitis and risk of asthma in a US birth cohort. We studied a cohort nested within the Massachusetts General Hospital Obstetric Maternal Study (MOMS), a prospective cohort of pregnant women enrolled during 1998-2006. Children of mothers enrolled in MOMS were included in the analysis if they received care within our health system (n = 3653). Diagnoses and medications were extracted from the children's electronic health records; we also examined pregnancy and perinatal risk factors collected for the underlying pregnancy study. The birth cohort was 52% male, 49% white, and 105 infants (2.9%) had severe bronchiolitis. Overall, 421 children (11.5%) developed asthma by age 5 years. Among the children with severe bronchiolitis, 27.6% developed asthma by age 5 years. In multivariable logistic regression adjusting for 12 risk factors, severe bronchiolitis remained a strong risk factor for developing asthma by age 5 years (odds ratio 2.57; 95% confidence interval 1.61-4.09). In a large Boston birth cohort, the frequency of severe bronchiolitis and childhood asthma was similar to published data. Among children with severe bronchiolitis, the risk of developing asthma was lower than prior studies but still high (27.6%). This difference may be due to different study designs, populations, and outcome definitions studied. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  17. Recent hip fracture trends in Sweden and Denmark with age-period-cohort effects

    DEFF Research Database (Denmark)

    Rosengren, B E; Björk, J; Cooper, C

    2017-01-01

    born thereafter however seem to have a higher hip fracture risk, and we expect a reversal of the present decline in rates, with increasing hip fracture rates in both Denmark and Sweden during the upcoming decade. CONCLUSIONS: Time trends, cohort, and period effects were different in SE and DK. This may......This study used nationwide hip fracture data from Denmark and Sweden during 1987-2010 to examine effects of (birth) cohort and period. We found that time trends, cohort, and period effects were different in the two countries. Results also indicated that hip fracture rates may increase in the not so...... far future. INTRODUCTION: The reasons for the downturn in hip fracture rates remain largely unclear but circumstances earlier in life seem important. METHODS: We ascertained hip fractures in the populations ≥50 years in Denmark and Sweden in national discharge registers. Country- and sex-specific age...

  18. Age-related changes in cortical bone mass: data from a German female cohort

    Energy Technology Data Exchange (ETDEWEB)

    Toledo, V.A. Molina; Jergas, M. [St. Elisabeth-Krankenhaus, Department of Diagnostic and Interventional Radiology, Cologne (Germany)

    2006-04-15

    To describe data from digital radiogrammetry (DXR) in an unselected German female cohort over a wide age range. Using a retrospective study design we analyzed radiographs of the hand from 540 German women (aged 5-96 years) using an automated assessment of cortical thickness, metacarpal index (MCI), and estimated cortical bone mineral density (DXR-BMD) on digitized radiographs. Both hands were radiographed in 97 women. In this group DXR-BMD and cortical thickness were significantly higher in the right metacarpals while there was no significant difference in MCI. To study the association with age we differentiated young (<20 years), middle-aged (20-45 years), and an older patients (>45 years). In young women all parameters increased significantly with age in a linear fashion (r=0.8 for DXR-BMD, r=0.7 for MCI). In those aged 25-45 years DXR-BMD and MCI were highest (peak bone mass). In women aged 45 or older all parameters decreased with age in an almost linear fashion with an annual change ranging from 0.7% to 0.9%. Our results for an unselected German female cohort indicate that DXR is a reliable, widely available osteodensitometric technique based on the refinement of conventional radiogrammetry. These findings are comparable to those from other studies and represent a valid resource for clinical application and for comparisons with other ethnic groups. (orig.)

  19. Recent hip fracture trends in Sweden and Denmark with age-period-cohort effects.

    Science.gov (United States)

    Rosengren, B E; Björk, J; Cooper, C; Abrahamsen, B

    2017-01-01

    This study used nationwide hip fracture data from Denmark and Sweden during 1987-2010 to examine effects of (birth) cohort and period. We found that time trends, cohort, and period effects were different in the two countries. Results also indicated that hip fracture rates may increase in the not so far future. The reasons for the downturn in hip fracture rates remain largely unclear but circumstances earlier in life seem important. We ascertained hip fractures in the populations ≥50 years in Denmark and Sweden in national discharge registers. Country- and sex-specific age-period-cohort (APC) effects during 1987-2010 were evaluated by log-likelihood estimates in Poisson regression models presented as incidence rate ratios (IRR). There were 399,596 hip fractures in SE and 248,773 in DK. Age-standardized hip fracture rate was stable in SE men but decreased in SE women and in DK. Combined period + cohort effects were generally stronger in SE than DK and in women than men. IRR per period ranged from 1.05 to 1.30 in SE and 0.95 to 1.21 in DK. IRR per birth cohort ranged from 1.07 to 3.13 in SE and 0.77 to 1.67 in DK. Relative period effects decreased with successive period in SE and described a convex curve in DK. Relative cohort effects increased with successive birth cohort in both countries but with lower risks for DK women and men and SE women born around the 1930s (age 75-86 years today and responsible for most hip fractures) partly explaining the recent downturn. Men and women born thereafter however seem to have a higher hip fracture risk, and we expect a reversal of the present decline in rates, with increasing hip fracture rates in both Denmark and Sweden during the upcoming decade. Time trends, cohort, and period effects were different in SE and DK. This may reflect differences in general health as evident in known differences in life expectancy, healthcare organization, and prevention such as use of anti-osteoporosis drugs. Analyses indicate that hip

  20. Support for Marijuana (Cannabis Legalization: Untangling Age, Period, and Cohort Effects

    Directory of Open Access Journals (Sweden)

    William Campbell

    2017-02-01

    Full Text Available In three large, nationally representative surveys of U.S. 12th graders, college students, and adults ('N' = 9 million conducted 1968–2015, Americans became significantly more supportive of legal marijuana (cannabis starting in the mid-1980’s. Hierarchical models using age-period-cohort analysis on the adult (General Social Survey sample showed that the increased support for legalization is primarily a time period effect rather than generational or age effect; thus, Americans of all ages became more supportive of legal marijuana. Among 12th graders, support for marijuana legalization was closely linked to perceptions of marijuana safety.

  1. The Life Course, Cohort Dynamics, and International Differences in Aging Trajectories.

    Science.gov (United States)

    Haas, Steven A; Oi, Katsuya; Zhou, Zhangjun

    2017-12-01

    In recent years, population health research has focused on understanding the determinants of later-life health. Two strands of that work have focused on (1) international comparisons of later-life health and (2) assessing the early-life origins of disease and disability and the importance of life course processes. However, the less frequently examined intersection of these approaches remains an important frontier. The present study contributes to the integration of these approaches. We use the Health and Retirement Study family of data sets and a cohort dynamic approach to compare functional health trajectories across 12 high-income countries and to examine the role of life course processes and cohort dynamics in contributing to variation in those trajectories. We find substantial international variation in functional health trajectories and an important role of cohort dynamics in generating that variation, with younger cohorts often less healthy at comparable ages than the older cohorts they are replacing. We further find evidence of heterogeneous effects of life course processes on health trajectories. The results have important implications for future trends in morbidity and mortality as well as public policy.

  2. Birth cohort differences in cardiovascular risk factors in a Brazilian population of older elderly: the Bambuí cohort study of aging (1997 and 2008

    Directory of Open Access Journals (Sweden)

    Marco Polo Dias Freitas

    2011-01-01

    Full Text Available The aim of this study was to investigate whether cohort differences exist in the prevalence of cardiovascular risk factors among older elderly from the Bambuí Cohort Study of Aging. Participants were those aged 71-81 years at two points in time a decade apart: 457 in 1997 (earlier cohort and 553 in 2008 (recent cohort. The prevalence of hypertension (PR = 1.27; 95%CI: 1.19-1.36 and of diabetes mellitus (PR = 1.39; 95%CI: 1.06-1.83 was higher in the recent cohort compared to the earlier one, regardless of sex. The recent cohort had a lower prevalence of smoking (PR = 0.58; 95%CI: 0.42-0.80, and lower total cholesterol/HDL cholesterol ratio level (PR = 0.85; 95%CI: 0.80-0.89. There was a 136% increase in the pharmacologic treatment of diabetes and a 56% increase in pharmacologic management of hypertension in 2008 in comparison with 1997. Overall, the number of cardiovascular risk factors in the recent cohort remained similar to that of the early cohort.

  3. A Novel Approach for Analysis of the Log-Linear Age-Period-Cohort Model: Application to Lung Cancer Incidence

    Directory of Open Access Journals (Sweden)

    Tengiz Mdzinarishvili

    2009-12-01

    Full Text Available A simple, computationally efficient procedure for analyses of the time period and birth cohort effects on the distribution of the age-specific incidence rates of cancers is proposed. Assuming that cohort effects for neighboring cohorts are almost equal and using the Log-Linear Age-Period-Cohort Model, this procedure allows one to evaluate temporal trends and birth cohort variations of any type of cancer without prior knowledge of the hazard function. This procedure was used to estimate the influence of time period and birth cohort effects on the distribution of the age-specific incidence rates of first primary, microscopically confirmed lung cancer (LC cases from the SEER9 database. It was shown that since 1975, the time period effect coefficients for men increase up to 1980 and then decrease until 2004. For women, these coefficients increase from 1975 up to 1990 and then remain nearly constant. The LC birth cohort effect coefficients for men and women increase from the cohort of 1890–94 until the cohort of 1925–29, then decrease until the cohort of 1950–54 and then remain almost unchanged. Overall, LC incidence rates, adjusted by period and cohort effects, increase up to the age of about 72–75, turn over, and then fall after the age of 75–78. The peak of the adjusted rates in men is around the age of 77–78, while in women, it is around the age of 72–73. Therefore, these results suggest that the age distribution of the incidence rates in men and women fall at old ages.

  4. The Lothian Birth Cohort 1936: a study to examine influences on cognitive ageing from age 11 to age 70 and beyond

    Directory of Open Access Journals (Sweden)

    Whalley Lawrence J

    2007-12-01

    Full Text Available Abstract Background Cognitive ageing is a major burden for society and a major influence in lowering people's independence and quality of life. It is the most feared aspect of ageing. There are large individual differences in age-related cognitive changes. Seeking the determinants of cognitive ageing is a research priority. A limitation of many studies is the lack of a sufficiently long period between cognitive assessments to examine determinants. Here, the aim is to examine influences on cognitive ageing between childhood and old age. Methods/Design The study is designed as a follow-up cohort study. The participants comprise surviving members of the Scottish Mental Survey of 1947 (SMS1947; N = 70,805 who reside in the Edinburgh area (Lothian of Scotland. The SMS1947 applied a valid test of general intelligence to all children born in 1936 and attending Scottish schools in June 1947. A total of 1091 participants make up the Lothian Birth Cohort 1936. They undertook: a medical interview and examination; physical fitness testing; extensive cognitive testing (reasoning, memory, speed of information processing, and executive function; personality, quality of life and other psycho-social questionnaires; and a food frequency questionnaire. They have taken the same mental ability test (the Moray House Test No. 12 at age 11 and age 70. They provided blood samples for DNA extraction and testing and other biomarker analyses. Here we describe the background and aims of the study, the recruitment procedures and details of numbers tested, and the details of all examinations. Discussion The principal strength of this cohort is the rarely captured phenotype of lifetime cognitive change. There is additional rich information to examine the determinants of individual differences in this lifetime cognitive change. This protocol report is important in alerting other researchers to the data available in the cohort.

  5. Effect of women's age on embryo morphology, cleavage rate and competence-A multicenter cohort study

    DEFF Research Database (Denmark)

    Grøndahl, Marie Louise; Christiansen, Sofie Lindgren; Kesmodel, Ulrik Schiøler

    2017-01-01

    .0001) with increasing age. Maternal age had no effect on cleavage parameters or on the morphology of the embryo day 2 post insemination. Interestingly, initial hCG value after single embryo transfer followed by ongoing pregnancy was increased with age in both IVF (p = 0.007) and ICSI (p = 0.001) cycles. For the first...... time, we show that a woman's age does impose a significant footprint on early embryo morphological development (3PN). In addition, the developmentally competent embryos were associated with increased initial hCG values as the age of the women increased. Further studies are needed to elucidate......This multicenter cohort study on embryo assessment and outcome data from 11,744 IVF/ICSI cycles with 104,830 oocytes and 42,074 embryos, presents the effect of women's age on oocyte, zygote, embryo morphology and cleavage parameters, as well as cycle outcome measures corrected for confounding...

  6. Serum 2,3,7,8-tetrachlorodibenzo-p-dioxin levels and their association with age, body mass index, smoking, military record-based variables, and estimated exposure to Agent Orange in Korean Vietnam veterans.

    Science.gov (United States)

    Yi, Sang-Wook; Ohrr, Heechoul; Won, Jong-Uk; Song, Jae-Seok; Hong, Jae-Seok

    2013-09-01

    The aim of this study was to examine the levels of serum 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and evaluate their association with age, body mass index, smoking, military record-based variables, and estimated exposure to Agent Orange in Korean Vietnam veterans. Serum levels of TCDD were analyzed in 102 Vietnam veterans. Information on age, body mass index, and smoking status were obtained from a self-reported questionnaire. The perceived exposure was assessed by a 6-item questionnaire. Two proximity-based exposures were constructed by division/brigade level and battalion/company level unit information using the Stellman exposure opportunity index model. The mean and median of serum TCDD levels was 1.2 parts per trillion (ppt) and 0.9 ppt, respectively. Only 2 Vietnam veterans had elevated levels of TCDD (>10 ppt). The levels of TCDD did not tend to increase with the likelihood of exposure to Agent Orange, as estimated from either proximity-based exposure or perceived self-reported exposure. The serum TCDD levels were not significantly different according to military unit, year of first deployment, duration of deployment, military rank, age, body mass index, and smoking status. The average serum TCDD levels in the Korean Vietnam veterans were lower than those reported for other occupationally or environmentally exposed groups and US Vietnam veterans, and their use as an objective marker of Agent Orange exposure may have some limitations. The unit of deployment, duration of deployment, year of first deployment, military rank, perceived self-reported exposure, and proximity-based exposure to Agent Orange were not associated with TCDD levels in Korean Vietnam veterans. Age, body mass index and smoking also were not associated with TCDD levels.

  7. Activity participation and cognitive aging from age 50 to 80 in the glostrup 1914 cohort

    DEFF Research Database (Denmark)

    Gow, Alan J; Mortensen, Erik L; Avlund, Kirsten

    2012-01-01

    To examine the cognitively protective effect of leisure and physical activities while accounting for prior cognitive ability, a rarely considered confounder of the previously reported associations between activity and cognitive aging.......To examine the cognitively protective effect of leisure and physical activities while accounting for prior cognitive ability, a rarely considered confounder of the previously reported associations between activity and cognitive aging....

  8. Age-period-cohort analysis of hepatitis A incidence rates in Korea from 2002 to 2012.

    Science.gov (United States)

    Seo, Joo Yeon; Choi, Sungyong; Choi, BoYoul; Ki, Moran

    2016-01-01

    This study aimed to evaluate the epidemiology of hepatitis A in Korea from 2002 to 2012 using age-period-cohort analyses. We used claims data from the Korean National Health Insurance Corporation for the entire population. Census data from 2010 were used as the standard population. The incidence of hepatitis A was assumed to have a Poisson distribution, and the models and effects were evaluated using the intrinsic estimator method, the likelihood ratio, and the Akaike information criterion. The incidence of hepatitis A gradually increased until 2007 (from 17.55 to 35.72 per 100,000 population) and peaked in 2009 (177.47 per 100,000 population). The highest incidence was observed among 27-29-year-old individuals when we omitted data from 2005 to 2007. From 2005 to 2007, the peak incidence was observed among 24-26-year-old individuals, followed by 27-29-year-olds. The best model fits were observed when the age-period-cohort variables were all considered at the same time for males, females, and the whole population. The incidence of hepatitis A exhibited significant age-period-cohort effects; its incidence peaked in 2009 and was especially high among Koreans 20-39 years of age. These epidemiological patterns may help predict when high incidence rates of hepatitis A may occur in developing countries during their socioeconomic development.

  9. Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort.

    Directory of Open Access Journals (Sweden)

    Louise C Kenny

    Full Text Available BACKGROUND: Recent decades have witnessed an increase in mean maternal age at childbirth in most high-resourced countries. Advanced maternal age has been associated with several adverse maternal and perinatal outcomes. Although there are many studies on this topic, data from large contemporary population-based cohorts that controls for demographic variables known to influence perinatal outcomes is limited. METHODS: We performed a population-based cohort study using data on all singleton births in 2004-2008 from the North Western Perinatal Survey based at The University of Manchester, UK. We compared pregnancy outcomes in women aged 30-34, 35-39 and ≥40 years with women aged 20-29 years using log-linear binomial regression. Models were adjusted for parity, ethnicity, social deprivation score and body mass index. RESULTS: The final study cohort consisted of 215,344 births; 122,307 mothers (54.19% were aged 20-29 years, 62,371(27.63% were aged 30-34 years, 33,966(15.05% were aged 35-39 years and 7,066(3.13% were aged ≥40 years. Women aged 40+ at delivery were at increased risk of stillbirth (RR = 1.83, [95% CI 1.37-2.43], pre-term (RR = 1.25, [95% CI: 1.14-1.36] and very pre-term birth (RR = 1.29, [95% CI:1.08-1.55], Macrosomia (RR = 1.31, [95% CI: 1.12-1.54], extremely large for gestational age (RR = 1.40, [95% CI: 1.25-1.58] and Caesarean delivery (RR = 1.83, [95% CI: 1.77-1.90]. CONCLUSIONS: Advanced maternal age is associated with a range of adverse pregnancy outcomes. These risks are independent of parity and remain after adjusting for the ameliorating effects of higher socioeconomic status. The data from this large contemporary cohort will be of interest to healthcare providers and women and will facilitate evidence based counselling of older expectant mothers.

  10. Health Programs for Veterans

    Science.gov (United States)

    ... Health Administration » Health Programs for Veterans Veterans Health Administration Health Programs for Veterans Beyond the doctors and ... families of patients receiving medical care at major military and VA medical centers Geriatrics & Extended Care Geriatric ...

  11. Trajectories of frailty among Chinese older people in Hong Kong between 2001 and 2012: an age-period-cohort analysis.

    Science.gov (United States)

    Yu, Ruby; Wong, Moses; Chong, K C; Chang, Billy; Lum, C M; Auyeung, T W; Lee, Jenny; Lee, Ruby; Woo, Jean

    2017-11-17

    there is little evidence to suggest that older people today are living in better health than their predecessors did at the same age. Only a few studies have evaluated whether there are birth cohort effects on frailty, an indicator of health in older people, encompassing physical, functional and mental health dimensions. this study examined longitudinal trajectories of frailty among Chinese older people in Hong Kong. this study utilised data from the 18 Elderly Health Centres of the Department of Health comprising a total of 417,949 observations from 94,550 community-dwelling Chinese people aged ≥65 years in one early birth cohort (1901-23) and four later birth cohorts (1924-29, 1930-35, 1936-41, 1942-47) collected between 2001 and 2012, to examine trajectories of the frailty index and how birth cohorts may have contributed to the trends using an age-period-cohort analysis. more recent cohorts had higher levels of frailty than did earlier cohorts at the same age, controlling for period, gender, marital status, educational levels, socioeconomic status, lifestyle and social factors. Older age, being female, widowhood, lower education and smoking were associated with higher levels of frailty. more recent cohorts had higher levels of frailty than did earlier cohorts. Frailty interventions, coupled with early detection, should be developed to combat the increasing rates of frailty in Hong Kong Chinese.

  12. Qualitative analysis of couples' experience with prostate cancer by age cohort.

    Science.gov (United States)

    Harden, Janet K; Northouse, Laurel L; Mood, Darlene W

    2006-01-01

    Prostate cancer is a significant cause of morbidity and mortality in men in all adult life stages. Normative developmental tasks of aging combined with disease-related stressors may negatively affect adjustment to prostate cancer and, consequently, affect the quality of life of both the man and his spouse. The purpose of this study was to examine the experiences of men with prostate cancer and their partners according to their life cycle cohort: 50-64 (late middle age), 65-74 (young-old), and 75-84 (old-old). Qualitative interviews with 15 couples were used to provide information about the dyad's experiences with prostate cancer. Interview data were analyzed to identify preliminary coding schemas, which were subsequently refined and modified into themes. Three major themes were identified from the data. Across all age groups, prostate cancer had a significant effect on: (1) couples' daily lives, (2) their dyadic and family relationships, and (3) their developmental stage. There were also differences in age groups. Couples in the late middle age group reported greater disappointment and anger at their inability to reach life goals and establish financial security. Couples in the young-old group made more spontaneous comments about being satisfied with their life than the couples in the other 2 groups. Couples in the old-old group reported slower recovery from the illness than the younger couples. Results indicate that although prostate cancer may have some universal effects on couples, it also may have differential effects by age cohort. Hence, targeted interventions by age cohort may be warranted.

  13. Age-specific contributions to changes in the period and cohort life expectancy

    DEFF Research Database (Denmark)

    Canudas-Romo, Vladimir; Schoen, Robert

    2005-01-01

    Period life expectancy has increased more slowly than its cohort counterpart. This paper explores the differences between life expectancies at a given time (the gap) and the time required for period life expectancy to reach the current level of cohort life expectancy (the lag). Additionally......, to understand the disparity between the two life expectancies we identify and compare age-specific contributions to change in life expectancy. Using mortality models and historical data for Sweden, we examine the effect of mortality changes over time. Our results indicate that the widening of the gap between...... the two life expectancies is primarily a consequence of the dramatic mortality decline at older ages that occurred during the twentieth century. These results imply that the divergence between the two measures is likely to become even greater in the future as reductions in deaths are concentrated at older...

  14. Trends in mortality from septicaemia and pneumonia with economic development: an age-period-cohort analysis.

    Directory of Open Access Journals (Sweden)

    Irene O L Wong

    Full Text Available BACKGROUND: Hong Kong population has experienced drastic changes in its economic development in the 1940s. Taking advantage of Hong Kong's unique demographic and socioeconomic history, characterized by massive, punctuated migration waves from Southern China, and recent, rapid transition from a pre-industrialized society to the first ethnic Chinese community reaching "first world" status over the last 60 years (i.e., in two or three generations, we examined the longitudinal trends in infection related mortality including septicemia compared to trends in non-bacterial pneumonia to generate hypotheses for further testing in other recently transitioned economies and to provide generalized aetiological insights on how economic transition affects infection-related mortality. METHODS: We used deaths from septicemia and pneumonia not specified as bacterial, and population figures in Hong Kong from 1976-2005. We fitted age-period-cohort models to decompose septicemia and non-bacterial pneumonia mortality rates into age, period and cohort effects. RESULTS: Septicaemia-related deaths increased exponentially with age, with a downturn by period. The birth cohort curves had downward inflections in both sexes in the 1940s, with a steeper deceleration for women. Non-bacterial pneumonia-related deaths also increased exponentially with age, but the birth cohort patterns showed no downturns for those born in the 1940s. CONCLUSION: The observed changes appeared to suggest that better early life conditions may enable better development of adaptive immunity, thus enhancing immunity against bacterial infections, with greater benefits for women than men. Given the interaction between the immune system and the gonadotropic axis, these observations are compatible with the hypothesis that upregulation of the gonadotropic axis underlies some of the changes in disease patterns with economic development.

  15. Universal gestational age effects on cognitive and basic mathematic processing : 2 cohorts in 2 countries

    OpenAIRE

    Wolke, Dieter; Strauss, Vicky Yu-Chun; Johnson, Samantha J.; Gilmore, Camilla; Marlow, Neil; Jaekel, Julia

    2015-01-01

    Objective:\\ud To determine whether general cognitive ability, basic mathematic processing, and mathematic attainment are universally affected by gestation at birth, as well as whether mathematic attainment is more strongly associated with cohort-specific factors such as schooling than basic cognitive and mathematical abilities.\\ud \\ud Study design:\\ud The Bavarian Longitudinal Study (BLS, 1289 children, 27-41 weeks gestational age [GA]) was used to estimate effects of GA on IQ, basic mathemat...

  16. Universal Gestational Age Effects on Cognitive and Basic Mathematic Processing: 2 Cohorts in 2 Countries

    OpenAIRE

    Wolke, Dieter; Strauss, Vicky Yu-Chun; Johnson, Samantha; Gilmore, Camilla; Marlow, Neil; Jaekel, Julia

    2015-01-01

    Objective To determine whether general cognitive ability, basic mathematic processing, and mathematic attainment are universally affected by gestation at birth, as well as whether mathematic attainment is more strongly associated with cohort-specific factors such as schooling than basic cognitive and mathematical abilities. Study design The Bavarian Longitudinal Study (BLS, 1289 children, 27-41?weeks gestational age [GA]) was used to estimate effects of GA on IQ, basic mathematic processing, ...

  17. Sex, BMI and age differences in metabolic syndrome: the Dutch Lifelines Cohort Study

    Science.gov (United States)

    Slagter, Sandra N; van Waateringe, Robert P; van Beek, André P; van der Klauw, Melanie M; van Vliet-Ostaptchouk, Jana V

    2017-01-01

    Introduction To evaluate the prevalence of metabolic syndrome (MetS) and its individual components within sex-, body mass index (BMI)- and age combined clusters. In addition, we used the age-adjusted blood pressure thresholds to demonstrate the effect on the prevalence of MetS and elevated blood pressure. Subjects and methods Cross-sectional data from 74,531 Western European participants, aged 18–79 years, were used from the Dutch Lifelines Cohort Study. MetS was defined according to the revised NCEP-ATPIII. Age-adjusted blood pressure thresholds were defined as recommended by the eight reports of the Joint National Committee (≥140/90 mmHg for those aged ATPIII, results in an overestimation of MetS prevalence. PMID:28420718

  18. Long-term trends in major cardiovascular risk factors in cohorts in aging men in the European cohorts of the Seven countries study

    OpenAIRE

    Lanti, M; Nedeljkovic, S; Nissinen, A; Kafatos, A. (Anthony); Kromhout, D.

    2005-01-01

    ACKGROUND AND AIMS: Time trends in major cardiovascular risk factors are described in cohorts of middle-aged men followed for 35 years in 9 European cohorts of Finland, The Netherlands, Italy, Serbia and Greece. METHODS: Men aged 40 to 59 years at entry in the early 1960s were repeatedly re-examined 3 to 5 times over the last 35 years. Systolic blood pressure, serum cholesterol, body weight and body mass index were considered for analysis, including study of aging (35 years of follow-up) and ...

  19. Cognitive Ageing in Great Britain in the New Century: Cohort Differences in Episodic Memory.

    Directory of Open Access Journals (Sweden)

    Gindo Tampubolon

    Full Text Available Dementias in high income countries are set to be the third major burden of disease even as older people are increasingly required to think for themselves how to provide for their lives in retirement. Meanwhile the period of older age continues to extend with increase in life expectancy. This challenge demands an understanding of how cognition changes over an extended period in later life. But studying cognitive ageing in the population faces a difficulty from the fact that older respondents are liable to leave (attrite before study completion. This study tested three hypotheses: trajectories of cognitive ageing in Britain show an improvement beyond the age of 50; and they are lifted by secular improvement in cognition across cohorts; lastly they are susceptible to distortion due to attrition.Using the English Longitudinal Study of Ageing, this paper studied trajectories of episodic memory of Britons aged 50-89 from 2002 to 2013 (N = 5931. Using joint models the analysis found that levels of episodic memory follow a curvilinear shape, not a steady decline, in later life. The findings also revealed secular improvement in cognitive ageing such that as a cohort is being replaced episodic memory levels in the population improve. The analysis lastly demonstrated that failure to simultaneously model attrition can produce distorted pictures of cognitive ageing.Old age in this century is not necessarily a period dominated by cognitive decline. In identifying behavioural factors associated with better cognitive ageing, such as social connections of traditional and online kinds, the paper raises possibilities of mustering an adequate response to the cognition challenge.

  20. Methylenetetrahydrofolate reductase (MTHFR) polymorphism A1298C (Glu429Ala) predicts decline in renal function over time in the African-American Study of Kidney Disease and Hypertension (AASK) Trial and Veterans Affairs Hypertension Cohort (VAHC).

    Science.gov (United States)

    Fung, Maple M; Salem, Rany M; Lipkowitz, Michael S; Bhatnagar, Vibha; Pandey, Braj; Schork, Nicholas J; O'Connor, Daniel T

    2012-01-01

    Hyperhomocysteinemia is associated with increased venous thrombosis and cardiovascular disease (CVD). Mutations in the human methylenetetrahydrofolate reductase (MTHFR) gene have been associated with increased homocysteine levels and risks of CVD in various populations including those with kidney disease. Here, we evaluated the influence of MTHFR variants on progressive loss of kidney function. We analyzed 821 subjects with hypertensive nephrosclerosis from the longitudinal National Institute of Diabetes and Digestive and Kidney Diseases African-American Study of Kidney Disease and Hypertension (AASK) Trial to determine whether decline in glomerular filtration rate (GFR) over ∼4.2 years was predicted by common genetic variation within MTHFR at non-synonymous positions C677T (Ala222Val) and A1298C (Glu429Ala) or by MTHFR haplotypes. The effect on GFR decline was then supported by a study of 1333 subjects from the San Diego Veterans Affairs Hypertension Cohort (VAHC), followed over ∼4.5 years. Linear effect models were utilized to determine both genotype [single-nucleotide polymorphism (SNP)] and genotype (SNP)-by-time interactions. In AASK, the polymorphism at A1298C predicted the rate of GFR decline: A1298/A1298 major allele homozygosity resulted in a less pronounced decline of GFR, with a significant SNP-by-time interaction. An independent follow-up study in the San Diego VAHC subjects supports that A1298/A1298 homozygotes have the greatest estimated GFR throughout the study. Haplotype analysis with C677T yielded concurring results. We conclude that the MTHFR-coding polymorphism at A1298C is associated with renal decline in African-Americans with hypertensive nephrosclerosis and is supported by a veteran cohort with a primary care diagnosis of hypertension. Further investigation is needed to confirm such findings and to determine what molecular mechanism may contribute to this association.

  1. Methylenetetrahydrofolate reductase (MTHFR) polymorphism A1298C (Glu429Ala) predicts decline in renal function over time in the African-American Study of Kidney Disease and Hypertension (AASK) Trial and Veterans Affairs Hypertension Cohort (VAHC)

    Science.gov (United States)

    Salem, Rany M.; Lipkowitz, Michael S.; Bhatnagar, Vibha; Pandey, Braj; Schork, Nicholas J.; O’Connor, Daniel T.

    2012-01-01

    Background. Hyperhomocysteinemia is associated with increased venous thrombosis and cardiovascular disease (CVD). Mutations in the human methylenetetrahydrofolate reductase (MTHFR) gene have been associated with increased homocysteine levels and risks of CVD in various populations including those with kidney disease. Here, we evaluated the influence of MTHFR variants on progressive loss of kidney function. Methods. We analyzed 821 subjects with hypertensive nephrosclerosis from the longitudinal National Institute of Diabetes and Digestive and Kidney Diseases African-American Study of Kidney Disease and Hypertension (AASK) Trial to determine whether decline in glomerular filtration rate (GFR) over ∼4.2 years was predicted by common genetic variation within MTHFR at non-synonymous positions C677T (Ala222Val) and A1298C (Glu429Ala) or by MTHFR haplotypes. The effect on GFR decline was then supported by a study of 1333 subjects from the San Diego Veterans Affairs Hypertension Cohort (VAHC), followed over ∼4.5 years. Linear effect models were utilized to determine both genotype [single-nucleotide polymorphism (SNP)] and genotype (SNP)-by-time interactions. Results. In AASK, the polymorphism at A1298C predicted the rate of GFR decline: A1298/A1298 major allele homozygosity resulted in a less pronounced decline of GFR, with a significant SNP-by-time interaction. An independent follow-up study in the San Diego VAHC subjects supports that A1298/A1298 homozygotes have the greatest estimated GFR throughout the study. Haplotype analysis with C677T yielded concurring results. Conclusion. We conclude that the MTHFR-coding polymorphism at A1298C is associated with renal decline in African-Americans with hypertensive nephrosclerosis and is supported by a veteran cohort with a primary care diagnosis of hypertension. Further investigation is needed to confirm such findings and to determine what molecular mechanism may contribute to this association. PMID:21613384

  2. Do Racial Disparities Exist in the Use of Prostate Cancer Screening and Detection Tools in Veterans?

    Science.gov (United States)

    Hudson, M’Liss A.; Luo, Suhong; Chrusciel, Timothy; Yan, Yan; Grubb, Robert L.; Carson, Kenneth; Scherrer, Jeffrey F.

    2014-01-01

    Objective To determine whether racial disparities exist in the use of prostate cancer screening and detection tools in veterans. Methods and Materials Administrative data was obtained from the Corporate Data Warehouse on a national cohort of 275,831 veterans (21% AA) ages 40–70 years who were free of heart disease, an elevated PSA level (> 4.0 ng/mL), other clinical signs of prostate cancer, prostate cancer diagnosis, and treatment for prostate cancer between 10/1/1998 – 9/30/2000. Subjects were followed until 9/30/2007. Regular users were defined as those with at least one annual visit to the Veterans Healthcare Administration (VHA) between 10/1/1998 and 9/30/2000. We sought to determine if race was significantly associated with PSA testing, time to elevated PSA detection, time to prostate biopsy and time to diagnosis of prostate cancer. Chi square tests, logistic regression and Cox proportional hazard models were used to test for associations between race and prostate cancer variables. Results 84% of veterans ages 40–70 years undergo PSA testing. AA veterans are as likely as white veterans to undergo PSA testing. Screened AA veterans are more likely to have a PSA > 4 ng/mL, undergo prostate biopsy and be diagnosed with prostate cancer than screened white veterans. The time intervals to undergoing a prostate biopsy and being diagnosed with prostate cancer were statistically significantly shorter (although unlikely of clinical significance) for AA veterans with a PSA level > 4 ng/mL than that for white veterans with a PSA level > 4 ng/mL. When routine care in regular VHA users was compared to that of participants in major screening trials such as Prostate, Lung, Ovarian and Colon Cancer (PLCO) Trial and European Study of Screening for Prostate Cancer (ERSPC), prostate biopsy rates were lower (30% versus 40–86%), prostate cancer detection rates/person biopsied were higher (49% versus 31–45%), and incidence of prostate cancer was 1.1% versus 4.9–8

  3. Do racial disparities exist in the use of prostate cancer screening and detection tools in veterans?

    Science.gov (United States)

    Hudson, M'Liss A; Luo, Suhong; Chrusciel, Timothy; Yan, Yan; Grubb, Robert L; Carson, Kenneth; Scherrer, Jeffrey F

    2014-01-01

    To determine whether racial disparities exist in the use of prostate cancer screening and detection tools in veterans. Administrative data were obtained from the Corporate Data Warehouse on a national cohort of 275,831 veterans (21% African American [AA]) between the ages of 40 and 70 years who were free of heart disease, did not have an elevated prostate specific antigen (PSA) level (>4 ng/ml), did not have other clinical signs of prostate cancer, had not been diagnosed with prostate cancer, and had not received treatment for prostate cancer between January 10, 1998 and September 30, 2000. Subjects were followed up until September 30, 2007. Regular users were defined as those with at least 1 annual visit to the Veterans Healthcare Administration (VHA) between October 1, 1998 and September 30, 2000. We sought to determine if race was significantly associated with PSA testing, the time to elevated PSA detection, the time to prostate biopsy, and the time to diagnosis of prostate cancer. Chi-square tests, logistic regression, and Cox proportional hazard models were used to test for associations between race and prostate cancer variables. Eighty-four percent of the veterans between the ages 40 and 70 years undergo PSA testing. AA veterans are as likely as white veterans to undergo PSA testing. Screened AA veterans are more likely to have a PSA>4 ng/ml, undergo prostate biopsy, and be diagnosed with prostate cancer than screened white veterans. The time intervals between undergoing a prostate biopsy and being diagnosed with prostate cancer were statistically significantly shorter (although unlikely of clinical significance) for AA veterans with a PSA level>4 ng/ml than that for white veterans with a PSA level>4 ng/ml. When routine care in regular VHA users was compared with that of participants in major screening trials such as Prostate, Lung, Ovarian and Colon Cancer Trial and European Study of Screening for Prostate Cancer, prostate biopsy rates were lower (30% vs. 40

  4. Musculoskeletal complaints while growing up from age 11 to age 14 : the PIAMA birth cohort study

    NARCIS (Netherlands)

    Picavet, H Susan J; Berentzen, Nina; Scheuer, Ninotsjka; Ostelo, Raymond W J G; Brunekreef, Bert; Smit, Henriette A; Wijga, Alet

    2016-01-01

    For musculoskeletal complaints (MSCs) among adults, several risk factors are known, but the most important determinant is an earlier episode of MSCs. Research has shifted to younger ages, showing a high prevalence of MSCs among children and adolescents. Our purpose was to evaluate the prevalence of

  5. Prediction of BMI at age 11 in a longitudinal sample of the Ulm Birth Cohort Study

    Science.gov (United States)

    Walter, Viola; Wabitsch, Martin; Rothenbacher, Dietrich; Brenner, Hermann; Schimmelmann, Benno G.

    2017-01-01

    Obesity is one of the greatest public health challenges in the world with childhood prevalence rates between 20–26% and numerous associated health risks. The aim of the current study was to analyze the 11-year follow-up data of the Ulm Birth Cohort Study (UBCS), to identify whether abnormal eating behavior patterns, especially restrained eating, predict body mass index (BMI) at 11 years of age and to explore other factors known to be longitudinally associated with it. Of the original UBCS, n = 422 children (~ 40% of the original sample) and their parents participated in the 11-year follow-up. BMI at age 8 and 11 as well as information on restrained eating, psychological problems, depressive symptoms, lifestyle, and IQ at age 8 were assessed. Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to predict children’s BMI scores at age 11. PLS-SEM explained 68% of the variance of BMI at age 11, with BMI at age 8 being the most important predictor. Restrained eating, via BMI at age 8 as well as parental BMI, had further weak associations with BMI at age 11; no other predictor was statistically significant. Since established overweight at age 8 already predicts BMI scores at age 11 longitudinally, obesity interventions should be implemented in early childhood. PMID:28832593

  6. Prediction of BMI at age 11 in a longitudinal sample of the Ulm Birth Cohort Study.

    Science.gov (United States)

    Christiansen, Hanna; Brandt, Stephanie; Walter, Viola; Wabitsch, Martin; Rothenbacher, Dietrich; Brenner, Hermann; Schimmelmann, Benno G; Hirsch, Oliver

    2017-01-01

    Obesity is one of the greatest public health challenges in the world with childhood prevalence rates between 20-26% and numerous associated health risks. The aim of the current study was to analyze the 11-year follow-up data of the Ulm Birth Cohort Study (UBCS), to identify whether abnormal eating behavior patterns, especially restrained eating, predict body mass index (BMI) at 11 years of age and to explore other factors known to be longitudinally associated with it. Of the original UBCS, n = 422 children (~ 40% of the original sample) and their parents participated in the 11-year follow-up. BMI at age 8 and 11 as well as information on restrained eating, psychological problems, depressive symptoms, lifestyle, and IQ at age 8 were assessed. Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to predict children's BMI scores at age 11. PLS-SEM explained 68% of the variance of BMI at age 11, with BMI at age 8 being the most important predictor. Restrained eating, via BMI at age 8 as well as parental BMI, had further weak associations with BMI at age 11; no other predictor was statistically significant. Since established overweight at age 8 already predicts BMI scores at age 11 longitudinally, obesity interventions should be implemented in early childhood.

  7. Ovarian cancer histology-specific incidence trends in Canada 1969?1993: age-period-cohort analyses

    OpenAIRE

    Zhang, J; Ugnat, A-M; Clarke, K.; Mao, Y

    1999-01-01

    This study examined histology-specific incidence trends of ovarian cancer in Canada, 1969?1993. The impact of age, period and cohort effects on these trends were studied by means of age-period-cohort analysis. Age-standardized incidence rates of serous, endometrioid, clear cell and germ cell tumours increased significantly and the rates of sex cord-stromal and other classified epithelial ovarian tumours decreased considerably. The rates of mucinous and NOS/unclassified tumours remained unchan...

  8. Male partner reproductive coercion among women veterans.

    Science.gov (United States)

    Rosenfeld, Elian A; Miller, Elizabeth; Zhao, Xinhua; Sileanu, Florentina E; Mor, Maria K; Borrero, Sonya

    2017-10-19

    Male partner reproductive coercion is defined as male partners' attempts to promote pregnancy through interference with women's contraceptive behaviors and reproductive decision-making. Male partners may try to promote pregnancy through birth control sabotage such as taking away or destroying their partners' contraceptives, refusing to wear condoms, and/or verbally pressuring their partners to abstain from contraceptive use. Reproductive coercion is associated with an elevated risk for unintended pregnancy. Women who experience intimate partner violence, who are in racial/ethnic minorities, and who are of lower socioeconomic status are more likely to experience reproductive coercion. Women veterans who use Veterans Affairs for health care may be particularly vulnerable to reproductive coercion because they are disproportionally from racial/ethnic minority groups and experience high rates of intimate partner violence. We sought to examine the prevalence, correlates, and impact of reproductive coercion among women veterans who are served by the Veterans Affairs healthcare system. We analyzed data from a national telephone survey of women veterans aged 18-44 years, with no history of sterilization or hysterectomy, who had received care within the Veterans Affairs system in the previous 12 months. Participants who had sex with men in the last year were asked if they experienced male partner reproductive coercion. Adjusted logistic regression was used to examine the relationship between participant characteristics and male partner reproductive coercion and the relationship between reproductive coercion and the outcomes of contraceptive method used at last sex and pregnancy and unintended pregnancy in the last year. Among the 1241 women veterans in our study cohort, 11% reported experiencing male partner reproductive coercion in the past year. Black women, younger women, and single women were more likely to report reproductive coercion than their white, older, and

  9. Risk factors for homelessness among women veterans.

    Science.gov (United States)

    Washington, Donna L; Yano, Elizabeth M; McGuire, James; Hines, Vivian; Lee, Martin; Gelberg, Lillian

    2010-02-01

    Women veterans are three to four times more likely than non-veteran women to become homeless. However, their risk factors for homelessness have not been defined. Case-control study of non-institutionalized homeless women veterans (n533) and age-matched housed women veterans (n=165). Health, health care, and factors associated with homelessness were assessed using multiple logistic regression with a Monte Carlo algorithm to estimate exact standard errors of the model coefficients and p-values. Characteristics associated with homelessness were sexual assault during military service, being unemployed, being disabled, having worse overall health, and screening positive for an anxiety disorder or post-traumatic stress disorder. Protective factors were being a college graduate or married. Efforts to assess housed women veterans' risk factors for homelessness should be integrated into clinical care programs within and outside the Veterans Administration. Programs that work to ameliorate risk factors may prevent these women's living situations from deteriorating over time.

  10. Racial disparities in all-cause mortality among veterans with type 2 diabetes.

    Science.gov (United States)

    Lynch, Cheryl P; Gebregziabher, Mulugeta; Echols, Carrae; Gilbert, Gregory E; Zhao, Yumin; Egede, Leonard E

    2010-10-01

    Racial differences in mortality among veterans with diabetes are less well characterized than those in the general population. To examine racial differences in all-cause mortality in a large sample of veterans with diabetes. A retrospective cohort. Participants comprised 8,812 veterans with type 2 diabetes. The main outcome measure was time to death. The main predictor was race/ethnicity. Other risk factors (or covariates) included age, gender, marital status, employment, glycosylated hemoglobin (HgbA1c), and several ICD-9 coded physical and mental health comorbidities. Average follow-up was 4.5 years; 64% of veterans were non-Hispanic whites (NHW), 97% male, and 84% at least 50 years old. The overall mortality rate was 15% and was significantly lower for non-Hispanic blacks (NHB). Baseline HgbA1c values also differed for NHW (mean = 7.05) and NHB (mean = 7.65) (p age, not being employed or retired, poor glycemic control, cancer, Coronary Heart Disease (CHD), and anxiety disorder; while a lower risk was associated with being female and ever being married. The risk of death among NHB veterans with diabetes remained significantly lower than that of NHW after controlling for important confounding variables. Future studies in the VA need to examine detailed contributions of patient, provider and system-level factors on racial differences in mortality in adults with diabetes, especially if the findings of this study are replicated at other sites or using national VA data.

  11. Age, period and cohort influences on beer, wine and spirits consumption trends in the US National Alcohol Surveys.

    Science.gov (United States)

    Kerr, William C; Greenfield, Thomas K; Bond, Jason; Ye, Yu; Rehm, Jürgen

    2004-09-01

    To estimate the separate influences of age, period and cohort on the consumption of beer wine and spirits in the United States. Linear age-period-cohort models controlling for demographic change with extensive specification testing. Setting US general population 1979-2000. Monthly average of past-year consumption of beer, wine and spirits in five National Alcohol Surveys. Findings The strongest cohort effects are found for spirits; cohorts born before 1940 are found to have significantly higher consumption than those born after 1946, with especially high spirits consumption for men in the pre-1930s cohorts. Significant cohort effects are also found for beer with elevated consumption in the 1946-65 cohorts for men but in the pre-1940 cohorts for women. Significant negative effects of age are found for beer and spirits consumption, although not for wine. Significant period effects are found for men's beer and wine consumption and for women's spirits consumption. Increased educational attainment in the population over time is associated with reduced beer consumption and increased wine consumption. Changing cohort demographics are found to have significant effects on beverage-specific consumption, indicating the importance of controlling for these effects in the evaluation of alcohol policy effectiveness and the potential for substantial improvement in the forecasting of future beverage-specific consumption trends, alcohol dependence treatment demand and morbidity and mortality outcomes.

  12. A web tool for age-period-cohort analysis of cancer incidence and mortality rates.

    Science.gov (United States)

    Rosenberg, Philip S; Check, David P; Anderson, William F

    2014-11-01

    Age-period-cohort (APC) analysis can inform registry-based studies of cancer incidence and mortality, but concerns about statistical identifiability and interpretability, as well as the learning curves of statistical software packages, have limited its uptake. We implemented a panel of easy-to-interpret estimable APC functions and corresponding Wald tests in R code that can be accessed through a user-friendly Web tool. Input data for the Web tool consist of age-specific numbers of events and person-years over time, in the form of a rate matrix of paired columns. Output functions include model-based estimators of cross-sectional and longitudinal age-specific rates, period and cohort rate ratios that incorporate the overall annual percentage change (net drift), and estimators of the age-specific annual percentage change (local drifts). The Web tool includes built-in examples for teaching and demonstration. User data can be input from a Microsoft Excel worksheet or by uploading a comma-separated-value file. Model outputs can be saved in a variety of formats, including R and Excel. APC methodology can now be carried out through a freely available user-friendly Web tool. The tool can be accessed at http://analysistools.nci.nih.gov/apc/. The Web tool can help cancer surveillance researchers make important discoveries about emerging cancer trends and patterns. ©2014 American Association for Cancer Research.

  13. Alcohol use from ages 9 to 16: A cohort-sequential latent growth model.

    Science.gov (United States)

    Duncan, Susan C; Duncan, Terry E; Strycker, Lisa A

    2006-01-04

    This study examined alcohol use from pre-adolescence to mid-adolescence and determined the influence of hypothesized covariates on changes in alcohol use rates during this developmental period. The sample comprised 405 randomly recruited youth from three age cohorts (9, 11, and 13 years), assessed annually for 4 years. Youth were 48.4% female, 50.4% African-American, and 49.6% White. A cohort-sequential latent growth model was employed which modeled alcohol use (use versus non-use) from ages 9 to 16 years, accounting for demographic variables of gender, race, parent marital status, and family economic status. Covariates of alcohol use included parent alcohol use, family alcohol problems, family cohesion, parent supervision, peer deviance, peer alcohol use, and peer encouragement of alcohol use. Results showed that proportions of alcohol users increased steadily from ages 9 to 16 years. Significant covariates were found on the intercept and slope. Being female and higher levels of parent alcohol use were associated with higher initial rates of alcohol use, whereas greater friends' encouragement of alcohol use was related to lower initial rates of alcohol use (intercept). Alternatively, more peer deviance and friends' encouragement of alcohol use was related to an increase in alcohol use rates from ages 9 to 16 years (slope), as was being White and from a single-parent family.

  14. Investigation of risk factors for mortality in aged guide dogs: A retrospective cohort study.

    Science.gov (United States)

    Hoummady, S; Hua, J; Muller, C; Pouchelon, J L; Blondot, M; Gilbert, C; Desquilbet, L

    2016-09-15

    The overall median lifespan of domestic dogs has been estimated to 9-12 years, but little is known about risk factors for mortality in aged and a priori healthy dogs. The objective of this retrospective cohort study was to determine which characteristics are associated with mortality in aged and a priori healthy guide dogs, in a retrospective cohort study of 116 guide dogs followed from a systematic geriatric examination at the age of 8-10 years old. A geriatric grid collected the clinical data and usual biological parameters were measured at the time of examination. Univariate (Kaplan-Meier estimates) and multivariable (Cox proportional hazard model) survival analyses were used to assess the associations with time to all-cause death. The majority of dogs were Golden Retrievers (n=48) and Labrador Retrievers (n=27). Median age at geriatric examination was 8.9 years. A total of 76 dogs died during follow-up, leading to a median survival time from geriatric examination of 4.4 years. After adjustment for demographic and biological variables, an increased alanine amionotransferase level (adjusted Hazard Ratio (adjusted HR), 6.2; 95% confidence interval [95%CI], 2.0-19.0; Pguide dogs. These results may be useful for preventive medical care when conducting a geriatric examination in working dogs. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Interprofessional education in aged-care facilities: Tensions and opportunities among undergraduate health student cohorts.

    Science.gov (United States)

    Annear, Michael; Walker, Kim; Lucas, Peter; Lo, Amanda; Robinson, Andrew

    2016-09-01

    This article examines the reflective discourses of medical, nursing, and paramedic students participating in interprofessional education (IPE) activities in the context of aged-care clinical placements. The intent of the research is to explore how students engage with their interprofessional colleagues in an IPE assessment and care planning activity and elucidate how students configure their role as learners within the context of a non-traditional aged-care training environment. Research participants included cohorts of volunteer medical (n = 61), nursing (n = 46), and paramedic (n = 20) students who were on clinical placements at two large teaching aged-care facilities in Tasmania, Australia, over a period of 18 months. A total of 39 facilitated focus group discussions were undertaken with cohorts of undergraduate student volunteers from three health professions between February 2013 and October 2014. Thematic analysis of focus group transcripts was assisted by NVIVO software and verified through secondary coding and member checking procedures. With an acceptable level of agreement across two independent coders, four themes were identified from student focus group transcripts that described the IPE relations and perceptions of the aged-care environment. Emergent themes included reinforcement of professional hierarchies, IPE in aged care perceived as mundane and extraneous, opportunities for reciprocal teaching and learning, and understanding interprofessional roles. While not all students can be engaged with IPE activities in aged care, our evidence suggests that within 1 week of clinical placements there is a possibility to develop reciprocal professional relations, affirm a positive identity within a collaborative healthcare team, and support the health of vulnerable older adults with complex care needs. These important clinical learnings support aged-care-based IPE as a potentially powerful context for undergraduate learning in the 21st Century.

  16. Center for Women Veterans

    Science.gov (United States)

    ... various organizations and individuals are doing to challenge perceptions about women Veterans. Learn more » #VeteranOfTheDay - Nominate a Veteran Today! Veteran of the Day has been a tradition on VA’s social media pages for more than two years now. This ...

  17. Younger age at gout onset is related to obesity in a community-based cohort

    Science.gov (United States)

    McAdams DeMarco, Mara A.; Maynard, Janet W.; Huizinga, Mary Margret; Baer, Alan N.; Köttgen, Anna; Gelber, Allan C.; Coresh, Josef

    2011-01-01

    Objective Obesity is associated with gout risk. It is unclear whether obesity is associated with a younger age of gout onset. We examined whether obesity is related to age at gout onset and quantified the risk of incident gout by obesity status in the Campaign Against Cancer and Heart Disease (CLUE II) study, a longitudinal community-based cohort. Methods CLUE II began in 1989 as a cohort study of residents living within or surrounding Washington County, Maryland. Follow-up questionnaires queried whether each participant had been diagnosed with gout by a healthcare professional. Among participants with gout, we assessed whether obesity was related to age at disease onset. We also ascertained the eighteen-year risk of incident gout according to obesity status (BMI ≥30 kg/m2) at baseline with cumulative incidence ratios (RR) and 95% confidence intervals (CI) from Poisson regression. Results Among the study population (n=15,533), 517 developed incident gout. The prevalence of obesity at baseline was 16.2%. The overall mean age at gout onset was 59.3 years. The onset of gout was 3.1 years (95% CI: 0.3, 5.8) earlier in those who were obese at baseline and 11.0 years earlier (95% CI: 5.8, 16.1) in participants who were obese at age 21, compared to their non-obese participants. The 18-year adjusted RR of gout in obese participants compared to non-obese participants was 1.92 (95% CI: 1.55, 2.37). Conclusion Obesity is not only a risk factor for incident gout but was associated with an earlier age at gout onset. PMID:21485022

  18. Delivery outcomes for nulliparous women at the extremes of maternal age - a cohort study.

    LENUS (Irish Health Repository)

    Vaughan, DA

    2013-06-12

    OBJECTIVE: To examine the associations between extremes of maternal age (≤17 years or ≥40 years) and delivery outcomes. DESIGN: Retrospective cohort study. SETTING: Urban maternity hospital in Ireland. POPULATION: A total of 36 916 nulliparous women with singleton pregnancies who delivered between 2000 and 2011. METHODS: The study population was subdivided into five maternal age groups based on age at first booking visit: ≤17 years, 18-19 years, 20-34 years, 35-39 years and women aged ≥40 years. Logistic regression analyses were performed to examine the associations between extremes of maternal age and delivery outcomes, adjusting for potential confounding factors. MAIN OUTCOME MEASURES: Preterm birth, admission to the neonatal unit, congenital anomaly, caesarean section. RESULTS: Compared with maternal age 20-34 years, age ≤17 years was a risk factor for preterm birth (adjusted odds ratio [adjOR] 1.83, 95% confidence interval [95% CI] 1.33-2.52). Babies born to mothers ≥40 years were more likely to require admission to the neonatal unit (adjOR 1.35, 95% CI 1.06-1.72) and to have a congenital anomaly (adjOR 1.71, 95% CI 1.07-2.76). The overall caesarean section rate in nulliparous women was 23.9% with marked differences at the extremes of maternal age; 10.7% at age ≤17 years (adjOR 0.46, 95% CI 0.34-0.62) and 54.4% at age ≥40 years (adjOR 3.24, 95% CI 2.67-3.94). CONCLUSIONS: Extremes of maternal age need to be recognised as risk factors for adverse delivery outcomes. Low caesarean section rates in younger women suggest that a reduction in overall caesarean section rates may be possible.

  19. Mental health of small children for normal gestational age: a cohort study from Southeastern Brazil

    Directory of Open Access Journals (Sweden)

    Adriana Martins Saur

    2015-03-01

    Full Text Available The aim of this study is to investigate mental health problems in children born small for gestational age (SGA and those born appropriate for gestational age (AGA and to assess the association of these problems with child and family characteristics. Six hundred and seventy-seven children, belonging to a birth cohort from 1994 in Ribeirão Preto/SP (southeastern Brazil, were evaluated (140 SGA and 537 AGA. They were later reevaluated at school age (2004/2005 by means of the Strengths and Difficulties Questionnaire for mental health assessment (parent report. Results showed that children born SGA presented greater frequency of behavioral problems and emotional symptoms compared to children born AGA. Variables associated with mental health problems in the univariate model were: male sex, children born SGA, low educational level of parents, socioeconomic disadvantage, and belonging to families with many members. However, in multivariate analysis, two factors - being born SGA and father's low educational level - lost their statistical significance, and the other sociodemographic variables remained significant (male sex, low-level of maternal education, low socioeconomic level, families with many members. It has been concluded that being born SGA was not independently associated with mental health problems, but sociodemographic factors proved to be the predictors of this type of problem in the cohort studied.

  20. Shopper typologies amongst a Generation Y consumer cohort and variations in terms of age in the fashion apparel market

    National Research Council Canada - National Science Library

    Chengedzai Mafini; Manillall Dhurup; Lawrence Mandhlazi

    2014-01-01

    .... Generation Y consumers have emerged as an important marketing segment. Consequently, a need exists to investigate behavioural issues pertaining to this age cohort on a continuous basis.Methodology...

  1. A brief dietary assessment predicts executive dysfunction in an elderly cohort: results from the Einstein Aging Study

    Science.gov (United States)

    Objectives: To examine the association between diet and executive function, episodic memory and global verbal cognition in the Einstein Aging Study (EAS) cohort and determine whether race modifies this relationship. Design: Cross-sectional. Setting: Community. Participants: EAS participants without ...

  2. 2007 Veterans Employability Research Survey

    Data.gov (United States)

    Department of Veterans Affairs — The 2007 Veterans Employability Research Survey (VERS) was conducted to determine the factors that impact veterans' employability resulting from participation in the...

  3. Age, education and dementia related deaths. The Norwegian Counties Study and The Cohort of Norway.

    Science.gov (United States)

    Strand, Bjørn Heine; Langballe, Ellen Melbye; Rosness, Tor A; Bergem, Astrid Liv Mina; Engedal, Knut; Nafstad, Per; Tell, Grethe S; Ormstad, Heidi; Tambs, Kristian; Bjertness, Espen

    2014-10-15

    An inverse relationship between educational level and dementia has been reported in several studies. In this study we investigated the relationship between educational level and dementia related deaths for cohorts of people all born during 1915-39. The cohorts were followed up from adulthood or old age, taking into account possible confounders and mediating paths. Our study population comprised participants in Norwegian health examination studies in the period 1974-2002; The Counties Study and Cohort of Norway (CONOR). Dementia related deaths were defined as deaths with a dementia diagnosis on the death certificate and linked using the Cause of Death Registry to year 2012. The study included 90,843 participants, 2.06 million person years and 2440 dementia related deaths. Cox regression was used to assess the association between education and dementia related deaths. Both high and middle educational levels were associated with lower dementia related death risk compared to those with low education when follow-up started in adulthood (35-49 years, high versus low education: HR=0.68, 95% confidence interval (CI) 0.50-0.93; 50-69 years, high versus low education: HR=0.52, 95% CI 0.34-0.80). However, when follow-up started at old age (70-80 years) there was no significant association between education and dementia related death. Restricting the study population to those born during a five-year period 1925-29 (the birth cohort overlapping all three age groups), gave similar main findings. The protective effects found for both high and middle educational level compared to low education were robust to adjustment for cardiovascular health and life style factors, suggesting education to be a protective factor for dementia related death. Both high and middle educational levels were associated with decreased dementia related death risk compared with low educational level when follow-up started in adulthood, but no association was observed when follow-up started at old age

  4. Extension of Cox Proportional Hazard Model for Estimation of Interrelated Age-Period-Cohort Effects on Cancer Survival

    OpenAIRE

    Mdzinarishvili, Tengiz; Gleason, Michael X.; Kinarsky, Leo; Sherman, Simon

    2011-01-01

    In the frame of the Cox proportional hazard (PH) model, a novel two-step procedure for estimating age-period-cohort (APC) effects on the hazard function of death from cancer was developed. In the first step, the procedure estimates the influence of joint APC effects on the hazard function, using Cox PH regression procedures from a standard software package. In the second step, the coefficients for age at diagnosis, time period and birth cohort effects are estimated. To solve the identifiabili...

  5. Suicide in peacekeepers--a cohort study of mortality from suicide in 22,275 Norwegian veterans from international peacekeeping operations.

    Science.gov (United States)

    Thoresen, Siri; Mehlum, Lars; Moller, Bjorn

    2003-11-01

    Several studies have investigated post-traumatic stress reactions and other psychosocial problems in former peacekeepers. The question has also been raised as to whether such veterans might be at increased risk of suicide. This study investigated the suicide mortality in Norwegian former peacekeepers. Cause-specific mortality was identified in the population of Norwegian peacekeepers having participated in army missions in the years 1978-95. General population data were used for comparison. Standardized Mortality Ratios (SMRs) were calculated for different suicide methods and certain peacekeeping-related variables. Marital status was available for each year and controlled for by using separate suicide rates for unmarried, married and divorced. A moderately, but significantly, increased SMR of 1.4 for suicide was found among the former peacekeepers (95% confidence interval = 1.1-1.8). After adjusting for marital status, the SMR was reduced to insignificance (SMR = 1.1, 95% confidence interval = 0.9-1.4). There was a significant increase in suicide by means of firearms and carbon monoxide poisoning. The increased risk of suicide in former peacekeepers was related to the peace-keepers' lower marriage rate compared to the general population. This finding may indicate that the personnel were characterized by certain vulnerability factors before entering peacekeeping service, resulting in a reduced ability to enter into and remain in stable love relations. However, it cannot be excluded that stress reactions following peacekeeping may have contributed to possible strains on interpersonal relationships. Preventative work should, thus, include improved personnel selection routines and preferably also psychosocial support for veterans and their families. The increased number of suicides by use of firearms indicates that gun control might be an important prevention measure in this group.

  6. Age-specific fertility by educational level in the Finnish male cohort born 1940‒1950

    Directory of Open Access Journals (Sweden)

    Jessica Nisén

    2014-07-01

    Full Text Available Background: Education is positively associated with completed fertility rate (CFR among men in Nordic countries, but the age patterns of fertility by educational level are poorly documented. Moreover, it is not known what parities contribute to the higher CFR among more highly educated men. Objective: To describe men's fertility by age, parity, and education in Finland. Methods: The study is based on register data covering the male cohort born in 1940‒1950 (N=38,838. Education was measured at ages 30‒34 and classified as basic, lower secondary, upper secondary, and tertiary. Fertility was measured until ages 59‒69. We calculated completed and age-specific fertility rates, and decomposed the educational gradient in CFR into parity-specific contributions. Results: The more highly educated men had more children (CFR: basic 1.71 and tertiary 2.06, had them later (mean age at having the first child: basic 26.1 and tertiary 28.1, and had them within a shorter interval (interquartile range of age at having the first child: basic 5.8 and tertiary 5.2. The educational gradient in the cumulative fertility rate was negative at young ages but turned positive by the early thirties. High levels of childlessness among those with a basic education explained three-quarters of the CFR difference between the lowest and highest educational groups. Fertility at ages above 45 was low and did not widen the educational gradient in CFR. Conclusions: The fact that highly educated men have more children than their counterparts with less education is largely attributable to higher fertility levels at older ages and the lower probability of remaining childless. Variation in fertility timing and quantity is wider among men with a low level of education.

  7. Sex, BMI and age differences in metabolic syndrome: the Dutch Lifelines Cohort Study

    Directory of Open Access Journals (Sweden)

    Sandra N Slagter

    2017-06-01

    Full Text Available Introduction: To evaluate the prevalence of metabolic syndrome (MetS and its individual components within sex-, body mass index (BMI- and age combined clusters. In addition, we used the age-adjusted blood pressure thresholds to demonstrate the effect on the prevalence of MetS and elevated blood pressure. Subjects and methods: Cross-sectional data from 74,531 Western European participants, aged 18–79 years, were used from the Dutch Lifelines Cohort Study. MetS was defined according to the revised NCEP-ATPIII. Age-adjusted blood pressure thresholds were defined as recommended by the eight reports of the Joint National Committee (≥140/90 mmHg for those aged <60 years, and ≥150/90 mmHg for those aged ≥60 years. Results: 19.2% men and 12.1% women had MetS. MetS prevalence increased with BMI and age. Independent of BMI, abdominal obesity dominated MetS prevalence especially in women, while elevated blood pressure was already highly prevalent among young men. Applying age-adjusted blood pressure thresholds resulted in a 0.2–11.9% prevalence drop in MetS and 6.0–36.3% prevalence drop in elevated blood pressure, within the combined sex, BMI and age clusters. Conclusions: We observed a gender disparity with age and BMI for the prevalence of MetS and, especially, abdominal obesity and elevated blood pressure. The strict threshold level for elevated blood pressure in the revised NCEP-ATPIII, results in an overestimation of MetS prevalence.

  8. Post traumatic stress disorder and resilience in veterans who served ...

    African Journals Online (AJOL)

    study. JAMA 1988;259:2701-7. 12. Card JJ. Epidemiology of PTSD in a national cohort of Vietnam. Veterans. Journal of Clinical Psychology 1987 ;43(1):6-17. 13. Schnurr PP, Lunney CA, Sengupta A, Waelde LC. A descriptive analysis of PTSD chronicity in Vietnam veterans. Journal of. Traumatic Stress 2003 ;16(6):545-53.

  9. Patterns of lung cancer mortality in 23 countries: Application of the Age-Period-Cohort model

    Directory of Open Access Journals (Sweden)

    Huang Yi-Chia

    2005-03-01

    Full Text Available Abstract Background Smoking habits do not seem to be the main explanation of the epidemiological characteristics of female lung cancer mortality in Asian countries. However, Asian countries are often excluded from studies of geographical differences in trends for lung cancer mortality. We thus examined lung cancer trends from 1971 to 1995 among men and women for 23 countries, including four in Asia. Methods International and national data were used to analyze lung cancer mortality from 1971 to 1995 in both sexes. Age-standardized mortality rates (ASMR were analyzed in five consecutive five-year periods and for each five-year age group in the age range 30 to 79. The age-period-cohort (APC model was used to estimate the period effect (adjusted for age and cohort effects for mortality from lung cancer. Results The sex ratio of the ASMR for lung cancer was lower in Asian countries, while the sex ratio of smoking prevalence was higher in Asian countries. The mean values of the sex ratio of the ASMR from lung cancer in Taiwan, Hong Kong, Singapore, and Japan for the five 5-year period were 2.10, 2.39, 3.07, and 3.55, respectively. These values not only remained quite constant over each five-year period, but were also lower than seen in the western countries. The period effect, for lung cancer mortality as derived for the 23 countries from the APC model, could be classified into seven patterns. Conclusion Period effects for both men and women in 23 countries, as derived using the APC model, could be classified into seven patterns. Four Asian countries have a relatively low sex ratio in lung cancer mortality and a relatively high sex ratio in smoking prevalence. Factors other than smoking might be important, especially for women in Asian countries.

  10. Age, flight experience, and risk of crash involvement in a cohort of professional pilots.

    Science.gov (United States)

    Li, Guohua; Baker, Susan P; Grabowski, Jurek G; Qiang, Yandong; McCarthy, Melissa L; Rebok, George W

    2003-05-15

    Federal aviation regulations prohibit airline pilots from flying beyond the age of 60 years. However, the relation between pilot age and flight safety has not been rigorously assessed using empirical data. From 1987 to 1997, the authors followed a cohort of 3,306 commuter air carrier and air taxi pilots who were aged 45-54 years in 1987. During the follow-up period, the pilots accumulated a total of 12.9 million flight hours and 66 aviation crashes, yielding a rate of 5.1 crashes per million pilot flight hours. Crash risk remained fairly stable as the pilots aged from their late forties to their late fifties. Flight experience, as measured by total flight time at baseline, showed a significant protective effect against the risk of crash involvement. With adjustment for age, pilots who had 5,000-9,999 hours of total flight time at baseline had a 57% lower risk of a crash than their less experienced counterparts (relative risk = 0.43, 95% confidence interval: 0.21, 0.87). The protective effect of flight experience leveled off after total flight time reached 10,000 hours. The lack of an association between pilot age and crash risk may reflect a strong "healthy worker effect" stemming from the rigorous medical standards and periodic physical examinations required for professional pilots.

  11. Childhood diet and asthma and atopy at 8 years of age: the PIAMA birth cohort study.

    Science.gov (United States)

    Willers, S M; Wijga, A H; Brunekreef, B; Scholtens, S; Postma, D S; Kerkhof, M; de Jongste, J C; Smit, H A

    2011-05-01

    Diet may affect the development of asthma. We investigated whether asthma or atopy outcomes at 8 yrs of age were associated with long-term dietary exposure, and whether associations were different for consumption at early or later age. The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort enrolled 4,146 participants at baseline, who were followed up to 8 yrs of age. Dietary intakes of interest were fruit, vegetables, brown/wholemeal bread, fish, milk, butter and margarine. Associations between food intake at early (2-3 yrs) and later (7-8 yrs) age, and long-term intake, asthma and atopy at 8 yrs of age were calculated by logistic regression. Complete longitudinal dietary data for at least one of the food groups were available for 2,870 children. Fruit consumption at early age was associated with reduced asthma symptoms (OR per 1 consumption day per week increase 0.93, 95% CI 0.85-1.00). Long-term fruit intake was inversely associated with asthma symptoms (OR 0.90, 95% CI 0.82-0.99) and sensitisation to inhaled allergens (OR 0.90, 95% CI 0.82-0.99). We found no consistent associations between diet and outcomes for other foods. This study indicates no consistent effects of increased early or late consumption, or long-term intake of certain foods on asthma and atopy in 8-yr-olds, with a possible exception for fruit.

  12. Mortality in American Veterans with the HLA-B27 gene.

    Science.gov (United States)

    Walsh, Jessica A; Zhou, Xi; Clegg, Daniel O; Teng, Chiachen; Cannon, Grant W; Sauer, Brian

    2015-04-01

    To compare survival in American veterans with and without the HLA-B27 (B27) gene. Mortality was evaluated in a national cohort of veterans with clinically available B27 test results between October 1, 1999, and December 31, 2011. The primary outcome was the mortality difference between B27-positive and B27-negative veterans, adjusted for age, sex, race, and diagnoses codes for diseases that may have influenced both B27 testing and mortality, including psoriasis, inflammatory bowel disease, spondyloarthritis (SpA), and other types of inflammatory arthritis. The secondary outcomes were the adjusted mortality HR for B27+ and B27- veterans, in subgroups with and without SpA. Among veterans with available B27 test results, 27,652 (84.7%) were B27- and 4978 (15.3%) were B27+. The mean followup time was 4.6 years. Mortality was higher in the B27+ group than in the B27- group (HR 1.15, 95% CI 1.03-1.27). Mortality was also higher in the B27+ subgroups with SpA (HR 1.35, 95% CI 1.06-1.72) and without SpA (HR 1.11, 95% CI 0.99-1.24), but the difference was significant only in the subgroup with SpA. B27 positivity was associated with an increased mortality rate in a cohort of veterans clinically selected for B27 testing, after adjustment for SpA. In the subgroup with SpA, the mortality rate was associated with B27 positivity, and in the subgroup without SpA, there was a nonsignificant association between B27+ and mortality.

  13. Prisoner of war status, posttraumatic stress disorder, and dementia in older veterans.

    Science.gov (United States)

    Meziab, Omar; Kirby, Katharine A; Williams, Brie; Yaffe, Kristine; Byers, Amy L; Barnes, Deborah E

    2014-06-01

    It is not known whether prisoners of war (POWs) are more likely to develop dementia independently of the effects of posttraumatic stress disorder (PTSD). We performed a retrospective cohort study in 182,879 U.S. veterans age 55 years and older, and examined associations between POW status and PTSD at baseline (October 1, 2000-September 30, 2003), and incident dementia during follow-up (October 1, 2003-September 30, 2012). A total of 484 veterans (0.3%) reported being POWs, of whom 150 (31.0%) also had PTSD. After adjusting for demographics, medical and psychiatric comorbidities, period of service, and the competing risk of death, the risk of dementia was increased in veterans who were POWs only (hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.30-1.98) or had PTSD only (HR, 1.52; 95% CI, 1.41-1.64) and was greatest in veterans who were POWs and also had PTSD (HR, 2.24; 95% CI, 1.72-2.92). POW status and PTSD increase risk of dementia in an independent, additive manner in older veterans. Copyright © 2014. Published by Elsevier Inc.

  14. Driving simulator performance of veterans from the Iraq and Afghanistan wars.

    Science.gov (United States)

    Amick, Melissa M; Kraft, Melissa; McGlinchey, Regina

    2013-01-01

    Driving simulator performance was examined in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans to objectively evaluate driving abilities among this cohort who self-report poorer driving safety postdeployment. OIF/OEF Veterans (n = 25) and age- and education-matched civilian controls (n = 25) participated in a 30 min driving simulator assessment that measured the frequency of minor, moderate, and severe driving errors. Frequency of errors in specific content domains (speed regulation, positioning, and signaling) was also calculated. All participants answered questions about number of lifetime traffic "warnings," moving violation tickets, and accidents. Veterans completed the Posttraumatic Stress Disorder (PTSD) Checklist-Military Version. On the driving simulator assessment, Veterans committed more minor, moderate, severe, and speeding errors and reported poorer lifetime driving records than the civilian control group. Exploratory analyses revealed an association between increasing errors on the driving simulator with increasing symptoms of PTSD, although statistically this correlation did not reach significance. These findings suggest that Veterans perform more poorly on an objective evaluation of driving safety and that the presence of PTSD could be associated with worse performance on this standardized driving simulator assessment.

  15. Travel time and attrition from VHA care among women veterans: how far is too far?

    Science.gov (United States)

    Friedman, Sarah A; Frayne, Susan M; Berg, Eric; Hamilton, Alison B; Washington, Donna L; Saechao, Fay; Maisel, Natalya C; Lin, Julia Y; Hoggatt, Katherine J; Phibbs, Ciaran S

    2015-04-01

    Travel time, an access barrier, may contribute to attrition of women veterans from Veterans Health Administration (VHA) care. We examined whether travel time influences attrition: (a) among women veterans overall, (b) among new versus established patients, and (c) among rural versus urban patients. This retrospective cohort study used logistic regression to estimate the association between drive time and attrition, overall and for new/established and rural/urban patients. In total, 266,301 women veteran VHA outpatients in the Fiscal year 2009. An "attriter" did not return for VHA care during the second through third years after her first 2009 visit (T0). Drive time (log minutes) was between the patient's residence and her regular source of VHA care. "New" patients had no VHA visits within 3 years before T0. Models included age, service-connected disability, health status, and utilization as covariates. Overall, longer drive times were associated with higher odds of attrition: drive time adjusted odds ratio=1.11 (99% confidence interval, 1.09-1.14). The relationship between drive time and attrition was stronger among new patients but was not modified by rurality. Attrition among women veterans is sensitive to longer drive time. Linking new patients to VHA services designed to reduce distance barriers (telemedicine, community-based clinics, mobile clinics) may reduce attrition among women new to VHA.

  16. Mortality of breast cancer in Taiwan, 1971-2010: temporal changes and an age-period-cohort analysis.

    Science.gov (United States)

    Ho, M-L; Hsiao, Y-H; Su, S-Y; Chou, M-C; Liaw, Y-P

    2015-01-01

    The current paper describes the age, period and cohort effects on breast cancer mortality in Taiwan. Female breast cancer mortality data were collected from the Taiwan death registries for 1971-2010. The annual percentage changes, age- standardised mortality rates (ASMR) and age-period-cohort model were calculated. The mortality rates increased with advancing age groups when fixing the period. The percentage change in the breast cancer mortality rate increased from 54.79% at aged 20-44 years, to 149.78% in those aged 45-64 years (between 1971-75 and 2006-10). The mortality rates in the 45-64 age group increased steadily from 1971 to 1975 and 2006-10. The 1951 birth cohorts (actual birth cohort; 1947-55) showed peak mortalities in both the 50-54 and 45-49 age groups. We found that the 1951 birth cohorts had the greatest mortality risk from breast cancer. This might be attributed to the DDT that was used in large amounts to prevent deaths from malaria in Taiwan. However, future researches require DDT data to evaluate the association between breast cancer and DDT use.

  17. Are the 1976-1985 birth cohorts heavier drinkers? Age-period-cohort analyses of the National Alcohol Surveys 1979-2010.

    Science.gov (United States)

    Kerr, William C; Greenfield, Thomas K; Ye, Yu; Bond, Jason; Rehm, Jürgen

    2013-06-01

    To estimate age-period-cohort models predicting alcohol volume, heavy drinking and beverage-specific alcohol volume in order to evaluate whether the 1976-1985 birth cohorts drink relatively heavily. Data from seven cross-sectional surveys of the USA conducted between 1979 and 2010 were utilized in negative binomial generalized linear models of age, period and cohort effects predicting alcohol measures. General population surveys of the USA. Thirty-six thousand four hundred and thirty-two US adults (aged 18 years or older). Monthly number of alcohol drinks, beer, wine and spirits drinks, and days drinking five or more drinks in the past year derived from beverage-specific graduated frequency questions. Relative to the reference 1956-60 birth cohort, men in the 1976-1980 cohort for were found to consume more alcohol [incidence rate ratio (IRR) = 1.222: confidence interval (CI) 1.07-1.39) and to have more 5+ days (the number of days having five or more drinks) (IRR = 1.365: CI 1.09-1.71) as were men in the 1980-85 cohort for volume (IRR = 1.284: CI 1.10-1.50) and 5+ days (IRR = 1.437: CI 1.09-1.89). For women, those in the 1980-85 cohort were found to have higher alcohol volume (IRR = 1.299: CI 1.07-1.58) and more 5+ days (IRR = 1.547: CI 1.01-2.36). Beverage-specific models found different age patterns of volume by beverage with a flat age pattern for both genders' spirits and women's wine, an increasing age pattern for men's wine and a declining age pattern from those in their early 20s for beer. In the USA, men born between 1976 and 1985, and women born between 1981 and 1985 have higher alcohol consumption than in earlier or later years. © 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.

  18. Does overall diet in midlife predict future aging phenotypes? A cohort study.

    Science.gov (United States)

    Akbaraly, Tasnime; Sabia, Séverine; Hagger-Johnson, Gareth; Tabak, Adam G; Shipley, Martin J; Jokela, Markus; Brunner, Eric J; Hamer, Mark; Batty, G David; Singh-Manoux, Archana; Kivimaki, Mika

    2013-05-01

    The impact of diet on specific age-related diseases has been studied extensively, but few investigations have adopted a more holistic approach to determine the association of diet with overall health at older ages. We examined whether diet, assessed in midlife, using dietary patterns and adherence to the Alternative Healthy Eating Index (AHEI), is associated with aging phenotypes, identified after a mean 16-year follow-up. Data were drawn from the Whitehall II cohort study of 5350 adults (age 51.3±5.3 years, 29.4% women). Diet was assessed at baseline (1991-1993). Mortality, chronic diseases, and functioning were ascertained from hospital data, register linkage, and screenings every 5 years and were used to create 5 outcomes at follow-up: ideal aging (free of chronic conditions and high performance in physical, mental, and cognitive functioning tests; 4%), nonfatal cardiovascular event (12.7%), cardiovascular death (2.8%), noncardiovascular death (7.3%), [corrected] and normal aging (73.2%). Low adherence to the AHEI was associated with an increased risk of cardiovascular and noncardiovascular death. In addition, participants with a "Western-type" diet (characterized by high intakes of fried and sweet food, processed food and red meat, refined grains, and high-fat dairy products) had lower odds of ideal aging (odds ratio for top vs bottom tertile: 0.58; 95% confidence interval, 0.36-0.94; P=.02), independently of other health behaviors. By considering healthy aging as a composite of cardiovascular, metabolic, musculoskeletal, respiratory, mental, and cognitive function, the present study offers a new perspective on the impact of diet on aging phenotypes. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Age of Alcohol Initiation and Progression to Binge Drinking in Adolescence: A Prospective Cohort Study.

    Science.gov (United States)

    Aiken, Alexandra; Clare, Philip J; Wadolowski, Monika; Hutchinson, Delyse; Najman, Jackob M; Slade, Tim; Bruno, Raimondo; McBride, Nyanda; Kypri, Kypros; Mattick, Richard P

    2017-11-21

    Early alcohol initiation is common and has been associated with the development of alcohol problems. Yet, past research on the association of age of initiation with later problem drinking has produced inconsistent findings. Using prospective data from the Australian Parental Supply of Alcohol Longitudinal Study cohort, this study examined age of alcohol initiation, and of first drunkenness, and associations with subsequent drinking in adolescence. A total of 1,673 parent-child dyads recruited through Australian secondary schools completed annual surveys for 5 years (grades 7 to 11). Limiting the sample to those adolescents who had initiated alcohol use by age 17 (n = 839), multinomial logistic regression models were used to examine associations between (i) age of initiation to alcohol use (consuming at least 1 full serve) and (ii) age of first drunkenness, and 2 outcomes: (i) binge drinking (consuming >4 standard drinks on a single occasion), and (ii) the total number of alcoholic drinks consumed in the past year, adjusted for a range of potential child, parent, family, and peer covariates. Fifty percent of adolescents reported alcohol use and 36% reported bingeing at wave 5 (mean age 16.9 years), and the mean age of initiation to alcohol use for drinkers was 15.1 years. Age of initiation was significantly associated with binge drinking and total quantity of alcohol consumed in unadjusted and adjusted models. Age of first drunkenness was associated with total quantity of alcohol consumed in unadjusted models but not adjusted models and was not associated with subsequent bingeing. Initiating alcohol use earlier in adolescence is associated with an increased risk of binge drinking and higher quantity of consumption in late secondary school, supporting an argument for delaying alcohol initiation for as long as possible to reduce the risk for problematic use in later adolescence and the alcohol-related harms that may accompany this use. Copyright © 2017 by the

  20. Association between metformin use and transformation of monoclonal gammopathy of undetermined significance to multiple myeloma in U.S. veterans with diabetes mellitus: a population-based cohort study

    Science.gov (United States)

    Chang, Su-Hsin; Luo, Suhong; O’Brian, Katiuscia K.; Thomas, Theodore S.; Colditz, Graham A.; Carlsson, Nils P.; Carson, Kenneth R.

    2015-01-01

    Background Multiple myeloma (MM) is one of the most common hematologic malignancies in the United States and is consistently preceded by monoclonal gammopathy of undetermined significance (MGUS). Methods A retrospective cohort of patients in the U.S. Veterans Health Administration database diagnosed with MGUS between 1, October, 1999 and 31, December, 2009 and diabetes mellitus prior to their MGUS diagnosis was identified and followed through 6, August, 2013. Patient-level clinical data were reviewed to verify diagnoses and to abstract data on size of baseline M-protein and type of MGUS, i.e., immunoglobulin (Ig) subtype or light-chain, when available. Metformin users were defined as patients that were prescribed metformin for at least 4 years, with no single break between consecutive prescriptions ≥6 months. Kaplan-Meier curves and Cox models were used to analyze the association between metformin use and the progression of MGUS to MM. Findings The analytic cohort consisted of 2,003 MGUS patients with a median follow-up time of 69 months. Within the analytic cohort, 463 metformin users (23·1%) were identified. Among the metformin users, 13 patients progressed to MM, while 74 patients progressed to MM among the non-metformin users. Metformin use was associated with a reduced risk of transformation to MM (Hazard ratio, HR: 0·47; 95% confidence interval, CI: 0·25–0·87). Interpretation For diabetics diagnosed with MGUS, metformin use for 4 years or longer was associated with a reduced risk of transformation of MGUS to MM. Prospective studies are required to determine whether this association is causal and whether these results can be extrapolated to non-diabetics. PMID:26034780

  1. Comparison of Female Collegiate Athletes and College Age Cohort in Tuck Jump Assessment.

    Science.gov (United States)

    Smith, Craig A; Olson, Brandon K; Olson, Lisa A; Chimera, Nicole J; Warren, Meghan

    2017-04-01

    Smith, CA, Olson, BK, Olson, LA, Chimera, NJ, and Warren, M. Comparison of female collegiate athletes and college age cohort in tuck jump assessment. J Strength Cond Res 31(4): 1048-1054, 2017-The tuck jump assessment (TJA) is a plyometric jumping assessment with 10 flaw criteria against which technique is assessed over a 10-second interval. The TJA has been reported as a tool for identifying neuromuscular deficits that increase risk for anterior cruciate ligament injury, but group specific data on female TJA scores are limited. No cut point has been developed for groups with different activity levels or participation in athletics. This study investigated the association between TJA score and athletic participation in college-aged females. One hundred twenty-one females (53 collegiate athletes and 68 college students) completed the TJA. TJA score was the sum of flaws for the 10 criteria observed, and the number of jumps was recorded. Poisson regression was used to assess the association between TJA score and number of jumps. The association between each of the 10 flaws between groups was assessed with the chi-square test. No significant association was found between groups for TJA score (mean ± SD: 4.66 ± 1.07 athletes; 5.45 ± 1.05 college cohort; p = 0.06; β = 0.82). Athletes jumped significantly more times (12.23 ± 1.04 athletes; 9.35 ± 1.04 college cohort). Athletes had a lower proportion of 2 flaws: "thighs do not reach parallel" and "pause between jumps." Lower statistical power may limit interpretation of the remaining flaws. The lack of control of the number of jumps may impact TJA score. To improve the TJA usefulness on the field and clinic, the protocol may need to standardize the number of jumps.

  2. Do homeless veterans have the same needs and outcomes as non-veterans?

    Science.gov (United States)

    Tsai, Jack; Mares, Alvin S; Rosenheck, Robert A

    2012-01-01

    Although veterans have been found to be at increased risk for homelessness as compared to non-veterans, it is not clear whether those who are homeless have more severe health problems or poorer outcomes in community-based supported housing. This observational study compared 162 chronically homeless veterans to 388 non-veterans enrolled in a national-supported housing initiative over a 1-year period. Results showed that veterans tended to be older, were more likely to be in the Vietnam era age group, to be male, and were more likely to have completed high school than other chronically homeless adults. There were no differences between veterans and non-veterans on housing or clinical status at baseline or at follow-up, but both groups showed significant improvement over time. These findings suggest that the greater risk of homelessness among veterans does not translate into more severe problems or treatment outcomes. Supported housing programs are similarly effective for veterans and non-veterans.

  3. Treatment-seeking veterans of Iraq and Afghanistan: comparison with veterans of previous wars.

    Science.gov (United States)

    Fontana, Alan; Rosenheck, Robert

    2008-07-01

    Differences in the characteristics and mental health needs of veterans of the Iraq/Afghanistan war when compared with those of veterans who served in the Persian Gulf war and in the Vietnam war may have important implications for Veterans Affairs (VA) program and treatment planning. Subjects were drawn from administrative data bases of veterans who sought treatment from specialized VA programs for treatment of posttraumatic stress disorder (PTSD). Current Iraq/Afghanistan veterans were compared with 4 samples of outpatient and inpatient Persian Gulf and Vietnam veterans whose admission to treatment was either contemporaneous or noncontemporaneous with their admission. A series of analyses of covariance was used hierachically to control for program site and age. In analyses of contemporaneous veterans uncontrolled for age, Iraq/Afghanistan veterans differed most notably from Vietnam veterans by being younger, more likely to be female, less likely to be either married or separated/divorced, more often working, less likely to have ever been incarcerated, and less likely to report exposure to atrocities in the military. Regarding clinical status, Iraq/Afghanistan veterans were less often diagnosed with substance abuse disorders, manifested more violent behavior, and had lower rates of VA disability compensation because of PTSD. Differences are more muted in comparisons with Persian Gulf veterans, particularly in those involving noncontemporaneous samples, or those that controlled for age differences. Among recent war veterans with PTSD, social functioning has largely been left intact. There is a window of opportunity, therefore, for developing and focusing on treatment interventions that emphasize the preservation of these social assets.

  4. Prevalence of unplanned hospitalizations caused by adverse drug reactions in older veterans.

    Science.gov (United States)

    Marcum, Zachary A; Amuan, Megan E; Hanlon, Joseph T; Aspinall, Sherrie L; Handler, Steven M; Ruby, Christine M; Pugh, Mary Jo V

    2012-01-01

    To describe the prevalence of unplanned hospitalizations caused by adverse drug reactions (ADRs) in older veterans and to examine the association between this outcome and polypharmacy after controlling for comorbidities and other patient characteristics. Retrospective cohort. Veterans Affairs Medical Centers. Six hundred seventy-eight randomly selected unplanned hospitalizations of older (aged ≥ 65) veterans between October 1, 2003, and September 30, 2006. Naranjo ADR algorithm, ADR preventability, and polypharmacy (0-4, 5-8, and ≥9 scheduled medications). Seventy ADRs involving 113 drugs were found in 68 (10%) hospitalizations of older veterans, of which 25 (36.8%) were preventable. Extrapolating to the population of more than 2.4 million older veterans receiving care during the study period, 8,000 hospitalizations may have been unnecessary. The most common ADRs that occurred were bradycardia (n = 6; beta-blockers, digoxin), hypoglycemia (n = 6; sulfonylureas, insulin), falls (n = 6; antidepressants, angiotensin-converting enzyme inhibitors), and mental status changes (n = 6; anticonvulsants, benzodiazepines). Overall, 44.8% of veterans took nine or more outpatient medications and 35.4% took five to eight. Using multivariable logistic regression and controlling for demographic, health-status, and access-to-care variables, polypharmacy (≥9 and 5-8) was associated with greater risk of ADR-related hospitalization (adjusted odds ratio (AOR) = 3.90, 95% confidence interval (CI) = 1.43-10.61 and AOR = 2.85, 95% CI = 1.03-7.85, respectively). ADRs, determined using a validated causality algorithm, are a common cause of unplanned hospitalization in older veterans, are frequently preventable, and are associated with polypharmacy. © 2011, Copyright the Authors Journal compilation © 2011, The American Geriatrics Society.

  5. Honoring our Nation's Veterans

    Directory of Open Access Journals (Sweden)

    Robbins RA

    2015-11-01

    Full Text Available No abstract available. Article truncated at 150 words. Today is Armistice Day, renamed Veterans Day in 1954, to honor our Nation's Veterans. In Washington the rhetoric from both the political right and left supports our Veterans. My cynical side reminds me that this might have something to do with Veterans voting in a higher percentage than the population as a whole, but let me give the politicians this one. Serving our Country in the military is something that deserves to be honored. I was proud to serve our Veterans over 30 years at the four Department of Veterans Affairs (VA hospitals. However, the VA has had a very bad year. First, in Washington there were the resignations of the Secretary of Veterans Affairs, Eric Shinseki; the undersecretary for the Veterans Health Administration, Robert Petzel; and the undersecretary for the Veterans Benefits Administration, Allison Hickey. Locally, in the light of the VA wait scandal there were the firing of ...

  6. Childhood conduct disorder trajectories, prior risk factors and cannabis use at age 16: birth cohort study.

    Science.gov (United States)

    Heron, Jon; Barker, Edward D; Joinson, Carol; Lewis, Glyn; Hickman, Matthew; Munafò, Marcus; Macleod, John

    2013-12-01

    To investigate the prevalence of cannabis use and problem use in boys and girls at age 16 years, and to investigate the role of adversity in early life and of conduct disorder between the ages of 4 and 13 years as risk factors for these outcomes. Birth cohort study. England. A total of 4159 (2393 girls) participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort providing information on cannabis use at age 16. Cannabis use and problem cannabis use at age 16 were assessed by postal questionnaire. Material adversity, maternal substance use, maternal mental health and child conduct disorder were all assessed by maternal report. Cannabis use was more common among girls than boys (21.4% versus 18.3%, P = 0.005). Problem cannabis use was more common in boys than girls (3.6% versus 2.8%, P = 0.007). Early-onset persistent conduct problems were associated strongly with problem cannabis use [odds ratio (OR) = 6.46, 95% confidence interval (CI) = 4.06-10.28]. Residence in subsidized housing (OR = 3.10, 95% CI = 1.95, 4.92); maternal cannabis use (OR 8.84, 95% CI 5.64-13.9) and any maternal smoking in the postnatal period (OR = 2.69, 95% CI = 1.90-3.81) all predicted problem cannabis use. Attributable risks for adolescent problem cannabis use associated with the above factors were 25, 13, 17 and 24%, respectively. Maternal smoking and cannabis use, early material disadvantage and early-onset persistent conduct problems are important risk factors for adolescent problem cannabis use. This may have implications for prevention. © 2013 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

  7. The physical and mental health of Australian Vietnam veterans 3 decades after the war and its relation to military service, combat, and post-traumatic stress disorder.

    Science.gov (United States)

    O'Toole, Brian I; Catts, Stanley V; Outram, Sue; Pierse, Katherine R; Cockburn, Jill

    2009-08-01

    The long-term health consequences of war service remain unclear, despite burgeoning scientific interest. A longitudinal cohort study of a random sample of Australian Vietnam veterans was designed to assess veterans' postwar physical and mental health 36 years after the war (2005-2006) and to examine its relation to Army service, combat, and post-traumatic stress disorder (PTSD) assessed 14 years previously (1990-1993). Prevalences in veterans (n = 450) were compared with those in the Australian general population. Veterans' Army service and data from the first assessments were evaluated using multivariate logistic regression prediction modeling. Veterans' general health and some health risk factors were poorer and medical consultation rates were higher than Australian population expectations. Of 67 long-term conditions, the prevalences of 47 were higher and the prevalences of 4 were lower when compared with population expectations. Half of all veterans took some form of medication for mental well-being. The prevalence of psychiatric diagnoses exceeded Australian population expectations. Military and war service characteristics and age were the most frequent predictors of physical health endpoints, while PTSD was most strongly associated with psychiatric diagnoses. Draftees had better physical health than regular enlistees but no better mental health. Army service and war-related PTSD are associated with risk of illness in later life among Australian Vietnam veterans.

  8. Trajectories of gambling problems from mid-adolescence to age 30 in a general population cohort.

    Science.gov (United States)

    Carbonneau, René; Vitaro, Frank; Brendgen, Mara; Tremblay, Richard E

    2015-12-01

    Studies of gambling starting before adulthood in the general population are either cross-sectional, based on the stability of these behaviors between 2 time points, or cover a short developmental period. The present study aimed at investigating the developmental trajectories of gambling problems across 3 key periods of development, mid-adolescence, early adulthood, and age 30, in a mixed-gender cohort from the general population. Using a semiparametric mixture model, trajectories were computed based on self-reports collected at ages 15 (N = 1,882), 22 (N = 1,785), and 30 (N = 1,358). Two distinct trajectories were identified: 1 trajectory including males and females who were unlikely to have experienced gambling problems across the 15-year period, and 1 trajectory including participants likely to have experienced at least 1 problem over the last 12 months at each time of assessment. Participants following a high trajectory were predominantly male, participated frequently in 3 to 4 different gambling activities, and were more likely to report substance use and problems related to their alcohol and drug consumption at age 30. Thus, gambling problems in the general population are already observable at age 15 in a small group of individuals, who maintain some level of these problems through early adulthood, before moderately but significantly desisting by age 30, while also experiencing other addictive behaviors and related problems. (c) 2016 APA, all rights reserved).

  9. Menarcheal Age and Risk of Type 2 Diabetes: A Community-Based Cohort Study.

    Science.gov (United States)

    Farahmand, Maryam; Tehrani, Fahimeh Ramezani; Dovom, Marzieh Rostami; Azizi, Fereidoun

    2017-06-01

    It has been reported that early menarche is associated with higher risk for type 2 diabetes. We aimed to explore the association between age at menarche and risk of type 2 diabetes in a population-based cohort study. For the purpose of the present study, 5191 subjects of reproductive age who were participants of the Tehran Lipid and Glucose Study and also met the eligibility criteria were selected. Demographic, lifestyle, reproductive, and anthropometric data as well as risk factors for metabolic diseases were collected. Menarcheal age was categorized into five categories, as 17 years. Diabetes and pre-diabetes were defined according to the American Diabetes Association criteria. Logistic regression analysis was used to assess the risk of the menarcheal age group for type 2 diabetes and pre-diabetes. Of 5625 participants, 673 women had pre-diabetes and 187 had diabetes. Early menarche was associated with higher risk of diabetes and pre-diabetes, compared to the reference group (13-14 years), (OR=3.55, 95% CI: 1.6-7.8 and OR=2.55, 95% CI:1.4-4.8, respectively), an association which remained after further adjustment for potential confounders including family history of diabetes, parity, education, age, body mass index, waist circumference, smoking history, physical activity, and duration of oral contraceptives use. Results showed early menarche to be a potential risk factor for type 2 diabetes and pre-diabetes.

  10. The Effect of Age on Fracture Risk: A Population-Based Cohort Study

    Directory of Open Access Journals (Sweden)

    Wenbin Liang

    2016-01-01

    Full Text Available Aim. To precisely estimate the effect of age on the risk of fracture hospitalisation among the Western Australia population over the life course. Methods. This population-based cohort study used hospital data on fractures for the period January 1991 to January 2013 among Western Australians born between 1915 and 1990. Results. The average incidence rates (per 10,000 person-years of fracture hospitalisation (95% confidence interval were 50.12 (49.90, 50.35, 55.14 (54.82, 55.48, and 45.02 (44.71, 45.32 for both males and females, males only, and females only, respectively. The age-specific rate of fracture hospitalisation (in natural logarithm form in adults (>18 years was well predicted by age at its 1st, 2nd, and 3rd power in males with an adjusted R-squared of 0.98 and p 0.8 with an adjusted R-squared of 0.99 and p<0.001. Conclusions. Overall trends in age and gender specific risk of fracture among the Western Australian population were similar to estimates reported from previous studies. The trend in fracture hospitalisation risk over the life course can be almost fully explained by age.

  11. Parenting style in childhood and mortality risk at older ages: a longitudinal cohort study.

    Science.gov (United States)

    Demakakos, Panayotes; Pillas, Demetris; Marmot, Michael; Steptoe, Andrew

    2016-08-01

    Parenting style is associated with offspring health, but whether it is associated with offspring mortality at older ages remains unknown. We examined whether childhood experiences of suboptimal parenting style are associated with increased risk of death at older ages. Longitudinal cohort study of 1964 community-dwelling adults aged 65-79 years. The association between parenting style and mortality was inverse and graded. Participants in the poorest parenting style score quartile had increased risk of death (hazard ratio (HR) = 1.72, 95% CI 1.20-2.48) compared with those in the optimal parenting style score quartile after adjustment for age and gender. Full adjustment for covariates partially explained this association (HR = 1.49, 95% CI 1.02-2.18). Parenting style was inversely associated with cancer and other mortality, but not cardiovascular mortality. Maternal and paternal parenting styles were individually associated with mortality. Experiences of suboptimal parenting in childhood are associated with increased risk of death at older ages. © The Royal College of Psychiatrists 2016.

  12. Associations of pet ownership with biomarkers of ageing: population based cohort study.

    Science.gov (United States)

    Batty, G David; Zaninotto, Paola; Watt, Richard G; Bell, Steven

    2017-12-13

    To examine the prospective relation between animal companionship and biomarkers of ageing in older people. Analyses of data from the English Longitudinal Study of Ageing, an ongoing, open, prospective cohort study initiated in 2002-03. Nationally representative study from England. 8785 adults (55% women) with a mean age of 67 years (SD 9) at pet ownership assessment in 2010-11 (wave 5). Established biomarkers of ageing in the domains of physical, immunological, and psychological function, as assessed in 2012-13 (wave 6). One third of study members reported pet ownership: 1619 (18%) owned a dog, 1077 (12%) a cat, and 274 (3%) another animal. After adjustment for a range of covariates, there was no evidence of a clear association of any type of pet ownership with walking speed, lung function, chair rise time, grip strength, leg raises, balance, three markers of systemic inflammation, memory, or depressive symptoms. In this population of older adults, the companionship of creatures great and small seems to essentially confer no relation with standard ageing phenotypes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Infant motor development predicts sports participation at age 14 years: northern Finland birth cohort of 1966.

    Directory of Open Access Journals (Sweden)

    Charlotte L Ridgway

    2009-08-01

    Full Text Available Motor proficiency is positively associated with physical activity levels. The aim of this study is to investigate associations between the timing of infant motor development and subsequent sports participation during adolescence.Prospective observational study. The study population consisted of 9,009 individuals from the Northern Finland Birth Cohort 1966. Motor development was assessed by parental report at age 1 year, using age at walking with support and age at standing unaided. At follow up aged 14 years, data were collected on the school grade awarded for physical education (PE. Self report was used to collect information on the frequency of sports participation and number of different sports reported.Earlier infant motor development was associated with improved school PE grade, for age at walking supported (p<0.001 and standing unaided (p = <0.001. Earlier infant motor development, in terms of age at walking supported, was positively associated with the number of different sports reported (p = 0.003 and with a greater frequency of sports participation (p = 0.043. These associations were independent of gestational age and birth weight, as well as father's social class and body mass index at age 14 years.Earlier infant motor development may predict higher levels of physical activity as indicated by higher school PE grade, participation in a greater number of different types of sports and increased frequency of sports participation. Identification of young children with slower motor development may allow early targeted interventions to improve motor skills and thereby increase physical activity in later life.

  14. Surgery and Adjuvant Chemotherapy Use Among Veterans With Colon Cancer: Insights From a California Study

    Science.gov (United States)

    Hynes, Denise M.; Tarlov, Elizabeth; Durazo-Arvizu, Ramon; Perrin, Ruth; Zhang, Qiuying; Weichle, Thomas; Ferreira, M. Rosario; Lee, Todd; Benson, Al B.; Bhoopalam, Nirmala; Bennett, Charles L.

    2010-01-01

    Purpose US veterans have been shown to be a vulnerable population with high cancer rates, and cancer care quality in Veterans Affairs (VA) hospitals is the focus of a congressionally mandated review. We examined rates of surgery and chemotherapy use among veterans with colon cancer at VA and non-VA facilities in California to gain insight into factors associated with quality of cancer care. Methods A retrospective cohort of incident colon cancer patients from the California Cancer Registry, who were ≥ 66 years old and eligible to use VA and Medicare between 1999 and 2001, were observed for 6 months after diagnosis. Results Among 601 veterans with colon cancer, 72% were initially diagnosed and treated in non-VA facilities. Among veterans with stage I to III cancer, those diagnosed and initially treated in VA facilities experienced similar colectomy rates as those at non-VA facilities. Stage III patients diagnosed and initially treated in VA versus non-VA facilities had similar odds of receiving adjuvant chemotherapy. In both settings, older patients had lower odds of receiving chemotherapy than their younger counterparts even when race and comorbidity were considered (age 76 to 85 years: odds ratio [OR] = 0.18; 95% CI, 0.07 to 0.46; age ≥ 86 years: OR = 0.17; 95% CI, 0.04 to 0.73). Conclusion In California, older veterans with colon cancer used both VA and non-VA facilities for cancer treatment, and odds of receiving cancer-directed surgery and chemotherapy were similar in both systems. Among stage III patients, older age lowered odds of receiving adjuvant chemotherapy in both systems. Further studies should continue to explore potential health system effects on quality of colon cancer care across the United States. PMID:20406940

  15. Immune recovery of middle-aged HIV patients following antiretroviral therapy: An observational cohort study.

    Science.gov (United States)

    Wong, Ngai Sze; Chan, Kenny Chi Wai; Cheung, Edward Ka Hin; Wong, Ka Hing; Lee, Shui Shan

    2017-07-01

    In HIV-infected persons, age is negatively associated with optimal CD4 recovery following antiretroviral therapy. Our understanding of the situation in older adults, especially the middle-aged is, however, limited. We undertook to examine the latter's pattern of CD4/CD8 recovery following antiretroviral therapy.Retrospective clinical cohort data of HIV patients diagnosed between 1985 and 2014 in Hong Kong were collected. They were categorized by age at treatment initiation, viz., young adults (age 18-49), middle-aged (age 50-64), and elderly (≥65 years' old). Predictors of immune recovery (CD4 count, CD8 count, CD4/CD8 ratio) over time were examined using multivariable linear generalized estimating equations.A total of 2754 patients (aged ≥18) have been on antiretroviral therapy, with baseline characteristics similar between middle-aged and the elderly. Late diagnosis, defined as progression to AIDS within 3 months of HIV diagnosis, was less common in middle-aged (odds ratio = 0.58, 95% confidence interval = 0.37-0.91). Among Chinese patients who have been on treatment for ≥4 years (n = 913), 80.6%, 14.6%, and 4.8% were young adults, middle-aged, and elderly respectively. Late treatment initiation, defined as AIDS diagnosis or CD4 count ≤100 cells/μL before treatment, was common in middle-aged and elderly, the former however had faster CD4 recovery (3.95 vs. 3.36 cells/μL/month), but slower CD8 decline (-1.76 vs. -4.34 cells/μL/month) and CD4/CD8 normalization (0.009 vs. 0.0101/month).As a transitional age group, the immune recovery of middle-aged patients lagged behind young adults largely because of late treatment initiation. Following adoption of early and non-CD4-guided treatment initiation, their long-term clinical outcome is expected to improve.

  16. Longitudinal trends in self-reported anxiety. Effects of age and birth cohort during 25 years.

    Science.gov (United States)

    Calling, Susanna; Midlöv, Patrik; Johansson, Sven-Erik; Sundquist, Kristina; Sundquist, Jan

    2017-04-26

    Anxiety has been suggested to increase among young individuals, but previous studies on longitudinal trends are inconclusive. The aim of this study was to analyze longitudinally, the changes over time of prevalence of self-reported anxiety in the Swedish population between 1980/1981 and 2004/2005, in different birth cohorts and age groups. A random sample of non-institutionalized persons aged 16-71 years was interviewed every eighth year. Self-reported anxiety was assessed using the question" Do you suffer from nervousness, uneasiness, or anxiety?" (no; yes, mild; yes, severe). Mixed models with random intercepts were used to estimate changes in rates of anxiety (mild or severe) within different age groups and birth cohorts and in males and females separately. In addition to three time-related variables - year of interview, age at the time of the interview, and year of birth -the following explanatory variables were included: education, urbanization, marital status, smoking, leisure time physical activity and body mass index. Overall prevalence of self-reported anxiety increased from 8.0 to 12.4% in males and from 17.8% to 23.6% in females, during the 25-year follow-up period. The increasing trend was found in all age groups except in the oldest age groups, and the highest increase was found in young adults 16-23 years, with more than a three-fold increase in females, and a 2.5-fold increase in males, after adjustments for covariates. Between 1980/81 and 2004/05, there was an increasing prevalence of self-reported anxiety in all age groups except in the oldest, which indicates increased suffering for a large part of the population, and probably an increased burden on the health care system. Clinical efforts should focus particularly on young females (16-23 years), where the increase was particularly large; almost one third experienced anxiety at the end of the 25-year follow-up.

  17. Long-term cognitive correlates of traumatic brain injury across adulthood and interactions with APOE genotype, sex, and age cohorts.

    Science.gov (United States)

    Eramudugolla, Ranmalee; Bielak, Allison A M; Bunce, David; Easteal, Simon; Cherbuin, Nicolas; Anstey, Kaarin J

    2014-04-01

    There is continuing debate about long-term effects of brain injury. We examined a range of traumatic brain injury (TBI) variables (TBI history, severity, frequency, and age of injury) as predictors of cognitive outcome over 8 years in an adult population, and interactions with apolipoprotein E (APOE) genotype, sex, and age cohorts. Three randomly sampled age cohorts (20-24, 40-44, 60-64 years at baseline; N = 6333) were each evaluated three times over 8 years. TBI variables, based on self-report, were separately modeled as predictors of cognitive performance using linear mixed effects models. TBI predicted longitudinal cognitive decline in all three age groups. APOE ε4 + genotypes in the young and middle-aged groups predicted lower baseline cognitive performance in the context of TBI. Baseline cognitive performance was better for young females than males but this pattern reversed in middle age and old age. The findings suggest TBI history is associated with long-term cognitive impairment and decline across the adult lifespan. A role for APOE genotype was apparent in the younger cohorts but there was no evidence that it is associated with impairment in early old age. The effect of sex and TBI on cognition varied with age cohort, consistent with a proposed neuroprotective role for estrogen.

  18. Age, academic performance, and stimulant prescribing for ADHD: a nationwide cohort study.

    Science.gov (United States)

    Zoëga, Helga; Valdimarsdóttir, Unnur A; Hernández-Díaz, Sonia

    2012-12-01

    We evaluated whether younger age in class is associated with poorer academic performance and an increased risk of being prescribed stimulants for attention-deficit/hyperactivity disorder (ADHD). This was a nationwide population-based cohort study, linking data from national registries of prescribed drugs and standardized scholastic examinations. The study population comprised all children born in 1994-1996 who took standardized tests in Iceland at ages 9 and 12 (n = 11 785). We estimated risks of receiving low test scores (0-10th percentile) and being prescribed stimulants for ADHD. Comparisons were made according to children's relative age in class. Mean test scores in mathematics and language arts were lowest among the youngest children in the fourth grade, although the gap attenuated in the seventh grade. Compared with the oldest third, those in the youngest third of class had an increased relative risk of receiving a low test score at age 9 for mathematics (1.9; 95% confidence interval [CI] 1.6-2.2) and language arts (1.8; 95% CI 1.6-2.1), whereas at age 12, the relative risk was 1.6 in both subjects. Children in the youngest third of class were 50% more likely (1.5; 95% CI 1.3-1.8) than those in the oldest third to be prescribed stimulants between ages 7 and 14. Relative age among classmates affects children's academic performance into puberty, as well as their risk of being prescribed stimulants for ADHD. This should be taken into account when evaluating children's performance and behavior in school to prevent unnecessary stimulant treatment.

  19. Green space and cognitive ageing: A retrospective life course analysis in the Lothian Birth Cohort 1936.

    Science.gov (United States)

    Cherrie, Mark P C; Shortt, Niamh K; Mitchell, Richard J; Taylor, Adele M; Redmond, Paul; Thompson, Catharine Ward; Starr, John M; Deary, Ian J; Pearce, Jamie R

    2017-11-07

    International evidence suggests that green space has beneficial effects on general and mental health but little is known about how lifetime exposure to green space influences cognitive ageing. Employing a novel longitudinal life course approach, we examined the association between lifetime availability of public parks and cognitive ageing. Lifetime residential information was gathered from the participants of the Lothian Birth Cohort 1936 using a "life-grid" questionnaire at age 78 years. Parks information from 1949, 1969 and 2009 was used to determine a percentage of parks within a 1500 m buffer zone surrounding residence for childhood, adulthood, and later adulthood periods. Linear regressions were undertaken to test for association with age-standardised, residualised change in cognitive function (Moray House Test score) from age 11 to 70 years, and from age 70 to 76 (n = 281). The most appropriate model was selected using the results of a partial F-test, and then stratified by demographic, genetic and socioeconomic factors. The local provision of park space in childhood and adulthood were both important in explaining the change in cognitive function in later life. The association between childhood and adulthood park availability and change in the Moray House Test Score from age 70 to 76 was strongest for women, those without an APOE e4 allele (a genetic risk factor), and those in the lowest socioeconomic groups. Greater neighbourhood provision of public parks from childhood through to adulthood may help to slow down the rate of cognitive decline in later life, recognising that such environmental associations are always sensitive to individual characteristics. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. [A prospective cohort study on injuries among school-age children with and without behavior problems].

    Science.gov (United States)

    Peng, Ying-chun; Ni, Jin-fa; Tao, Fang-biao; Wu, Xi-ke

    2003-08-01

    To study the annual incidence of injuries and the relationship between behavior problems and injuries among school-age children. A prospective cohort study on injuries for 1-year follow-up period was conducted among 2 005 school-age children selected by cluster sampling from three primary schools in Maanshan city. They subjects were divided into two groups with or without exposure according to behavior problems rated by the Rutter Child Behavior Questionnaire at the beginning of the study. Nonparametric test was performed to analyze the differences in injuries between the two groups of children, and the influential factors for injuries were analyzed with multi-classification ordinal response variable logistic regression model. The overall incidence rate for injuries in school-age children was 42.51%, while among children with and without behavior problems were 64.87% and 38.85%, respectively. There were significant differences between the two groups (u = -6.054, P = 0.000). However, the incidence rates of injuries in school-age children with antisocial (A) behavior, neurotic (N) behavior and mixed (M) behavior were 66.99%, 67.41% and 61.40%, respectively. No significant differences were found among them (u(A,N) = -0.052, P = 0.958; u(A,M) = -0.400, P = 0.689; u(N,M) = -0.364, P = 0.716). Multivariate analysis indicated that injuries in school-age children were associated with children behavior problems, maternal age at childbirth, bad conditions during mother pregnancy, education background of mother, prevention measures for safety at home and the child accompanied to travel between school and home by adults. Behavior problems of children seemed to be the major risk factors for injuries. Children with behavior problems represented a significant risk group for injuries among school-age children. When planning intervention strategies on injuries, behavior problems should be emphasized to ensure optimal effectiveness of intervention.

  1. Association of aging and survival in a large HIV-infected cohort on antiretroviral therapy.

    Science.gov (United States)

    Bakanda, Celestin; Birungi, Josephine; Mwesigwa, Robert; Ford, Nathan; Cooper, Curtis L; Au-Yeung, Christopher; Chan, Keith; Nachega, Jean B; Wood, Evan; Hogg, Robert S; Dybul, Mark; Mills, Edward J

    2011-03-13

    To examine if there is a significant difference in survival between elderly (>50 years) and nonelderly adult patients receiving combination antiretroviral therapy in Uganda between 2004 and 2010. Prospective observational study. Patients 18-49 years of age (nonelderly) and 50 years of age and older enrolled in the AIDS Support Organization Uganda HIV/AIDS national programme were assessed for time to all-cause mortality. We applied a Weibull multivariable regression. Among the 22 087 patients eligible for analyses, 19 657 (89.0%) were aged between 18 and 49 years and 2430 (11.0%) were aged 50 years or older. These populations differed in terms of the distributions of sex, baseline CD4 cell count and death. The age group 40-44 displayed the lowest crude mortality rate [31.4 deaths per 1000 person-years; 95% confidence interval (CI) 28.1, 34.7) and the age group 60-64 displayed the highest crude mortality rate (58.9 deaths per 1000 person-years; 95% CI 42.2, 75.5). Kaplan-Meier survival estimates indicated that nonelderly patients had better survival than elderly patients (P age status was importantly associated (adjusted hazard ratio 1.23, 95% CI 1.08-1.42) with mortality, when controlling for sex, baseline CD4 cell count and year of therapy initiation. As antiretroviral treatment cohorts mature, the proportion of patients who are elderly will inevitably increase. Elderly patients may require focused clinical care that extends beyond HIV treatment.

  2. Sex differential in mortality trends of old-aged Danes: A nation wide study of age, period and cohort effects

    DEFF Research Database (Denmark)

    Jacobsen, Rune; Oksuzyan, Anna; Engberg, Henriette

    2008-01-01

    OBJECTIVE: Over the last half century the mortality rates in Denmark for females above age 80 have declined dramatically whereas the decline for males have been modest, resulting in a change in sex-ratio for centenarians from 2 to 5. Here we investigate whether this mortality pattern is mainly...... effects. The observed rates were better described by the age, period and cohort model than by other models. CONCLUSIONS: Our results suggest that causes for both the overall increased difference in mortality and the short term fluctuations in mortality rates are primarily to be found in the period...... explained by period effects, cohort effects or both. This can provide clues for where to search for causes behind the changes in sex differential in mortality seen in many Western countries during the last decades. METHODS: Age-period-cohort study of mortality for all Danish women and men aged 79-98 during...

  3. Cognitive impacts of ambient air pollution in the National Social Health and Aging Project (NSHAP) cohort.

    Science.gov (United States)

    Tallon, Lindsay A; Manjourides, Justin; Pun, Vivian C; Salhi, Carmel; Suh, Helen

    2017-07-01

    Pathways through which air pollution may impact cognitive function are poorly understood, particularly with regard to whether and how air pollution interacts with social and emotional factors to influence cognitive health. To examine the association between air pollutant exposures and cognitive outcomes among older adults participating in the National Social Life, Health, and Aging Project (NSHAP) cohort study. Measures of cognitive function, social connectedness, and physical and mental health were obtained for each NSHAP participant starting with Wave 1 of the study in 2005. Cognitive function was assessed using the Chicago Cognitive Function Measure (CCFM) for 3377 participants. Exposures to fine particles (PM2.5) were estimated for each participant using GIS-based spatio-temporal models, and exposures to nitrogen dioxide (NO2) were obtained from the nearest EPA monitors. In adjusted linear regression models, IQR increases in 1 to 7year PM2.5 exposures were associated with a 0.22 (95% CI: -0.44, -0.01) to a 0.25 (95% CI: -0.43, -0.06) point decrease in CCFM scores, equivalent to aging 1.6years, while exposures to NO2 were equivalent to aging 1.9years. The impacts of PM2.5 on cognition were modified by stroke, anxiety, and stress, and were mediated by depression. The impacts of NO2 were mediated by stress and effect modification by impaired activities of daily living for NO2 was found. Exposures to long-term PM2.5 and NO2 were associated with decreased cognitive function in our cohort of older Americans, and individuals who experienced a stroke or elevated anxiety were more susceptible to the effects of PM2.5 on cognition. Additionally, mediation results suggest that PM2.5 may impact cognition through pathways related to mood disorders. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Trends and Age-Period-Cohort Effects on the Incidence and Mortality Rate of Cervical Cancer in Korea.

    Science.gov (United States)

    Moon, Eun-Kyeong; Oh, Chang-Mo; Won, Young-Joo; Lee, Jong-Keun; Jung, Kyu-Won; Cho, Hyunsoon; Jun, Jae Kwan; Lim, Myong Cheol; Ki, Moran

    2017-04-01

    This study was conducted to describe the trends and age-period-cohort effects on the incidence and mortality rate of cervical cancer in Korea. The incidence and mortality rate of cervical cancer among ≥ 20-year-old women from 1993 to 2012 were obtained from the Korea Central Cancer Registry and the Korean Statistical Information Service. Age-standardized rates were calculated and Joinpoint regression was used to evaluate the trends in the incidence and mortality rate. Age-period-cohort analysis was performed to investigate the independent effects of age, period and cohort. The incidence of cervical cancer decreased from 32.8 per 100,000 in 1993 to 15.9 per 100,000 in 2012 (annual percent change [APC], -3.9%; 95% confidence interval [CI], -4.2% to -3.6%). The mortality rate decreased from 5.2 per 100,000 in 1993 to 2.1 per 100,000 in 2012 (APC, -4.8%; 95% CI, -5.1% to -4.4%); however, the incidence and mortality rates among young women (age-period-cohort model of the incidence and mortality rate showed decreasing period effects between 1993 and 2008 and decreasing cohort effects between 1928 and 1973, while birth cohorts after 1973 exhibited slight increases in the incidence and mortality rate of cervical cancer. Recent decreases in the incidence and mortality rate of cervical cancer were due to decreases in the period and cohort effects, which reflect the implementation of a cancer screening program and changes in lifestyle. However, our findings also highlighted an increase in cohort effects on the incidence and mortality rate among young women born after 1973.

  5. Age Adjusted D-Dimer for exclusion of Pulmonary Embolism: a retrospective cohort study.

    LENUS (Irish Health Repository)

    Monks, D

    2017-08-01

    D-Dimer (DD) will increase with age and recent studies have shown the upper limit of normal can be raised in those who are low risk and over 50. We studied age adjusted D-dimer (AADD) levels to assess whether pulmonary embolism (PE) could be safely excluded. This study analysed the Emergency Department (ED) Computed Tomographic Pulmonary Angiography (CTPA) requests. There were 756 requests. The parameters studied were; age, DD value, calculated AADD, CT result and Simplified Geneva Score (SGS). The primary outcome was the diagnostic performance of AADD. One hundred and eighty-five patients were included in the final cohort. Twenty-one patients had a negative DD after age adjustment. Of these one had a PE, corresponding to a failure rate of 4.76% (1 in 22). The sensitivity of AADD was 0.96 (95% CI 0.76 to 0.99) and its specificity was 0.12 (95% CI 0.08- 0.19). AADD demonstrated a reduction in false positives with one false negative, giving rise to a failure rate higher than that of other larger studies. Further study is indicated to accurately define the diagnostic characteristics for the Irish context.

  6. Joint replacement surgery in homeless veterans

    Directory of Open Access Journals (Sweden)

    Chase G. Bennett, MD

    2017-12-01

    Full Text Available Total joint arthroplasty (TJA in a homeless patient is generally considered contraindicated. Here, we report our known medical and social (housing and employment results of homeless veterans who had TJA. Thirty-seven TJAs were performed on 33 homeless patients (31 men at our hospital between November 2000 and March 2014. This was 1.2% of all TJAs. Average age was 54 years. Average hospital stay was 4.1 days. There were no major inpatient complications. Thirty-four cases had at least 1-year follow-up in any clinic within the Veterans Affairs health care system. There were no known surgery-related reoperations or readmissions. At final follow-up, 24 patients had stable housing and 9 were employed. The extensive and coordinated medical and social services that were provided to veterans from the Department of Veterans Affairs contributed to our positive results. Keywords: Homeless, Veteran, Joint replacement, Total hip, Total knee, Employment

  7. Associated Factors for Falls, Recurrent Falls, and Injurious Falls in Aged Men Living in Taiwan Veterans Homes

    Directory of Open Access Journals (Sweden)

    Yan-Chiou Ku

    2013-06-01

    Conclusion: This study demonstrated that the advanced age, depression status, stroke, gouty arthritis, and cataract are independent variables for predicting falls; depression is the only clinical factor capable of predicting the recurrent falls. These variables were potential targets for effective prevention of falls.

  8. The longitudinal urban cohort ageing study (LUCAS: study protocol and participation in the first decade

    Directory of Open Access Journals (Sweden)

    Dapp Ulrike

    2012-07-01

    Full Text Available Abstract Background We present concept, study protocol and selected baseline data of the Longitudinal Urban Cohort Ageing Study (LUCAS in Germany. LUCAS is a long-running cohort study of community-dwelling seniors complemented by specific studies of geriatric patients or diseases. Aims were to (1 Describe individual ageing trajectories in a metropolitan setting, documenting changes in functional status, the onset of frailty, disability and need of care; (2 Find determinants of healthy ageing; (3 Assess long-term effects of specific health promotion interventions; (4 Produce results for health care planning for fit, pre-frail, frail and disabled elderly persons; (5 Set up a framework for embedded studies to investigate various hypotheses in specific subgroups of elderly. Methods/Design In 2000, twenty-one general practitioners (GPs were recruited in the Hamburg metropolitan area; they generated lists of all their patients 60 years and older. Persons not terminally ill, without daily need of assistance or professional care were eligible. Of these, n = 3,326 (48 % agreed to participate and completed a small (baseline and an extensive health questionnaire (wave 1. In 2007/2008, a re-recruitment took place including 2,012 participants: 743 men, 1,269 women (647 deaths, 197 losses, 470 declined further participation. In 2009/2010 n = 1,627 returned the questionnaire (90 deaths, 47 losses, 248 declined further participation resulting in a good participation rate over ten years with limited and quantified dropouts. Presently, follow-up data from 2007/2008 (wave 2 and 2009/2010 (wave 3 are available. Data wave 4 is due in 2011/2012, and the project will be continued until 2013. Information on survival and need of nursing care was collected continuously and cross-checked against official records. We used Fisher’s exact test and t-tests. The study served repeatedly to evaluate health promotion interventions and concepts. Discussion LUCAS

  9. Design and methods of the national Vietnam veterans longitudinal study.

    Science.gov (United States)

    Schlenger, William E; Corry, Nida H; Kulka, Richard A; Williams, Christianna S; Henn-Haase, Clare; Marmar, Charles R

    2015-09-01

    The National Vietnam Veterans Longitudinal Study (NVVLS) is the second assessment of a representative cohort of US veterans who served during the Vietnam War era, either in Vietnam or elsewhere. The cohort was initially surveyed in the National Vietnam Veterans Readjustment Study (NVVRS) from 1984 to 1988 to assess the prevalence, incidence, and effects of post-traumatic stress disorder (PTSD) and other post-war problems. The NVVLS sought to re-interview the cohort to assess the long-term course of PTSD. NVVLS data collection began July 3, 2012 and ended May 17, 2013, comprising three components: a mailed health questionnaire, a telephone health survey interview, and, for a probability sample of theater Veterans, a clinical diagnostic telephone interview administered by licensed psychologists. Excluding decedents, 78.8% completed the questionnaire and/or telephone survey, and 55.0% of selected living veterans participated in the clinical interview. This report provides a description of the NVVLS design and methods. Together, the NVVRS and NVVLS constitute a nationally representative longitudinal study of Vietnam veterans, and extend the NVVRS as a critical resource for scientific and policy analyses for Vietnam veterans, with policy relevance for Iraq and Afghanistan veterans. Copyright © 2015 John Wiley & Sons, Ltd.

  10. Jaundice in primary care: a cohort study of adults aged >45 years using electronic medical records.

    Science.gov (United States)

    Taylor, Anna; Stapley, Sally; Hamilton, William

    2012-08-01

    Jaundice is a rare but important symptom of malignant and benign conditions. When patients present in primary care, understanding the relative likelihood of different disease processes can help GPs to investigate and refer patients appropriately. To identify and quantify the various causes of jaundice in adults presenting in primary care. Historical cohort study using electronic primary care records. UK General Practice Research Database. Participants (186 814 men and women) aged >45 years with clinical events recorded in primary care records between 1 January 2005 and 31 December 2007. Data were searched for episodes of jaundice and explanatory diagnoses identified within the subsequent 12 months. If no diagnosis was found, the patient's preceding medical record was searched for relevant chronic diseases. From the full cohort, 277 patients had at least one record of jaundice between 1 January 2005 and 31 December 2006. Ninety-two (33%) were found to have bile duct stones; 74 (27%) had an explanatory cancer [pancreatic cancer 34 (12%), cholangiocarcinoma 13 (5%) and other diagnosed primary malignancy 27 (10%)]. Liver disease attributed to excess alcohol explained 26 (9%) and other diagnoses were identified in 24 (9%). Sixty-one (22%) had no diagnosis related to jaundice recorded. Although the most common cause of jaundice is bile duct stones, cancers are present in over a quarter of patients with jaundice in this study, demonstrating the importance of urgent investigation into the underlying cause.

  11. Menopause and HIV infection: age at onset and associated factors, ANRS CO3 Aquitaine cohort.

    Science.gov (United States)

    de Pommerol, M; Hessamfar, M; Lawson-Ayayi, S; Neau, D; Geffard, S; Farbos, S; Uwamaliya, B; Vandenhende, M-A; Pellegrin, J-L; Blancpain, S; Dabis, F; Morlat, P

    2011-02-01

    The aim of the paper is to describe the characteristics of postmenopausal HIV-infected women and to investigate the factors associated with an earlier onset of menopause in a hospital-based cohort. Information was collected using a self-administered questionnaire. A Cox model was used to determine factors associated with menopause. Among the 404 women who completed the questionnaire, 69 were naturally postmenopausal at the time of the study (median age at onset: 49 years, premature menopause <40 years: 12%). The onset of menopause was studied among the 41 women still menstruating at the enrollment in the cohort, and who experienced menopause during follow-up. African origin (hazard ratio [HR] = 8.16; 95% confidence interval [CI] = 2.23-29.89) and history of injecting drug use (IDU) (HR = 2.46; 95% CI = 1.03-5.85) were associated with an increased risk of earlier menopause. Women with a CD4 cell count <200 cells/mm(3) tended to reach menopause earlier (HR = 2.25; 95% CI = 0.94-5.39). Earlier occurrence of menopause seems to be associated with factors already reported in HIV-negative women (IDU, ethnicity) and with HIV-related immunodeficiency.

  12. Universal gestational age effects on cognitive and basic mathematic processing: 2 cohorts in 2 countries.

    Science.gov (United States)

    Wolke, Dieter; Strauss, Vicky Yu-Chun; Johnson, Samantha; Gilmore, Camilla; Marlow, Neil; Jaekel, Julia

    2015-06-01

    To determine whether general cognitive ability, basic mathematic processing, and mathematic attainment are universally affected by gestation at birth, as well as whether mathematic attainment is more strongly associated with cohort-specific factors such as schooling than basic cognitive and mathematical abilities. The Bavarian Longitudinal Study (BLS, 1289 children, 27-41 weeks gestational age [GA]) was used to estimate effects of GA on IQ, basic mathematic processing, and mathematic attainment. These estimations were used to predict IQ, mathematic processing, and mathematic attainment in the EPICure Study (171 children mathematic attainment scores by 2.34 (95% CI: -2.99, -1.70) and 2.76 (95% CI: -3.40, -2.11) points, respectively. There were no differences among children born 34-41 weeks GA. Similarly, for children born mathematic processing scores decreased by 1.77 (95% CI: -2.20, -1.34) points with each lower GA week. The prediction function generated using BLS data accurately predicted the effect of GA on IQ and mathematic processing among EPICure children. However, these children had better attainment than predicted by BLS. Prematurity has adverse effects on basic mathematic processing following birth at all gestations mathematic attainment mathematic processing scores from one cohort to another among children cared for in different eras and countries suggests that universal neurodevelopmental factors may explain the effects of gestation at birth. In contrast, mathematic attainment may be improved by schooling. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  13. The History of Stuttering by 7 Years of Age: Follow-Up of a Prospective Community Cohort

    Science.gov (United States)

    Kefalianos, Elaina; Onslow, Mark; Packman, Ann; Vogel, Adam; Pezic, Angela; Mensah, Fiona; Conway, Laura; Bavin, Edith; Block, Susan; Reilly, Sheena

    2017-01-01

    Purpose: For a community cohort of children confirmed to have stuttered by the age of 4 years, we report (a) the recovery rate from stuttering, (b) predictors of recovery, and (c) comorbidities at the age of 7 years. Method: This study was nested in the Early Language in Victoria Study. Predictors of stuttering recovery included child, family, and…

  14. Strength and muscle quality in a well-functioning cohort of older adults : the Health, Aging and Body Composition Study

    NARCIS (Netherlands)

    Newman, Anne B; Haggerty, Catherine L; Goodpaster, Bret H; Harris, Tamara B; Kritchevsky, Steve; Nevitt, Michael; Miles, Toni P; Visser, Marjolein

    OBJECTIVES: To determine whether lower lean mass and higher fat mass have independent effects on the loss of strength and muscle quality in older adults and might explain part of the effect of age. DESIGN: Single-episode, cross-sectional analyses of a cohort of subjects in the Health, Aging and Body

  15. Risk factors for deformational plagiocephaly at birth and at 7 weeks of age: a prospective cohort study

    NARCIS (Netherlands)

    van Vlimmeren, Leo A.; van der Graaf, Yolanda; Boere-Boonekamp, Magda M.; L'Hoir, Monique P.; Helders, Paul J. M.; Engelbert, Raoul H. H.

    2007-01-01

    The purpose of this work was to identify risk factors for deformational plagiocephaly within 48 hours of birth and at 7 weeks of age. This was a prospective cohort study in which 380 healthy neonates born at term in Bernhoven Hospital in Veghel were followed at birth and at 7 weeks of age. Data

  16. Farming environment and prevalence of atopy at age 31: prospective birth cohort study in Finland.

    Science.gov (United States)

    Lampi, J; Canoy, D; Jarvis, D; Hartikainen, A-L; Keski-Nisula, L; Järvelin, M-R; Pekkanen, J

    2011-07-01

    Cross-sectional studies have shown an association between the farming environment and a decreased risk of atopic sensitization, mainly related to contact with farm animals in the childhood. Investigate the association of a farming environment, especially farm animal contact, during infancy, with atopic sensitization and allergic diseases at the age of 31. In a prospective birth cohort study, 5509 subjects born in northern Finland in 1966 were followed up at the age of 31. Prenatal exposure to the farming environment was documented before or at birth. At age 31, information on health status and childhood exposure to pets was collected by a questionnaire and skin prick tests were performed. Being born to a family having farm animals decreased the risk of atopic sensitization [odds ratio (OR) 0.67; 95% confidence interval (CI) 0.56-0.80], atopic eczema ever (OR 0.77; 95% CI 0.66-0.91), doctor-diagnosed asthma ever (OR 0.74; 95% CI 0.55-1.00), allergic rhinitis at age 31 (OR 0.87; 95% CI 0.73-1.03) and allergic conjunctivitis (OR 0.86; 95% CI 0.72-1.02) at age 31. There was a suggestion that the reduced risk of allergic sensitization was particularly evident among the subjects whose mothers worked with farm animals during pregnancy, and that the reduced risk of the above diseases by farm animal exposure was largely explained by the reduced risk of atopy. Having cats and dogs in childhood revealed similar associations as farm animals with atopic sensitization. Contact with farm animals in early childhood reduces the risk of atopic sensitization, doctor-diagnosed asthma and allergic diseases at age 31. © 2011 Blackwell Publishing Ltd.

  17. Age at puberty and adult blood pressure and body size in a British birth cohort study.

    Science.gov (United States)

    Hardy, Rebecca; Kuh, Diana; Whincup, Peter H; Wadsworth, Michael Ej

    2006-01-01

    To investigate the association between age at puberty and blood pressure at age 53 years. A prospective birth cohort study with regular contacts through childhood and adulthood until the age of 53 years. A total of 1193 men and 1204 women, from a sample of 5362 born in Britain in March 1946. Blood pressure at age 53 years. Regression models indicated that men who had reached puberty latest had a lower mean systolic blood pressure (SBP; P = 0.03) and diastolic blood pressure (DBP; P = 0.01) at 53 years than others. The mean SBP (95% confidence interval) was 6.4 mmHg (1.8, 10.9) greater in the earliest puberty group compared with the latest; for DBP the difference was 4.6 mmHg (1.9, 7.4). The associations were not accounted for by current body size, even though later puberty was associated with a decreasing body mass index (BMI) at 53 years. Neither were they accounted for by prepubertal body size, birth weight, or childhood and adult social class. Although women who reached puberty early had a higher BMI and shorter stature at 53 years compared with other women, they did not have higher blood pressure. Better health behaviours in men reaching puberty late may explain the association between age at puberty and blood pressure. Alternatively, age at puberty may be a marker of the whole growth trajectory, distinguishing characteristics important in the later development of high blood pressure. The association of early puberty with high adult BMI in both sexes highlights the importance of controlling obesity in those who mature early.

  18. Extension of cox proportional hazard model for estimation of interrelated age-period-cohort effects on cancer survival.

    Science.gov (United States)

    Mdzinarishvili, Tengiz; Gleason, Michael X; Kinarsky, Leo; Sherman, Simon

    2011-02-23

    In the frame of the Cox proportional hazard (PH) model, a novel two-step procedure for estimating age-period-cohort (APC) effects on the hazard function of death from cancer was developed. In the first step, the procedure estimates the influence of joint APC effects on the hazard function, using Cox PH regression procedures from a standard software package. In the second step, the coefficients for age at diagnosis, time period and birth cohort effects are estimated. To solve the identifiability problem that arises in estimating these coefficients, an assumption that neighboring birth cohorts almost equally affect the hazard function was utilized. Using an anchoring technique, simple procedures for obtaining estimates of interrelated age at diagnosis, time period and birth cohort effect coefficients were developed.As a proof-of-concept these procedures were used to analyze survival data, collected in the SEER database, on white men and women diagnosed with LC in 1975-1999 and the age at diagnosis, time period and birth cohort effect coefficients were estimated. The PH assumption was evaluated by a graphical approach using log-log plots. Analysis of trends of these coefficients suggests that the hazard of death from LC for a given time from cancer diagnosis: (i) decreases between 1975 and 1999; (ii) increases with increasing the age at diagnosis; and (iii) depends upon birth cohort effects.The proposed computing procedure can be used for estimating joint APC effects, as well as interrelated age at diagnosis, time period and birth cohort effects in survival analysis of different types of cancer.

  19. Veterans and Homelessness

    National Research Council Canada - National Science Library

    Perl, Libby

    2007-01-01

    .... The Department of Veterans Affairs (VA) estimates that it has served approximately 300 returning veterans in its homeless programs and has identified over 1,000 more as being at risk of homelessness...

  20. For Homeless Veterans

    Science.gov (United States)

    ... for VA health care services and are experiencing homelessness. VA case managers may connect these Veterans with ... Veterans who have experienced long-term or repeated homelessness. As of Sept. 30, 2015, HUD had allocated ...

  1. Minority Veteran Report

    Data.gov (United States)

    Department of Veterans Affairs — This report is the first comprehensive report that chronicles the history of racial and ethnic minorities in the military and as Veterans, profiles characteristics...

  2. Minority Veteran Report 2014

    Data.gov (United States)

    Department of Veterans Affairs — This report is the first comprehensive report that chronicles the history of racial and ethnic minorities in the military and as Veterans, profiles characteristics...

  3. Paralyzed Veterans of America

    Science.gov (United States)

    ... Clothing Donate a Vehicle Matching Gifts Buy PVA Gear Donate Donate Now Give Monthly Planned Giving View ... PVA1946 National Veterans Wheelchair Games App Download Now TOP Contact Us Paralyzed Veterans of America 801 Eighteenth ...

  4. Master Veteran Index (MVI)

    Data.gov (United States)

    Department of Veterans Affairs — As of June 28, 2010, the Master Veteran Index (MVI) database based on the enhanced Master Patient Index (MPI) is the authoritative identity service within the VA,...

  5. Early child care and obesity at 12 months of age in the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Neelon, S E B; Andersen, Camilla Schou; Morgen, C S

    2015-01-01

    Background/Objectives:Evidence suggests that the child care environment may be more obesogenic than the family home, and previous studies have found that child care use may be associated with obesity in children. Few studies, however, have focused on child care during infancy, which may...... be an especially vulnerable period. This study examined child care use in infancy and weight status at 12 months of age in a country where paid maternity leave is common and early child care is not as prevalent as in other developed countries.Subjects/Methods:We studied 27821 children born to mothers participating...... in the Danish National Birth Cohort (DNBC), a longitudinal study of pregnant women enrolled between 1997 and 2002, who were also included in the Childcare Database, a national record of child care use in Denmark. The exposure was days in child care from birth to 12 months. The outcomes were sex-specific body...

  6. Micronutrient intake and risk of prostate cancer in a cohort of middle-aged, Danish men

    DEFF Research Database (Denmark)

    Roswall, Nina; Larsen, Signe B.; Friis, Søren

    2013-01-01

    Purpose: Micronutrients may protect against prostate cancer. However, few studies have had high-quality assessment of both dietary and supplemental consumption of micronutrients, rendering possible different source-specific effects difficult to discern. This study evaluates associations between...... intake of vitamin C, E, folate, and beta-carotene and prostate cancer risk, focusing on possible different effects of dietary, supplemental, or total intake and on potential effect modification by alcohol intake and BMI. Methods: Danish prospective cohort study of 26,856 men aged 50-64 years...... was inversely associated with prostate cancer risk, notably on a continuous scale [HR 0.88 (95 % CI 0.79-0.98) per 100 µg increase/day]. The risk reduction was largely confined to non-aggressive tumors [HR 0.71 (0.55-0.93) per 100 µg increase/day]. No influence on prostate cancer risk was observed for dietary...

  7. Back injuries in a cohort of schoolchildren aged 6-12

    DEFF Research Database (Denmark)

    Franz, Claudia; Jespersen, Eva; Rexen, Christina

    2016-01-01

    The aims of this prospective school cohort study were to describe the epidemiology of diagnosed back pain in childhood, classified as either nontraumatic or traumatic back injury, and to estimate the association with physical activity in different settings. Over 2.5 years, 1240 children aged 6......-12 years were surveyed weekly using mobile text messages to ask about the presence or absence of back pain. Pain was clinically diagnosed and injuries were classified using the International Classification of Diseases version 10. Physical activity data were obtained from text messages and accelerometers....... Of the 315 back injuries diagnosed, 186 injuries were nontraumatic and 129 were traumatic. The incidence rate ratio was 1.5 for a nontraumatic back injury compared with a traumatic injury. The overall estimated back injury incidence rate was 0.20 per 1000 physical activity units (95% confidence interval 0...

  8. [Comparability of studies of epidemiological research on aging : Results from the Longitudinal Urban Cohort Ageing Study (LUCAS) and three representative Hamburg cross-sectional studies of healthy aging].

    Science.gov (United States)

    Dapp, Ulrike; Dirksen-Fischer, Martin; Rieger-Ndakorerwa, Gudrun; Fertmann, Regina; Stender, Klaus-Peter; Golgert, Stefan; von Renteln-Kruse, Wolfgang; Minder, Christoph E

    2016-05-01

    Participants of the Longitudinal Urban Cohort Ageing Study (LUCAS) were recruited from patients 60 years and older from general practitioner's offices in Hamburg. This is different from the usual methods of drawing representative samples. The research question addressed the comparability of LUCAS results with those from cross-sectional surveys with participants randomly chosen from a population list. Therefore, the LUCAS data collected in four waves during the first 12 years were compared with data (age, gender) from the Hamburg Statistics Office (HSO), and selected characteristics (socio-demography, health, mobility) from three representative cross-sectional surveys in older Hamburg citizens. First, HSO data compiled in population pyramids for older men and women were compared with equivalent pyramids based on the LUCAS data at recruitment (2000/01) and in waves 2 to 4. Second, characteristics worded identically in the cross-sectional surveys and the simultaneous LUCAS waves were compared. The LUCAS population pyramids were in good accordance at all time points with those of the general older population in Hamburg (except ages 60-64 in men in 2000). Good comparability was also found for health related characteristics from the three representative studies and simultaneous LUCAS waves (e. g. need of nursing care in 2012: LUCAS 7.1 %; Hamburg 7.4 %). Information on health in old age generated periodically in the LUCAS cohort was largely comparable with that from representative cross-sectional studies and statistics registries. Older people are frequently under-represented in epidemiological studies. Therefore, the LUCAS data may provide useful information for Hamburg and similar metropolitan areas in Germany.

  9. Arthritis, comorbidities, and care utilization in veterans of operations enduring and Iraqi Freedom.

    Science.gov (United States)

    Rivera, Jessica C; Amuan, Megan E; Morris, Ruth M; Johnson, Anthony E; Pugh, Mary Jo

    2017-03-01

    Veteran populations are known to have frequencies of arthritis higher than civilian populations. The aim of this study is to define the prevalence of arthritis among a cohort of veterans from ongoing U.S. military operations. A retrospective cohort study using Veterans Administration data sources for service connected disability, comorbidities, clinic utilization, and pharmacy utilization was conducted including veterans who deployed in service to operations in Afghanistan or Iraq, comparing veterans with a diagnosis of arthritis, arthritis plus back pain, and veterans with no pain diagnoses. The frequency of arthritis was 11.8%. Veterans with arthritis and arthritis plus back pain had greater frequencies of diabetes, hyperlipidemia, hypertension, and obesity compare to veterans with no pain diagnosis. Veterans with arthritis plus back pain had the highest pain clinic utilization and prescription use of opioids and anti-inflammatories. Veterans with no pain diagnosis had higher frequencies of diagnosis and clinic utilization for mental health disorders. Arthritis is prevalent among the latest generation of combat veterans and is associated with diabetes, obesity, and cardiovascular comorbidities. The need for arthritis care and associated comorbidities is expected to increase as the Veterans Administration and the civilian health care sector assumes care of these veterans. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:682-687, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  10. Younger age as a prognostic indicator in breast cancer: A cohort study

    LENUS (Irish Health Repository)

    Kheirelseid, Elrasheid A.H.

    2011-08-28

    Abstract Background The debate continues as to whether younger women who present with breast cancer have a more aggressive form of disease and a worse prognosis. The objectives of this study were to determine the incidence of breast cancer in women under 40 years old and to analyse the clinicopathological characteristics and outcome compared to an older patient cohort. Methods Data was acquired from a review of charts and the prospectively reviewed GUH Department of Surgery database. Included in the study were 276 women diagnosed with breast cancer under the age of forty and 2869 women over forty. For survival analysis each women less than 40 was matched with two women over forty for both disease stage and grade. Results The proportion of women diagnosed with breast cancer under the age of forty in our cohort was 8.8%. In comparison to their older counterparts, those under forty had a higher tumour grade (p = 0.044) and stage (p = 0.046), a lower incidence of lobular tumours (p < 0.001), higher estrogen receptor negativity (p < 0.001) and higher HER2 over-expression (p = 0.002); there was no statistical difference as regards tumour size (p = 0.477). There was no significant difference in overall survival (OS) for both groups; and factors like tumour size (p = 0.026), invasion (p = 0.026) and histological type (p = 0.027), PR (p = 0.031) and HER2 (p = 0.002) status and treatment received were independent predictors of OS Conclusion Breast cancer in younger women has distinct histopathological characteristics; however, this does not result in a reduced survival in this population.

  11. Low Systolic Blood Pressure and Mortality From All Causes and Vascular Diseases Among Older Middle-aged Men: Korean Veterans Health Study

    Directory of Open Access Journals (Sweden)

    Sang-Wook Yi

    2015-03-01

    Full Text Available Objectives: Recently, low systolic blood pressure (SBP was found to be associated with an increased risk of death from vascular diseases in a rural elderly population in Korea. However, evidence on the association between low SBP and vascular diseases is scarce. The aim of this study was to prospectively examine the association between low SBP and mortality from all causes and vascular diseases in older middle-aged Korean men. Methods: From 2004 to 2010, 94 085 Korean Vietnam War veterans were followed-up for deaths. The adjusted hazard ratios (aHR were calculated using the Cox proportional hazard model. A stratified analysis was conducted by age at enrollment. SBP was self-reported by a postal survey in 2004. Results: Among the participants aged 60 and older, the lowest SBP (<90 mmHg category had an elevated aHR for mortality from all causes (aHR, 1.9; 95% confidence interval [CI], 1.2 to 3.1 and vascular diseases (International Classification of Disease, 10th revision, I00-I99; aHR, 3.2; 95% CI, 1.2 to 8.4 compared to those with an SBP of 100 to 119 mmHg. Those with an SBP below 80 mmHg (aHR, 4.5; 95% CI, 1.1 to 18.8 and those with an SBP of 80 to 89 mmHg (aHR, 3.1; 95% CI, 0.9 to 10.2 also had an increased risk of vascular mortality, compared to those with an SBP of 90 to 119 mmHg. This association was sustained when excluding the first two years of follow-up or preexisting vascular diseases. In men younger than 60 years, the association of low SBP was weaker than that in those aged 60 years or older. Conclusions: Our findings suggest that low SBP (<90 mmHg may increase vascular mortality in Korean men aged 60 years or older.

  12. A study of mitochondrial DNA mutations in peripheral lymphocytes in an aging cohort.

    Science.gov (United States)

    Zhang, B; Ye, S; Sayer, A A; Hammans, S R; Adio, S; Hinks, L J; Smythe, P J; Groot, D; Cooper, C; Day, I N M

    2003-04-01

    Somatic mutation in the mitochondrial genome occurs much more rapidly than in the nuclear genome and is a feature, possibly contributory, of the aging of cells and tissues. Identifying mitochondrial sequence changes in blood DNA of elderly subjects may provide a maker for the epigenetic changes of mitochondrial DNA known to occur in tissues with lower cellular turnover, and would also have implications for immunosenescence. No large-scale epidemiological studies have been reported previously. In this study we have established long-PCR banks of the mitochondrial genome from peripheral lymphocytes for an elderly cohort of 716 individuals with a range of measured aging phenotypes, and we have established assays for three widely reported mutations: the 4977 bp and 8048 bp deletions and point mutation A3243G. No individuals were identified with detectable heteroplasmy for these changes. Implications for tissue and population prevalence are discussed. The mitochondrial long-PCR DNA banks established will be useful for a wide range of studies of somatic mutation and of germline haplotypes in relation to aging.

  13. Age at first start and racing career of a cohort of Australian Standardbred horses.

    Science.gov (United States)

    Knight, P K; Thomson, P C

    2011-09-01

    OBJECTIVE Compare the career profiles of a cohort of Standardbred horses that first raced as 2-year-olds with those that started their racing careers at a later age. METHOD Retrospective analysis of the racing records of all foals born in New South Wales in the 2000 foaling season. RESULTS The career records of 999 horses were analysed. Almost half (43.9%) first raced as 2-year-olds and one-third (33.9%) as 3-year-olds. The median career duration for horses that first raced as 2-year-olds was 2.93 years (interquartile range (IQR) 2.70-3.16), which was significantly greater than the median for horses that first raced at 3, 4 or ≥5 years old (P raced as 2-year-olds, earned significantly more prize money than females or horses that started racing aged ≥3 years (P raced as 2-year-olds, had significantly more career starts than females or horses that started racing aged ≥3 years (P racing as a 2-year-old had a deleterious effect on a horse's racing career. © 2011 The Authors. Australian Veterinary Journal © 2011 Australian Veterinary Association.

  14. Age and leukocyte count as prognostic factors on acute lymphoblastic leukemia: hgmlal07 cohort

    Directory of Open Access Journals (Sweden)

    Washington Ladines-Castro

    2016-07-01

    Full Text Available In order to establish the cutoff with prognostic implications for white blood cell count and age at diagnosis in adults with acute lymphoblastic leukemia (ALL, we conducted an observational, descriptive and analytical study nested in a retrospective cohort of patients with ALL treated by institutional protocol HGMLAL07 during 2007-2014. We study 255 patients, the 52.9% (n=135 were female and 47.1% (n=120 were male. The mean age was 31 (16-80 years-old. The disease-free survival (DFS decreases in both genders after 20 years-old (p = 0.001. Leukocyte count average was 56.1 x 109/L (0.1-850 x 109/L. DFS decreases significantly from an equal or greater leukocyte count of 20 x 109/L (p<0.05. With this results, we can conclude that use foreign cutoff for age and leukocyte count could determine a bad prognosis stratification and a consequent suboptimal treatment.

  15. Equalisation of socioeconomic differences in injury risks at school age? A study of three age cohorts of Swedish children and adolescents

    DEFF Research Database (Denmark)

    Engström, K; Laflamme, L; Diderichsen, F

    2003-01-01

    The objective of the study was to investigate whether there is equalisation of socioeconomic differences in injury risks among Swedish children and adolescents. Equalisation was defined as a reduction in relative differences in risks between socioeconomic groups. All Swedish children...... and adolescents aged 5-19 in 1990 were grouped into three age cohorts and allocated to four household socioeconomic statuses, considering boys and girls separately. Each cohort was then followed up over a 5-year period (1990-1994) with regard to three injury diagnosis groups (as registered in the national...... applicable, relative risks were computed in order to see whether equalisation benefited all socioeconomic groups. Tendencies of equalisation were found among girls for two of the diagnosis groups: in traffic injuries for the youngest cohort (aged 5-9 in 1990) and in the case of self-inflicted injuries within...

  16. Caffeine consumption and cognitive function at age 70: the Lothian Birth Cohort 1936 study.

    Science.gov (United States)

    Corley, Janie; Jia, Xueli; Kyle, Janet A M; Gow, Alan J; Brett, Caroline E; Starr, John M; McNeill, Geraldine; Deary, Ian J

    2010-02-01

    To investigate the association between caffeine consumption and cognitive outcomes in later life. Participants were 923 healthy adults from the Lothian Birth Cohort 1936 Study, on whom there were intelligence quotient (IQ) data from age 11 years. Cognitive function at age 70 years was assessed, using tests measuring general cognitive ability, speed of information processing, and memory. Current caffeine consumption (using multiple measures of tea, coffee, and total dietary caffeine) was obtained by self-report questionnaire, and demographic and health information was collected in a standardized interview. In age- and sex-adjusted models, there were significant positive associations between total caffeine intake and general cognitive ability and memory. After adjustment for age 11 IQ and social class, both individually and together, most of these associations became nonsignificant. A robust positive association, however, was found between drinking ground coffee (e.g., filter and espresso) and performance on the National Adult Reading Test (NART, p = .007), and the Wechsler Test of Adult Reading (WTAR, p = .02). No gender effects were observed, contrary to previous studies. Generally, higher cognitive scores were associated with coffee consumption, and lower cognitive scores with tea consumption, but these effects were not significant in the fully adjusted model. The present study is rare in having childhood IQ in a large sample of older people. The results suggest that the significant caffeine intake-cognitive ability associations are bidirectional-because childhood IQ and estimated prior IQ are associated with the type of caffeine intake in old age-and partly confounded by social class.

  17. Brain lesions, hypertension and cognitive ageing in the 1921 and 1936 Aberdeen birth cohorts.

    Science.gov (United States)

    Murray, Alison D; Staff, Roger T; McNeil, Chris J; Salarirad, Sima; Starr, John M; Deary, Ian J; Whalley, Lawrence J

    2012-04-01

    The objectives of this study are to model the relative effects of positive (childhood intelligence) and negative (magnetic resonance imaging (MRI)-derived white matter hyperintensities (WMH)) predictors of late-life intelligence in two well-characterised normal cohorts aged 68 and 78 and to measure the influence of hypertension on WMH and lifelong cognitive change. The Scottish Mental Surveys of 1932 and 1947 tested the intelligence of almost all school children at age 11. One hundred and one participants born in 1921 and 233 participants born in 1936 had brain MRI, with measurement of WMH using Scheltens' scale, and tests of late-life fluid intelligence. Structural equation models of the effect of childhood intelligence and brain WMH on the general intelligence factor 'g' in late life in the two samples were constructed using AMOS 18. Similar models were constructed to test the effect of hypertension on WMH and lifelong cognitive change. Fluid intelligence scores were lower and WMH scores were higher in the older samples. Hypertensive participants in both samples had more WMH than normotensive participants. The positive influence of childhood intelligence on 'g' was greater in the younger sample. The negative effect of WMH on 'g' was linear and greater in the older sample due to greater WMH burden. The negative effect of hypertension on lifelong cognitive ageing was all mediated via MRI-derived brain WMH. The positive relationship between childhood and late-life intelligence decreases with age. The negative relationship between WMH and late-life intelligence is linear and increases with age.

  18. Gestational Age at Birth and 'Body-Mind' Health at 5 Years of Age: A Population Based Cohort Study.

    LENUS (Irish Health Repository)

    Cronin, Frances M

    2016-01-01

    Numerous studies have identified the effects of prematurity on the neonate\\'s physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000-2002 in the United Kingdom) was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children\\'s general health and severity of behavior problems. The association between parent\\'s general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764) rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor\\/fair health and\\/or serious behavior problems), suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32-36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%-6.2%), compared to 1% (0.2-2.3) for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies.

  19. Gestational Age at Birth and 'Body-Mind' Health at 5 Years of Age: A Population Based Cohort Study.

    Directory of Open Access Journals (Sweden)

    Frances M Cronin

    Full Text Available Numerous studies have identified the effects of prematurity on the neonate's physical health, however few studies have explored the effects of prematurity on both the physical and mental health of the child as they develop. Secondary analysis of data from the Millennium Cohort Study, a longitudinal study of infants (n = 18 818, born 2000-2002 in the United Kingdom was performed. Effects of gestational age at birth on health outcomes at 5 years were measured using parental rating of their children's general health and severity of behavior problems. The association between parent's general health ratings and behavior problem ratings was low: 86% of those reporting serious behavior problems (5% of the sample, n = 764 rated their child as being in excellent, very good, or good health. Still, a gradient of increasing risk of poorer outcome with decreasing gestational age was observed for a composite health measure (poor/fair health and/or serious behavior problems, suggesting an association with prematurity for this composite assessment of health status. The greatest contribution to the childhood composite health measure at 5 years was for children born at 32-36 weeks gestation: population attributable fractions for having poor outcomes was 3.4% (Bonferroni-adjusted 95% confidence interval 1.1%-6.2%, compared to 1% (0.2-2.3 for birth at less than 32 weeks. Results suggest that preterm children, by school entry, are not only at high risk of physical health problems, but also of behavioral health problems. The recognition of, and response to comprehensive health and well-being outcomes related to prematurity are important in order to correctly plan and deliver adequate paediatric health services and policies.

  20. The korean social life, health and aging project-health examination cohort.

    Science.gov (United States)

    Lee, Ju-Mi; Lee, Won Joon; Kim, Hyeon Chang; Choi, Wungrak; Lee, Jina; Sung, Kiho; Chu, Sang Hui; Park, Yeong-Ran; Youm, Yoosik

    2014-01-01

    The Korean Social Life, Health, and Aging Project (KSHAP) is a population-based longitudinal study of health determinants among elderly Koreans. The target population of the KSHAP are people aged 60 years or older and their spouses living in a rural community of Korea. A complete enumeration survey was conducted in the first wave of the KSHAP on 94.7% (814 of 860) of the target population between December 2011 and July 2012. The KSHAP-Health Examination (KSHAP-HE) cohort consists of 698 people who completed additional health examinations at a public health center (n=533) or at their home (n=165). Face-to-face questionnaires were used to interview participants on their demographics, social network characteristics, medical history, health behaviors, cognitive function, and depression symptoms. Health center examinations included anthropometric measures, body impedance analysis, resting blood pressure measurement, radial artery tonometry, bone densitometry, the timed up-and-go test, and fasting blood analysis. However, only anthropometric measures, blood pressure measurement, and non-fasting blood analysis were available for home health examinations. Collaboration is encouraged and access to the KSHAP baseline data will be available via the website of the Korean Social Science Data Archive (http://www.kossda.or.kr). The Korean Social Life, Health, and Aging Project (KSHAP) is a population-based longitudinal study of health determinants among elderly Koreans. The target population of the KSHAP are people aged 60 years or older and their spouses living in a rural community of Korea. A complete enumeration survey was conducted in the first wave of the KSHAP on 94.7% (814 of 860) of the target population between December 2011 and July 2012. The KSHAP-Health Examination (KSHAP-HE) cohort consists of 698 people who completed additional health examinations at a public health center (n=533) or at their home (n=165). Face-to-face questionnaires were used to interview

  1. Risk factors for childhood obesity at age 5: Analysis of the Millennium Cohort Study

    Directory of Open Access Journals (Sweden)

    Lyons Ronan A

    2009-12-01

    Full Text Available Abstract Background Weight at age 5 is a predictor for future health of the individual. This study examines risk factors for childhood obesity with a focus on ethnicity. Methods Data from the Millennium Cohort study were used. 17,561 singleton children of White/European (n = 15,062, Asian (n = 1,845 or African (n = 654 background were selected. Logistic regression and likelihood ratio tests were used to examine factors associated with obesity at age 5. All participants were interviewed in their own homes. The main exposures examined included; Birth weight, sedentary lifestyle, family health behaviours, ethnicity, education and income. Results Children with a sedentary lifestyle, large at birth, with high risk family health behaviours (overweight mothers, smoking near the child, missing breakfast and from a family with low income or low educational attainment, were more likely to be obese regardless of ethnicity. Feeding solid food before 3 months was associated with obesity in higher income White/European families. Even when controlling for socioeconomic status, ethnic background is an important independent risk factor for childhood obesity [Odds ratio of obesity; was 1.7 (95%CI: 1.2-2.3 for Asian and 2.7 (95%CI: 1.9-3.9 for African children, compared to White/European]. The final adjusted model suggests that increasing income does not have a great impact on lowering obesity levels, but that higher academic qualifications are associated with lower obesity levels [Odds of obesity: 0.63 (95%CI: 0.52-0.77 if primary carer leaves school after age 16 compared at age 16]. Conclusions Education of the primary carer is an important modifiable factor which can be targeted to address rising obesity levels in children. Interventions should be family centred supporting and showing people how they can implement lifestyle changes in their family.

  2. Age-related macular degeneration in ethnically diverse Australia: Melbourne Collaborative Cohort Study.

    Science.gov (United States)

    Robman, Liubov D; Islam, Fakir M A; Chong, Elaine W T; Adams, Madeleine K M; Simpson, Julie A; Aung, Khin Zaw; Makeyeva, Galina A; Hopper, John L; English, Dallas R; Giles, Graham G; Baird, Paul N; Guymer, Robyn H

    2015-04-01

    To determine and compare the prevalence of age-related macular degeneration (AMD) in older Australians of Anglo-Celtic and Southern European origin. A total of 21,132 participants of the Melbourne Collaborative Cohort Study, aged 47-86 years, were assessed for AMD in 2003-2007 with non-mydriatic fundus photography. Of these, 14% were born in Southern Europe (Greece, Italy or Malta), with the remaining 86% of Anglo-Celtic origin, born in Australia, the United Kingdom or New Zealand. Overall, 2694 participants (12.7%) had early stages of AMD, defined as either one or more drusen ≥ 125 μm (with or without pigmentary abnormalities) or one or more drusen 63-124 μm with pigmentary abnormalities in a 6000-μm diameter grading grid, in the absence of late AMD in either eye. A total of 122 participants (0.6%) had late AMD, defined as either geographic atrophy or neovascular AMD. In logistic regression analysis, adjusted for age, sex, smoking, education and physical activity, Southern Europeans compared to Anglo-Celts had a higher prevalence of the early stages of AMD (odds ratio, OR, 1.15, 95% confidence interval, CI, 1.00-1.34), and lower prevalence of late AMD (OR 0.36, 95% CI 0.17-0.78). Australians of Southern European origin have a higher prevalence of the early stages of AMD and lower prevalence of late AMD compared to those of Anglo-Celtic origin. Although AMD prevalence in the older age group(s) of Southern Europeans could be underestimated due to disparity in participation rates, it is likely that both lifestyle and genetic factors play their parts in differential AMD prevalence in these ethnic groups.

  3. Exposure to multiple chemicals in a cohort of reproductive-aged Danish women.

    Science.gov (United States)

    Rosofsky, Anna; Janulewicz, Patricia; Thayer, Kristina A; McClean, Michael; Wise, Lauren A; Calafat, Antonia M; Mikkelsen, Ellen M; Taylor, Kyla W; Hatch, Elizabeth E

    2017-04-01

    Current exposure assessment research does not sufficiently address multi-pollutant exposure and their correlations in human media. Understanding the extent of chemical exposure in reproductive-aged women is of particular concern due to the potential for in utero exposure and fetal susceptibility. The objectives of this study were to characterize concentrations of chemical biomarkers during preconception and examine correlations between and within chemical classes. We examined concentrations of 135 biomarkers from 16 chemical classes in blood and urine from 73 women aged 18-40 enrolled in Snart Foraeldre/Milieu, a prospective cohort study of pregnancy planners in Denmark (2011-2014). We compared biomarker concentrations with United States similarly-aged, non-pregnant women who participated in the National Health and Nutrition Environmental Survey (NHANES) and with other international biomonitoring studies. We performed principal component analysis to examine biomarker correlations. The mean number of biomarkers detected in the population was 92 (range: 60-108). The most commonly detected chemical classes were phthalates, metals, phytoestrogens and polycyclic aromatic hydrocarbons. Except blood mercury, urinary barium and enterolactone, geometric means were higher in women from NHANES. Chemical classes measured in urine generally did not load on a single component, suggesting high between-class correlation among urinary biomarkers, while there is high within-class correlation for biomarkers measured in serum and blood. We identified ubiquitous exposure to multiple chemical classes in reproductive-aged Danish women, supporting the need for more research on chemical mixtures during preconception and early pregnancy. Inter- and intra-class correlation between measured biomarkers may reflect common exposure sources, specific lifestyle factors or shared metabolism pathways. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. The prevalence of sacroilitis in psoriatic arthritis: new perspectives from a large, multicenter cohort. A Department of Veterans Affairs Cooperative Study

    Energy Technology Data Exchange (ETDEWEB)

    Battistone, M.J.; Clegg, D.O. [Division of Rheumatology, University of Utah Medical Center, Salt Lake City, UT (United States)]|[Department of Medicine, Division of Rheumatology, Veterans Affairs Medical Center, Salt Lake City, UT (United States); Manaster, B.J. [Department of Radiology, Division of Musculoskeletal Imaging, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA (United States); Reda, D.J. [Cooperative Studies Program Coordinating Center, VA Hospital, Hines, IL (United States)

    1999-04-01

    Objective. To determine the prevalence of radiographic evidence of sacroiliitis in a large population of patients with psoriatic arthritis. Patients and design. Patients were recruited from 15 clinical centers. This was part of a large, multicenter study of patients with an established diagnosis of ankylosing spondylitis, psoriatic arthritis, or reactive arthritis. For this cohort, an established diagnosis of psoriatic arthritis was required, with cutaneous manifestations and involvement of at least three appendicular joints. At entry, patients were not selected for the presence of axial involvement. Radiographs - one anteroposterior view of the pelvis and one oblique view of each sacroiliac joint - were graded using the New York classification scale by a musculoskeletal radiologist masked to the specific diagnosis and clinical symptoms. Re-evaluation of 10% of the films 3 years later quantified intraobserver variability. Results. Two hundred and two patients with psoriatic arthritis were studied. Duration of the disease averaged 12 years; all patients had psoriasis and peripheral arthritis. The prevalence of radiographic evidence of sacroiliitis (grade 2 or higher) was 78%; 71% of these had grade 3 disease. Conclusions. Previously reported prevalence of sacroiliitis in patients with psoriatic arthritis ranges from 30% to 50%. The prevalence of radiographic evidence of sacroiliitis in this large multicenter cohort of patients with appendicular psoriatic arthritis was substantially higher. (orig.) With 3 figs., 4 tabs., 29 refs.

  5. Examination of the common cause account in a population-based longitudinal study with narrow age cohort design.

    Science.gov (United States)

    Sternäng, Ola; Jonsson, Bert; Wahlin, Ake; Nyberg, Lars; Nilsson, Lars-Göran

    2010-01-01

    The common cause account suggests that there is a third factor causing aging effects in both sensory and cognitive functioning, hypothesized to be the integrity of the central nervous system [Lindenberger and Baltes; Psychol Aging 1994;9:339-355]. Importantly, the common cause account was developed based on cross-sectional data, which are especially biased by cohort effects. However, cohort effects can be controlled for in narrow age cohort (NAC) designs and by longitudinal examination. Findings from the few longitudinal studies that have studied the relation between age-related changes in sensory and cognitive functions are complex and give only partial support to the common cause account. The present paper examines the common cause account within a longitudinal setting. Our study is unique in the sense that it tests the common cause account within a longitudinal NAC design using data from the Betula project. The participants (n = 1,057) were in the age range of 45-90 years. The findings indicate that the relationship between sensory and memory functioning in both a longitudinal age-heterogeneous and a longitudinal NAC design are much weaker than that detected by an age-heterogeneous cross-sectional design. The demonstrated weak age-associated sensory-cognitive link raises questions regarding the explanatory value of the common cause account and related theoretical accounts for accounting for age-related cognitive changes. Copyright © 2010 S. Karger AG, Basel.

  6. Trends in AIDS Incidence in Individuals Aged 50 Years or Older in the City of Rio de Janeiro, Brazil, 1982–2011: An Age-Period-Cohort Analysis

    Directory of Open Access Journals (Sweden)

    Paulo Cavalcante Apratto Junior

    2014-07-01

    Full Text Available Objective: The aim of this study was to investigate the effects of three temporal components of AIDS incidence (i.e., age, period and cohort on individuals aged 50 or older living in Niteroi, Rio de Janeiro (Brazil. Methods: Age-specific incidence rates were calculated from 1982–2011. Negative binomial and Poisson models were used to analyze the risk of AIDS by age, period and cohort. Results: The risk of AIDS in men was 2.45 times higher than in women, regardless of age and period (p-value < 0.001. The incidence of AIDS in individuals older than 69 years was 7-fold lower than in those aged 50–59 years (p-value < 0.001. A decreasing trend in AIDS risk was observed from the youngest cohort (≥1940 to the oldest (1910–1919. From 1982 to 2006, we could detect an increasing trend in AIDS risk in the population aged 50 years or older. A peak in rates was detected in the period from 2002–2006. The incidence rates in 2002–2006 were six times higher than those in 1987–1991 (p-value < 0.001, independent of age and sex (p-value < 0.001. Conclusions: An increase of AIDS risk in older people was detected. This group should not be neglected by public health programs.

  7. Atherosclerosis, dementia, and Alzheimer disease in the Baltimore Longitudinal Study of Aging cohort.

    Science.gov (United States)

    Dolan, Hillary; Crain, Barbara; Troncoso, Juan; Resnick, Susan M; Zonderman, Alan B; Obrien, Richard J

    2010-08-01

    Although it is now accepted that asymptomatic cerebral infarcts are an important cause of dementia in the elderly, the relationship between atherosclerosis per se and dementia is controversial. Specifically, it is unclear whether atherosclerosis can cause the neuritic plaques and neurofibrillary tangles that define Alzheimer neuropathology and whether atherosclerosis, a potentially reversible risk factor, can influence cognition independent of brain infarcts. We examined the relationship between systemic atherosclerosis, Alzheimer type pathology, and dementia in autopsies from 200 participants in the Baltimore Longitudinal Study of Aging, a prospective study of the effect of aging on cognition, 175 of whom had complete body autopsies. Using a quantitative analysis of atherosclerosis in the aorta, heart, and intracranial vessels, we found no relationship between the degree of atherosclerosis in any of these systems and the degree of Alzheimer type brain pathology. However, we found that the presence of intracranial but not coronary or aortic atherosclerosis significantly increased the odds of dementia, independent of cerebral infarction. Given the large number of individuals with intracranial atherosclerosis in this cohort (136/200), the population attributable risk of dementia related to intracranial atherosclerosis (independent of infarction) is substantial and potentially reversible. Atherosclerosis of the intracranial arteries is an independent and important risk factor for dementia, suggesting potentially reversible pathways unrelated to Alzheimer pathology and stroke through which vascular changes may influence dementia risk.

  8. Intellectual Disability in a Birth Cohort: Prevalence, Etiology, and Determinants at the Age of 4 Years.

    Science.gov (United States)

    Karam, Simone M; Barros, Aluísio J D; Matijasevich, Alícia; Dos Santos, Iná S; Anselmi, Luciana; Barros, Fernando; Leistner-Segal, Sandra; Félix, Têmis M; Riegel, Mariluce; Maluf, Sharbel W; Giugliani, Roberto; Black, Maureen M

    2016-01-01

    Intellectual disability (ID), characterized by impairments in intellectual function and adaptive behavior, affects 1-3% of the population. Many studies investigated its etiology, but few are cohort studies in middle-income countries. To estimate prevalence, etiology, and factors related to ID among children prospectively followed since birth in a Southern Brazilian city (Pelotas). In 2004, maternity hospitals were visited daily and births were identified. Live-born infants (n = 4,231) whose family lived in the urban area have been followed for several years. At the age of 2 and 4 years, performances in development and intelligence tests were evaluated using the Battelle Developmental Inventory and Wechsler Intelligence Scale, respectively. Children considered as having developmental delay were invited to attend a genetic evaluation. At 4 years of age, the prevalence of ID was 4.5%, and the etiology was classified into 5 groups: environmental (44.4%), genetic (20.5%), idiopathic (12.6%), neonatal sequelae (13.2%), other diseases (9.3%). Most children presented impairment in two or more areas of adaptive behavior. There was no difference in prenatal care attendance or maternal schooling among the groups. For about 40% of children, ID was attributed to nonbiological factors, suggesting that the rate may be reduced with appropriate interventions early in life. © 2016 The Author(s) Published by S. Karger AG, Basel.

  9. Consumption of alcoholic beverages and cognitive decline at middle age: the Doetinchem Cohort Study.

    Science.gov (United States)

    Nooyens, Astrid C J; Bueno-de-Mesquita, H Bas; van Gelder, Boukje M; van Boxtel, Martin P J; Verschuren, W M Monique

    2014-02-01

    Accelerated cognitive decline increases the risk of dementia. Slowing down the rate of cognitive decline leads to the preservation of cognitive functioning in the elderly, who can live independently for a longer time. Alcohol consumption may influence the rate of cognitive decline. The aim of the present study was to evaluate the associations between the total consumption of alcoholic beverages and different types of alcoholic beverages and cognitive decline at middle age. In 2613 men and women of the Doetinchem Cohort Study, aged 43-70 years at baseline (1995-2002), cognitive function (global cognitive function and the domains memory, speed and flexibility) was assessed twice, with a 5-year time interval. In linear regression analyses, the consumption of different types of alcoholic beverages was analysed in relation to cognitive decline, adjusting for confounders. We observed that, in women, the total consumption of alcoholic beverages was inversely associated with the decline in global cognitive function over a 5-year period (P for trend = 0·02), while no association was observed in men. Regarding the consumption of different types of alcoholic beverages in men and women together, red wine consumption was inversely associated with the decline in global cognitive function (P for trend alcoholic beverages were associated with cognitive decline. In conclusion, only (moderate) red wine consumption was consistently associated with less strong cognitive decline. Therefore, it is most likely that non-alcoholic substances in red wine are responsible for any cognition-preserving effects.

  10. A population-based cohort study of breastfeeding according to gestational age at term delivery.

    Science.gov (United States)

    Lutsiv, Olha; Giglia, Lucia; Pullenayegum, Eleanor; Foster, Gary; Vera, Claudio; Chapman, Barbara; Fusch, Christoph; McDonald, Sarah D

    2013-11-01

    Because breastfeeding is the optimal form of infant feeding, this study was conducted to determine the effect of gestational age on breastfeeding in term infants. A retrospective population-based cohort study of singleton/twin hospital births was conducted in Ontario, Canada between April 1, 2009, and March 31, 2010. Multivariate logistic regression was used to determine the adjusted effect of gestational age on breastfeeding. Our study population comprised 92,364 infants, of whom 80,297 (86.9%) were exclusively or partially breastfed at the time of hospital discharge. Multivariate logistic regression analyses demonstrated that early-term infants had lower odds of being breastfed compared with infants born at 41 weeks gestation (40 weeks: aOR, 0.93; 95% CI, 0.86-0.99; 39 weeks: aOR, 0.87; 95% CI, 0.81-0.93; 38 weeks: aOR, 0.81; 95% CI, 0.75-0.88; 37 weeks: aOR, 0.74; 95% CI, 0.67-0.82). Using a population-based approach, we found that infants born at 40, 39, 38, and 37 weeks gestation had increasingly lower odds of being breastfed compared with infants born at 41 weeks. Clinicians need to be made aware of the differences in outcomes of infants delivered at early and late term, so that appropriate breastfeeding support can be provided to women at risk for not breastfeeding. Copyright © 2013 Mosby, Inc. All rights reserved.

  11. Stability and change in intelligence from age 11 to ages 70, 79, and 87: the Lothian Birth Cohorts of 1921 and 1936.

    Science.gov (United States)

    Gow, Alan J; Johnson, Wendy; Pattie, Alison; Brett, Caroline E; Roberts, Beverly; Starr, John M; Deary, Ian J

    2011-03-01

    Investigating the predictors of age-related cognitive change is a research priority. However, it is first necessary to discover the long-term stability of measures of cognitive ability because prior cognitive ability level might contribute to the amount of cognitive change experienced within old age. These two issues were examined in the Lothian Birth Cohorts of 1921 and 1936. Cognitive ability data were available from age 11 years when the participants completed the Moray House Test No. 12 (MHT). The Lothian Birth Cohort 1936 (LBC1936) completed the MHT a second time at age 70. The Lothian Birth Cohort 1921 (LBC1921) completed the MHT at ages 79 and 87. We examined cognitive stability and change from childhood to old age in both cohorts, and within old age in the LBC1921. Raw stability coefficients for the MHT from 11-70, 11-79, and 11-87 years were .67, .66, and .51, respectively; and larger when corrected for range restriction in the samples. Therefore, minimum estimates of the variance in later-life MHT accounted for by childhood performance on the same test ranged from 26-44%. This study also examined, in the LBC1921, whether MHT score at age 11 influenced the amount of change in MHT between ages 79 and 87. It did not. Higher intelligence from early life was apparently protective of intelligence in old age due to the stability of cognitive function across the lifespan, rather than because it slowed the decline experienced in later life. (c) 2011 APA, all rights reserved.

  12. Improving risk stratification among veterans diagnosed with prostate cancer: impact of the 17-gene prostate score assay.

    Science.gov (United States)

    Lynch, Julie A; Rothney, Megan P; Salup, Raoul R; Ercole, Cesar E; Mathur, Sharad C; Duchene, David A; Basler, Joseph W; Hernandez, Javier; Liss, Michael A; Porter, Michael P; Wright, Jonathan L; Risk, Michael C; Garzotto, Mark; Efimova, Olga; Barrett, Laurie; Berse, Brygida; Kemeter, Michael J; Febbo, Phillip G; Dash, Atreya

    2018-01-01

    Active surveillance (AS) has been widely implemented within Veterans Affairs' medical centers (VAMCs) as a standard of care for low-risk prostate cancer (PCa). Patient characteristics such as age, race, and Agent Orange (AO) exposure may influence advisability of AS in veterans. The 17-gene assay may improve risk stratification and management selection. To compare management strategies for PCa at 6 VAMCs before and after introduction of the Oncotype DX Genomic Prostate Score (GPS) assay. We reviewed records of patients diagnosed with PCa between 2013 and 2014 to identify management patterns in an untested cohort. From 2015 to 2016, these patients received GPS testing in a prospective study. Charts from 6 months post biopsy were reviewed for both cohorts to compare management received in the untested and tested cohorts. Men who just received their diagnosis and have National Comprehensive Cancer Network (NCCN) very low-, low-, and select cases of intermediate-risk PCa. Patient characteristics were generally similar in the untested and tested cohorts. AS utilization was 12% higher in the tested cohort compared with the untested cohort. In men younger than 60 years, utilization of AS in tested men was 33% higher than in untested men. AS in tested men was higher across all NCCN risk groups and races, particular in low-risk men (72% vs 90% for untested vs tested, respectively). Tested veterans exposed to AO received less AS than untested veterans. Tested nonexposed veterans received 19% more AS than untested veterans. Median GPS results did not significantly differ as a factor of race or AO exposure. Men who receive GPS testing are more likely to utilize AS within the year post diagnosis, regardless of age, race, and NCCN risk group. Median GPS was similar across racial groups and AO exposure groups, suggesting similar biology across these groups. The GPS assay may be a useful tool to refine risk assessment of PCa and increase rates of AS among clinically and

  13. Short-Term Changes in Postoperative Cognitive Function in Children Aged 5 to 12 Years Undergoing General Anesthesia: A Cohort Study

    National Research Council Canada - National Science Library

    Aun, Cindy S T; McBride, Catherine; Lee, Anna; Lau, Angel S C; Chung, Raymond C K; Yeung, Chung Kwong; Lai, Kelly Y C; Gin, Tony

    2016-01-01

    ...) and at 6 weeks after elective noncardiac surgery in school-age children.This was a prospective cohort study of 118 children undergoing GA and 126 age-matched controls of school children aged 5 to 12 years...

  14. Use of Veterans Affairs and Medicaid Services for Dually Enrolled Veterans.

    Science.gov (United States)

    Yoon, Jean; Vanneman, Megan E; Dally, Sharon K; Trivedi, Amal N; Phibbs, Ciaran S

    2017-06-13

    To examine how dual coverage for nonelderly, low-income veterans by Veterans Affairs (VA) and Medicaid affects their demand for care. Veterans Affairs utilization data and Medicaid Analytic Extract Files. A retrospective, longitudinal study of VA users prior to and following enrollment in Medicaid 2006-2010. Veterans Affairs reliance, or proportion of care provided by VA, was estimated with beta-binomial models, adjusting for patient and state Medicaid program factors. In a cohort of 19,890 nonelderly veterans, VA utilization levels were similar before and after enrolling in Medicaid. VA outpatient reliance was 0.65, and VA inpatient reliance was 0.53 after Medicaid enrollment. Factors significantly associated with greater VA reliance included sociodemographic factors, having a service-connected disability, comorbidity, and higher state Medicaid reimbursement. Factors significantly associated with less VA reliance included months enrolled in Medicaid, managed care enrollment, Medicaid eligibility type, longer drive time to VA care, greater Medicaid eligibility generosity, and better Medicaid quality. Veterans Affairs utilization following new Medicaid enrollment remained relatively unchanged, and the VA continued to provide the large majority of care for dually enrolled veterans. There was variation among patients as Medicaid eligibility and other program factors influenced their use of Medicaid services. © Health Research and Educational Trust.

  15. Cognitive and kidney function: results from a British birth cohort reaching retirement age.

    Directory of Open Access Journals (Sweden)

    Richard J Silverwood

    Full Text Available Previous studies have found associations between cognitive function and chronic kidney disease. We aimed to explore possible explanations for this association in the Medical Research Council National Survey of Health and Development, a prospective birth cohort representative of the general British population.Cognitive function at age 60-64 years was quantified using five measures (verbal memory, letter search speed and accuracy, simple and choice reaction times and glomerular filtration rate (eGFR at the same age was estimated using cystatin C. The cross-sectional association between cognitive function and eGFR was adjusted for background confounding factors (socioeconomic position, educational attainment, prior cognition, and potential explanations for any remaining association (smoking, diabetes, hypertension, inflammation, obesity.Data on all the analysis variables were available for 1306-1320 study members (depending on cognitive measure. Verbal memory and simple and choice reaction times were strongly associated with eGFR. For example, the lowest quartile of verbal memory corresponded to a 4.1 (95% confidence interval 2.0, 6.2 ml/min/1.73 m(2 lower eGFR relative to the highest quartile. Some of this association was explained by confounding due to socioeconomic factors, but very little of it by prior cognition. Smoking, diabetes, hypertension, inflammation and obesity explained some but not all of the remaining association.These analyses support the notion of a shared pathophysiology of impaired cognitive and kidney function at older age, which precedes clinical disease. The implications of these findings for clinical care and research are important and under-recognised, though further confirmatory studies are required.

  16. The Impact of Veteran Status on Life-Space Mobility among Older Black and White Men in the Deep South.

    Science.gov (United States)

    McCaskill, Gina M; Sawyer, Patricia; Burgio, Kathryn L; Kennedy, Richard; Williams, Courtney P; Clay, Olivio J; Brown, Cynthia J; Allman, Richard M

    2015-08-07

    To examine life-space mobility over 8.5 years among older Black and White male veterans and non-veterans in the Deep South. A prospective longitudinal study of community-dwelling Black and White male adults aged >65 years (N=501; mean age=74.9; 50% Black and 50% White) enrolled in the University of Alabama at Birmingham (UAB) Study of Aging. Data from baseline in-home assessments with follow-up telephone assessments of life-space mobility completed every 6 months were used in linear mixed-effects modeling analyses to examine life-space mobility trajectories. Life-space mobility. In comparison to veterans, non-veterans were more likely to be Black, single, and live in rural areas. They also reported lower income and education. Veterans had higher baseline life-space (73.7 vs 64.9 for non-veterans; Pspace trajectories for White non-veterans (P=.009), but not for White veterans (P=.807) nor Black non-veterans (P=.633). Mortality at 8.5 years was 43.5% for veterans and 49.5% for non-veterans (P=.190) with no significant differences by race-veteran status. Veterans had significantly higher baseline life-space mobility. There were significantly greater declines in life-space trajectories for White non-veterans in comparison to other race-veteran subgroups. Black veterans and non-veterans did not have significantly different trajectories.

  17. Prevalence of probable mental disorders and help-seeking behaviors among veteran and non-veteran community college students.

    Science.gov (United States)

    Fortney, John C; Curran, Geoffrey M; Hunt, Justin B; Cheney, Ann M; Lu, Liya; Valenstein, Marcia; Eisenberg, Daniel

    2016-01-01

    Millions of disadvantaged youth and returning veterans are enrolled in community colleges. Our objective was to determine the prevalence of mental disorders and help-seeking behaviors among community college students. Veterans (n=211) and non-veterans (n=554) were recruited from 11 community colleges and administered screeners for depression (PHQ-9), generalized anxiety (GAD-7), posttraumatic stress disorder (PC-PTSD), non-lethal self-injury, suicide ideation and suicide intent. The survey also asked about the perceived need for, barriers to and utilization of services. Regression analysis was used to compare prevalence between non-veterans and veterans adjusting for non-modifiable factors (age, gender and race/ethnicity). A large proportion of student veterans and non-veterans screened positive and unadjusted bivariate comparisons indicated that student veterans had a significantly higher prevalence of positive depression screens (33.1% versus 19.5%, Pdepression (OR=2.10, P=.01) and suicide ideation (OR=2.31, P=.03). Student veterans had significantly higher odds of perceiving a need for treatment than non-veterans (OR=1.93, P=.02) but were more likely to perceive stigma (beta=0.28, P=.02). Despite greater need among veterans, there were no significant differences between veterans and non-veterans in use of psychotropic medications, although veterans were more likely to receive psychotherapy (OR=2.35, P=.046). Findings highlight the substantial gap between the prevalence of probable mental health disorders and treatment seeking among community college students. Interventions are needed to link community college students to services, especially for student veterans. Copyright © 2016. Published by Elsevier Inc.

  18. Prevalence of Unplanned Hospitalizations Caused by Adverse Drug Reactions Among Older Veterans

    Science.gov (United States)

    Marcum, Zachary A.; Amuan, Megan E.; Hanlon, Joseph T.; Aspinall, Sherrie L.; Handler, Steven M.; Ruby, Christine M.; Pugh, Mary Jo V.

    2011-01-01

    Objectives To describe the prevalence of unplanned hospitalizations caused by ADRs among older Veterans and examine the association between this outcome and polypharmacy after controlling for comorbidities and other patient characteristics. Design Retrospective cohort. Setting Veterans Affairs Medical Centers (VAMC). Participants 678 randomly selected unplanned hospitalizations of older (age ≥ 65 years) Veterans between 10/01/03 and 09/30/06. Measurements Naranjo ADR algorithm, ADR preventability, and polypharmacy (0–4, 5–8, and ≥ 9 scheduled medications). Results Seventy ADRs involving 113 drugs were determined in 68 (10%) older Veterans’ hospitalizations, of which 36.8% (25/68) were preventable. Extrapolating to the population of over 2.4 million older Veterans receiving care during the study period, 8,000 hospitalizations may have been unnecessary. The most common ADRs that occurred were bradycardia (n=6; beta blockers, digoxin), hypoglycemia (n=6; sulfonylureas, insulin), falls (n=6; antidepressants, ACE-inhibitors), and mental status changes (n=6; anticonvulsants, benzodiazepines). Overall, 44.8% of Veterans took ≥ 9 outpatient medications and 35.4% took 5–8. Using multivariable logistic regression and controlling for demographic, health status, and access to care variables, polypharmacy (≥ 9 and 5–8) was associated with an increased risk of ADR-related hospitalization (AOR 3.90, 95% CI 1.43–10.61 and AOR 2.85, 95% CI 1.03–7.85, respectively). Conclusion ADRs determined by a validated causality algorithm are a common cause of unplanned hospitalization among older Veterans, are frequently preventable, and are associated with polypharmacy. PMID:22150441

  19. The relationship between intelligence and reaction time varies with age: Results from three representative narrow-age age cohorts at 30, 50 and 69 years.

    Science.gov (United States)

    Der, Geoff; Deary, Ian J

    2017-09-01

    Reaction time (RT) has played a prominent part in research on mental ability for over a century. Throughout this time a number of questions have been repeatedly posed: what is the relationship of RT to general mental ability, and is this the same for simple and choice RT? Does the relationship change with age? How important is RT variability compared with mean values? Here we examine these questions in three population representative cohorts. Participants were drawn from the West of Scotland Twenty-07 study, a longitudinal population based study designed to investigate socially structured health inequalities. At the fourth wave of data collection, part I of the Alice Heim 4 (AH4) test of general intelligence was administered, and reaction times were measured using a portable device. Means and standard deviations were recorded for simple and 4-choice reaction time. Full data were available for 2196 participants, comprising 714 aged 30 years, 813 aged 50, and 669 aged 69. Correlations of simple RT means with AH4 scores were - 0.27, - 0.30 and - 0.32, for age 30, 50 and 69, respectively; and - 0.44, - 0.47 and - 0.53 for 4-choice RT. The underlying relationships showed evidence of non-linearity, particularly for simple RT, with stronger association at lower AH4 scores. This was more pronounced with age. RT variability was correlated with the mean at 0.57, 0.57, 0.58 for simple RT; and 0.53, 0.53, 0.47 for choice RT. Residuals from regressing the RT variability on the mean showed no association with AH4 in the case of simple RT but a weak association for choice RT which decreased with age. There is a strong correlation of RT means with general mental ability which increases with age. The underlying relationship is complex for SRT. RT variability shows little association with mental ability when its dependence on the mean is removed. Combining samples with disparate ages may overestimate the association.

  20. Time trends in exposure of cattle to bovine spongiform encephalopathy and cohort effect in France and Italy: value of the classical Age-Period-Cohort approach

    Directory of Open Access Journals (Sweden)

    Ru Giuseppe

    2009-09-01

    Full Text Available Abstract Background The Age-Period-Cohort (APC analysis is routinely used for time trend analysis of cancer incidence or mortality rates, but in veterinary epidemiology, there are still only a few examples of this application. APC models were recently used to model the French epidemic assuming that the time trend for BSE was mainly due to a cohort effect in relation to the control measures that may have modified the BSE exposure of cohorts over time. We used a categorical APC analysis which did not require any functional form for the effect of the variables, and examined second differences to estimate the variation of the BSE trend. We also reanalysed the French epidemic and performed a simultaneous analysis of Italian data using more appropriate birth cohort categories for comparison. Results We used data from the exhaustive surveillance carried out in France and Italy between 2001 and 2007, and comparatively described the trend of the epidemic in both countries. At the end, the shape and irregularities of the trends were discussed in light of the main control measures adopted to control the disease. In Italy a decrease in the epidemic became apparent from 1996, following the application of rendering standards for the processing of specific risk material (SRM. For the French epidemic, the pattern of second differences in the birth cohorts confirmed the beginning of the decrease from 1995, just after the implementation of the meat and bone meal (MBM ban for all ruminants (1994. Conclusion The APC analysis proved to be highly suitable for the study of the trend in BSE epidemics and was helpful in understanding the effects of management and control of the disease. Additionally, such an approach may help in the implementation of changes in BSE regulations.

  1. Beyond pregnancy--the neglected burden of mortality in young women of reproductive age in Bangladesh: a prospective cohort study.

    Science.gov (United States)

    Labrique, A B; Sikder, S S; Wu, L; Rashid, M; Ali, H; Ullah, B; Shamim, A A; Mehra, S; Klemm, R; Banu, H; West, K P; Christian, P

    2013-08-01

    To describe proportionate mortality and causes of death unrelated to pregnancy. Prospective cohort study. Rural northwest Bangladesh. A cohort of 133,617 married women of reproductive age. Verbal autopsies were conducted for women who died whilst under surveillance in the cohort trial. Physician-assigned causes of death based on verbal autopsies were used to categorise deaths. The proportion of deaths due to non-communicable diseases, infectious diseases, injury or pregnancy. Of the 1107 deaths occurring among women between 2001 and 2007, 48% were attributed to non-communicable diseases, 22% to pregnancy, 17% to infections, 9% to injury and 4% to other causes. Although focus on pregnancy-related mortality remains important, more attention is warranted on non-communicable diseases among women of reproductive age. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.

  2. Adolescent cannabis and tobacco use and educational outcomes at age 16: birth cohort study.

    Science.gov (United States)

    Stiby, Alexander I; Hickman, Matthew; Munafò, Marcus R; Heron, Jon; Yip, Vikki L; Macleod, John

    2015-04-01

    To investigate the relationship between cannabis and tobacco use by age 15 and subsequent educational outcomes. Birth cohort study. England. The sample was drawn from the Avon Longitudinal Study of Parents and Children; a core sample of 1155 individuals had complete information on all the variables. The main exposures were cannabis and tobacco use at age 15 assessed in clinic by computer-assisted questionnaire and serum cotinine. The main outcomes were performance in standardized assessments at 16 [Key Stage 4, General Certificate of Secondary Education (GCSE)] in English and mathematics (mean scores), completion of five or more assessments at grade C level or higher and leaving school having achieved no qualifications. Analyses were sequentially adjusted for multiple covariates using a hierarchical approach. Covariates considered were: maternal substance use (ever tobacco or cannabis use, alcohol use above recommended limits); life course socio-economic position (family occupational class, maternal education, family income); child sex; month and year of birth; child educational attainment prior to age 11 (Key Stage 2); child substance use (tobacco, alcohol and cannabis) prior to age 15 and child conduct disorder. In fully adjusted models both cannabis and tobacco use at age 15 were associated with subsequent adverse educational outcomes. In general, the dose-response effect seen was consistent across all educational outcomes assessed. Weekly cannabis use was associated negatively with English GCSE results [grade point difference (GPD), -5.93, 95% confidence interval (CI) = -8.34, -3.53] and with mathematics GCSE results (GPD, -6.91, 95% CI = -9.92, -3.89). Daily tobacco smoking was associated negatively with English GCSE (GPD, -11.90, 95% CI = -13.47, -10.33) and with mathematics GCSE (GPD, -16.72, 95% CI = -18.57, -14.86). The greatest attenuation of these effects was seen on adjustment for other substance use and conduct disorder. Following

  3. Phthalate metabolites and bisphenol A in urines from German school-aged children: results of the Duisburg birth cohort and Bochum cohort studies.

    Science.gov (United States)

    Kasper-Sonnenberg, Monika; Koch, Holger M; Wittsiepe, Jürgen; Brüning, Thomas; Wilhelm, Michael

    2014-11-01

    Some phthalates and also bisphenol A (BPA) interfere with the human endocrine system and are labelled as reproductive toxicants. Children's exposure to these contaminants is suspected to be associated with developmental disorders and other health impairments. We provide biomonitoring data on 21 urinary phthalate metabolite and BPA levels in first morning urine of 8-10 year old children. Participants were children born between 1999 and 2002 of the Duisburg birth cohort (8-9 years, N=113) and of the Bochum cohort study (8-10 years, N=352). Additionally, for the Duisburg birth cohort we compare current data of children from Duisburg (8-9 years) with data from 2 years earlier when the children were 6-7 years old. We analyzed influences of important covariates on exposure levels by multiple regression analysis and those from two sampling time points by generalized equation estimation models adjusted for important covariates. Compared to recently published studies the phthalate metabolite and BPA concentrations were within the range of background levels. There were no significant differences between children from Bochum and Duisburg. Comparison between the two Duisburg birth cohort data sets (2007-2008 and 2009-2010) showed significant correlations for most of the phthalate metabolites (r Spearman between 0.25 and 0.51; p ≤ 0.05) but not for BPA (r Spearman=0.162; p=0.143). Most of the phthalate metabolites in the groups of the 6-7 and 8-9 years old Duisburg children were negatively associated with higher age, except for BPA concentrations with nearly constant levels. Exposure levels may be influenced by changes in child specific exposure patterns with age but also by the rapidly changing phthalate market. Copyright © 2014 Elsevier GmbH. All rights reserved.

  4. Prevalence of Intimate Partner Violence among Women Veterans who Utilize Veterans Health Administration Primary Care.

    Science.gov (United States)

    Kimerling, Rachel; Iverson, Katherine M; Dichter, Melissa E; Rodriguez, Allison L; Wong, Ava; Pavao, Joanne

    2016-08-01

    The objectives of this study were to identify the prevalence of past-year intimate partner violence (IPV) among women Veterans utilizing Veterans Health Administration (VHA) primary care, and to document associated demographic, military, and primary care characteristics. This was a retrospective cohort design, where participants completed a telephone survey in 2012 (84% participation rate); responses were linked to VHA administrative data for utilization in the year prior to the survey. A national stratified random sample of 6,287 women Veteran VHA primary care users participated in the study. Past-year IPV was assessed using the HARK screening tool. Self-report items and scales assessed demographic and military characteristics. Primary care characteristics were assessed via self-report and VHA administrative data. The prevalence of past-year IPV among women Veterans was 18.5% (se = 0.5%), with higher rates (22.2% - 25.5%) among women up to age 55. Other demographic correlates included indicators of economic hardship, lesbian or bisexual orientation, and being a parent/guardian of a child less than 18 years old. Military correlates included service during Vietnam to post-Vietnam eras, less than 10 years of service, and experiences of Military Sexual Trauma (MST). Most (77.3%, se = 1.2%) women who experienced IPV identified a VHA provider as their usual provider. Compared with women who did not report past-year IPV, women who reported IPV had more primary care visits, yet experienced lower continuity of care across providers. The high prevalence of past-year IPV among women beyond childbearing years, the majority of whom primarily rely on VHA as a source of health care, reinforces the importance of screening all women for IPV in VHA primary care settings. Key considerations for service implementation include sensitivity with respect to sexual orientation, race/ethnicity, and other aspects of diversity, as well as care coordination and linkages with social

  5. Age-period-cohort analysis of colorectal cancer, service members aged 20-59 years, active component, U.S. Armed Forces, 1997-2016.

    Science.gov (United States)

    Stahlman, Shauna; Oetting, Alexis

    2017-07-01

    In the U.S. general population, incidence of colorectal cancer appears to be increasing in younger age groups since the mid-1980s. The objective of this report was to better understand the time-varying elements (age, period, and birth cohort effects) in the epidemiology of colorectal cancer among the active component of the U.S. Armed Forces. During 1997-2016, there were 1,108 incident cases of colorectal cancer among service members aged 20-59 years, corresponding to an overall incidence rate of 4.3 per 100,000 person-years (p-yrs). Rates were particularly high among men (4.4 per 100,000 p-yrs) and non- Hispanic black service members (5.3 per 100,000 p-yrs). Overall crude incidence of colorectal cancer increased in an exponential fashion with increasing age groups until the oldest age group (55-59 years), in which the increase was attenuated. No birth cohort or period effects were identified in the age-period-cohort analysis. This finding could be due to limited power, selection bias, better screening practices in the Military Health System (MHS) compared with the general population, or true lack of effects. Continued population-based screening for colorectal cancer in the MHS is recommended to maintain low and decreasing incidence in the U.S. Armed Forces.

  6. Distance to Veterans Administration Medical Centers as a Barrier to Specialty Care for Homeless Women Veterans.

    Science.gov (United States)

    Gawron, Lori M; Pettey, Warren B P; Redd, Andrew M; Suo, Ying; Gundlapalli, Adi V

    2017-01-01

    Homeless women Veterans have a high prevalence of chronic mental and physical conditions that necessitate frequent healthcare visits, but travel burdens to specialty services may be overwhelming to navigate for this population, especially for those in rural settings. Access to specialty care is a key priority in the Veterans Health Administration (VHA) and understanding the geographic distribution and rural designation of this population in relation to medical centers (VAMC) can assist in care coordination. We identified 41,747 women Veterans age 18-44y with administrative evidence of homelessness in the VHA anytime during 2002-2015. We found 7% live in rural settings and 29% live >40miles from a VAMC. The mean travel distance for homeless women Veterans with a rural designation to a VAMC specialty center was 107 miles. Developing interventions to overcome this travel burden and engage vulnerable Veterans in necessary care can improve overall health outcomes for this high-risk population.

  7. Small for gestational age and perinatal mortality at term : An audit in a Dutch national cohort study

    NARCIS (Netherlands)

    Eskes, Martine; Waelput, Adja J. M.; Scherjon, Sicco A.; Bergman, Klasien A.; Abu-Hanna, Ameen; Ravelli, Anita C. J.

    Objective: To assess the underlying risk factors for perinatal mortality in term born small for gestational age infants. Study design: We performed a population based nationwide cohort study in the Netherlands of 465,532 term born infants from January 2010 to January 2013. Logistic regression

  8. Defining sarcopenia : The impact of different diagnostic criteria on the prevalence of sarcopenia in a large middle aged cohort

    NARCIS (Netherlands)

    Bijlsma, A. Y.; Meskers, C. G M; Ling, C. H Y; Narici, M.; Kurrle, S. E.; Cameron, I. D.; Westendorp, R. G J; Maier, A. B.

    Sarcopenia, low muscle mass, is an increasing problem in our ageing society. The prevalence of sarcopenia varies extremely between elderly cohorts ranging from 7% to over 50%. Without consensus on the definition of sarcopenia, a variety of diagnostic criteria are being used. We assessed the degree

  9. Statin utilization according to indication and age: A Danish cohort study on changing prescribing and purchasing behaviour

    DEFF Research Database (Denmark)

    Kildemoes, H. W.; Vass, Mikkel; Hendriksen, C.

    2012-01-01

    and age during 1996-2009, and to analyse changing prescribing and purchasing behaviour during time intervals (driver periods) a priori defined by potential influential factors. Methods: A nationwide cohort (N = 4,998,580) was followed in Danish individual-level registries. Based on a hierarchy of register...

  10. Age-specific incidence and treatment patterns of head and neck cancer in the Netherlands : A cohort study

    NARCIS (Netherlands)

    Halmos, G. B.; Bras, L.; Siesling, S.; van der Laan, B.F.A.M.; Langendijk, Johannes A.; van Dijk, Boukje A.C.

    2017-01-01

    Objectives: To explore the incidence and treatment pattern of head and neck cancer in different age groups. Design: Cohort study. Setting: Netherlands Cancer Registry. Participants: All new primary head and neck cancer cases diagnosed between 2010 and 2014 were included and categorised into

  11. Risk factors for deformational plagiocephaly at birth and at seven weeks of age - A prospective cohort study-

    NARCIS (Netherlands)

    van Vlimmeren, Leo A.; van der Graaf, Jolanda; Boere-Boonekamp, Magdalena M.; L'Hoir, Monique P.; Helders, Paul J.M.; Engelbert, Raoul H.H.

    2007-01-01

    OBJECTIVE. The purpose of this work was to identify risk factors for deformational plagiocephaly within 48 hours of birth and at 7 weeks of age. PATIENTS AND METHODS. This was a prospective cohort study in which 380 healthy neonates born at term in Bernhoven Hospital in Veghel were followed at birth

  12. Factors associated with incident and fatal pancreatic cancer in a cohort of middle-aged women.

    Science.gov (United States)

    Stevens, Richard J; Roddam, Andrew W; Spencer, Elizabeth A; Pirie, Kirstin L; Reeves, Gillian K; Green, Jane; Beral, Valerie

    2009-05-15

    Risk factors for pancreatic cancer, other than smoking and diabetes, are not well-established, especially for women. In a cohort of 1.3 million middle-aged women, followed for 9.2 million person-years for cancer incidence and 11.5 million person-years for mortality, there were 1,338 incident pancreatic cancer cases and 1,710 deaths from the disease. Using proportional hazards models, we calculated adjusted relative risks (RRs) and 95% confidence intervals (CIs) by smoking, height, body mass index (BMI), alcohol consumption, physical activity and history of diabetes. Pancreatic cancer incidence was greater in current than never smokers (RR 2.39, CI 2.10-2.73), the risk increasing with the number of cigarettes smoked. The incidence of pancreatic cancer also increased with increasing BMI (RR 1.34, CI 1.13-1.57 for BMI >or= 30 vs. 22.5-25 kg/m(2)), and with a history of diabetes (RR 1.58, CI 1.22-2.03, with vs. without such a history). These factors were also associated with increased mortality from pancreatic cancer. Height, alcohol consumption and physical activity showed little or no association with pancreatic cancer risk. (c) 2008 Wiley-Liss, Inc.

  13. Frailty, HIV infection, and mortality in an aging cohort of injection drug users.

    Directory of Open Access Journals (Sweden)

    Damani A Piggott

    Full Text Available Frailty is associated with morbidity and premature mortality among elderly HIV-uninfected adults, but the determinants and consequences of frailty in HIV-infected populations remain unclear. We evaluated the correlates of frailty, and the impact of frailty on mortality in a cohort of aging injection drug users (IDUs.Frailty was assessed using standard criteria among HIV-infected and uninfected IDUs in 6-month intervals from 2005 to 2008. Generalized linear mixed-model analyses assessed correlates of frailty. Cox proportional hazards models estimated risk for all-cause mortality.Of 1230 participants at baseline, the median age was 48 years and 29% were HIV-infected; the frailty prevalence was 12.3%. In multivariable analysis of 3,365 frailty measures, HIV-infected IDUs had an increased likelihood of frailty (OR, 1.66; 95% CI, 1.24-2.21 compared to HIV-uninfected IDUs; the association was strongest (OR, 2.37; 95% CI, 1.62-3.48 among HIV-infected IDUs with advanced HIV disease (CD4<350 cells/mm3 and detectable HIV RNA. No significant association was seen with less advanced disease. Sociodemographic factors, comorbidity, depressive symptoms, and prescription drug abuse were also independently associated with frailty. Mortality risk was increased with frailty alone (HR 2.63, 95% CI, 1.23-5.66, HIV infection alone (HR 3.29, 95% CI, 1.85-5.88, and being both HIV-infected and frail (HR, 7.06; 95%CI 3.49-14.3.Frailty was strongly associated with advanced HIV disease, but IDUs with well-controlled HIV had a similar prevalence to HIV-uninfected IDUs. Frailty was independently associated with mortality, with a marked increase in mortality risk for IDUs with both frailty and HIV infection.

  14. Bone fracture nonunion rate decreases with increasing age: A prospective inception cohort study.

    Science.gov (United States)

    Zura, Robert; Braid-Forbes, Mary Jo; Jeray, Kyle; Mehta, Samir; Einhorn, Thomas A; Watson, J Tracy; Della Rocca, Gregory J; Forbes, Kevin; Steen, R Grant

    2017-02-01

    Fracture nonunion risk is related to severity of injury and type of treatment, yet fracture healing is not fully explained by these factors alone. We hypothesize that patient demographic factors assessable by the clinician at fracture presentation can predict nonunion. A prospective cohort study design was used to examine ~2.5 million Medicare patients nationwide. Patients making fracture claims in the 5% Medicare Standard Analytic Files in 2011 were analyzed; continuous enrollment for 12months after fracture was required to capture the ICD-9-CM nonunion diagnosis code (733.82) or any procedure codes for nonunion repair. A stepwise regression analysis was used which dropped variables from analysis if they did not contribute sufficient explanatory power. In-sample predictive accuracy was assessed using a receiver operating characteristic (ROC) curve approach, and an out-of-sample comparison was drawn from the 2012 Medicare 5% SAF files. Overall, 47,437 Medicare patients had 56,492 fractures and 2.5% of fractures were nonunion. Patients with healed fracture (age 75.0±12.7SD) were older (pfracture patients had an age- and sex-adjusted death rate of 11.0% (pfracture in 14 of 18 bones were significantly more likely to die within one year of fracture (pFracture was associated with increased risk of death within 1year of fracture (pfracture is a major public health issue. Comorbidities associated with increased risk of nonunion include past or current smoking, alcoholism, obesity or morbid obesity, osteoarthritis, rheumatoid arthritis, type II diabetes, and/or open fracture (all, multivariate p<0.001). Nonunion prediction requires knowledge of 26 patient variables but predictive accuracy is currently comparable to the Framingham cardiovascular risk prediction. Copyright © 2016 Bioventus LLC. Published by Elsevier Inc. All rights reserved.

  15. Self-medication among adolescents aged 18 years: the 1993 Pelotas (Brazil) birth cohort study.

    Science.gov (United States)

    Bertoldi, Andréa Dâmaso; Camargo, Aline Lins; Silveira, Marysabel Pinto Telis; Menezes, Ana M B; Assunção, Maria Cecília Formoso; Gonçalves, Helen; Hallal, Pedro Curi

    2014-08-01

    To estimate the point prevalence of self-medication among adolescents aged 18 years and to evaluate the type of drugs used (either over-the-counter or prescription drugs) and socioeconomic, health-related, and behavioral correlates of self-medication. This cross-sectional study used data from the 1993 Pelotas (Brazil) Birth Cohort Study. Data were obtained through the administration of a questionnaire to adolescents aged 18 years. The outcome variables were point prevalence of medicine use and self-medication collected by self-report. The independent variables studied were gender, continuous medicine use, socioeconomic status, schooling, self-rated health, body mass index, and physical activity levels. Medicines were classified into therapeutic groups according to the Anatomical Therapeutic Chemical classification system. A total of 4,106 adolescents were interviewed. The point prevalence of medicine use was 41.1% (95% confidence interval [CI] 39.6-42.6), and the proportion of self-medication among medicine users was 65.1% (95% CI 62.8-67.4). The point prevalence of self-medication was 26.7% (95% CI 25.4-28.1), and it was higher among female adolescents, those more educated, and those who rated their health as poor. Out of the drugs used for self-medication (58% of all drugs used), 1,003 (78.7%) were nonprescription drugs and 271 (21.3%) were prescription drugs. The most frequently used drugs for self-medication were analgesics (56.1%), systemic antihistamines (7.4%), and anti-inflammatory and antirheumatic products (7.1%). A high point prevalence of self-medication was found among adolescents, which is particularly concerning due to high use of prescription drugs for self-medication. Interventions are needed to promote rational use of medicines in this population. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  16. Mental and Physical Health Conditions in US Combat Veterans: Results From the National Health and Resilience in Veterans Study.

    Science.gov (United States)

    Thomas, Melissa M; Harpaz-Rotem, Ilan; Tsai, Jack; Southwick, Steven M; Pietrzak, Robert H

    2017-06-22

    younger combat veterans to report having been diagnosed with heart disease (19.2% vs 2.6%) and heart attack (13.9% vs 2.5%). Compared to noncombat veterans in the United States, combat veterans have elevated rates of PTSD, suicide attempt, stroke, and chronic pain independent of other sociodemographic, military, and mental health factors. Younger combat veterans have elevated rates of PTSD, suicidal ideation, and migraine headaches, while older combat veterans have elevated rates of heart disease and heart attack. These results characterize the population-based burden of mental and physical health conditions in combat veterans. They further underscore the importance of age- and condition-sensitive screening, monitoring, and treatment efforts in this population.

  17. Headache diagnoses among Iraq and Afghanistan war veterans enrolled in VA: a gender comparison.

    Science.gov (United States)

    Carlson, Kathleen F; Taylor, Brent C; Hagel, Emily M; Cutting, Andrea; Kerns, Robert; Sayer, Nina A

    2013-01-01

    To examine the prevalence and correlates of headache diagnoses, by gender, among Iraq and Afghanistan War Veterans who use Department of Veterans Affairs (VA) health care. Understanding the health care needs of recent Veterans, and how these needs differ between women and men, is a priority for the VA. The potential for a large burden of headache disorders among Veterans seeking VA services exists but has not been examined in a representative sample. We conducted a historical cohort study using national VA inpatient and outpatient data from fiscal year 2011. Participants were all (n = 470,215) Iraq and Afghanistan War Veteran VA users in 2011; nearly 13% were women. We identified headache diagnoses using International Classification of Diseases (ICD-9) diagnosis codes assigned during one or more VA inpatient or outpatient encounters. Descriptive analyses included frequencies of patient characteristics, prevalence and types of headache diagnoses, and prevalence of comorbid diagnoses. Prevalence ratios (PR) with 95% confidence intervals (CI) were used to estimate associations between gender and headache diagnoses. Multivariate models adjusted for age and race. Additional models also adjusted for comorbid diagnoses. In 2011, 56,300 (11.9%) Veterans received a headache-related diagnosis. While controlling for age and race, headache diagnoses were 1.61 times more prevalent (95% CI = 1.58-1.64) among women (18%) than men (11%). Most of this difference was associated with migraine diagnoses, which were 2.66 times more prevalent (95% CI = 2.59-2.73) among women. Cluster and post-traumatic headache diagnoses were less prevalent in women than in men. These patterns remained the same when also controlling for comorbid diagnoses, which were common among both women and men with headache diagnoses. The most prevalent comorbid diagnoses examined were depression (46% of women with headache diagnoses vs 40% of men), post-traumatic stress disorder (38% vs 58%), and back

  18. Maternal age and severe maternal morbidity: A population-based retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Sarka Lisonkova

    2017-05-01

    Full Text Available One of the United Nations' Millennium Development Goals of 2000 was to reduce maternal mortality by 75% in 15 y; however, this challenge was not met by many industrialized countries. As average maternal age continues to rise in these countries, associated potentially life-threatening severe maternal morbidity has been understudied. Our primary objective was to examine the associations between maternal age and severe maternal morbidities. The secondary objective was to compare these associations with those for adverse fetal/infant outcomes.This was a population-based retrospective cohort study, including all singleton births to women residing in Washington State, US, 1 January 2003-31 December 2013 (n = 828,269. We compared age-specific rates of maternal mortality/severe morbidity (e.g., obstetric shock and adverse fetal/infant outcomes (e.g., perinatal death. Logistic regression was used to adjust for parity, body mass index, assisted conception, and other potential confounders. We compared crude odds ratios (ORs and adjusted ORs (AORs and risk differences and their 95% CIs. Severe maternal morbidity was significantly higher among teenage mothers than among those 25-29 y (crude OR = 1.5, 95% CI 1.5-1.6 and increased exponentially with maternal age over 39 y, from OR = 1.2 (95% CI 1.2-1.3 among women aged 35-39 y to OR = 5.4 (95% CI 2.4-12.5 among women aged ≥50 y. The elevated risk of severe morbidity among teen mothers disappeared after adjustment for confounders, except for maternal sepsis (AOR = 1.2, 95% CI 1.1-1.4. Adjusted rates of severe morbidity remained increased among mothers ≥35 y, namely, the rates of amniotic fluid embolism (AOR = 8.0, 95% CI 2.7-23.7 and obstetric shock (AOR = 2.9, 95% CI 1.3-6.6 among mothers ≥40 y, and renal failure (AOR = 15.9, 95% CI 4.8-52.0, complications of obstetric interventions (AOR = 4.7, 95% CI 2.3-9.5, and intensive care unit (ICU admission (AOR = 4.8, 95% CI 2.0-11.9 among those 45-49 y. The

  19. Maternal age and severe maternal morbidity: A population-based retrospective cohort study.

    Science.gov (United States)

    Lisonkova, Sarka; Potts, Jayson; Muraca, Giulia M; Razaz, Neda; Sabr, Yasser; Chan, Wee-Shian; Kramer, Michael S

    2017-05-01

    One of the United Nations' Millennium Development Goals of 2000 was to reduce maternal mortality by 75% in 15 y; however, this challenge was not met by many industrialized countries. As average maternal age continues to rise in these countries, associated potentially life-threatening severe maternal morbidity has been understudied. Our primary objective was to examine the associations between maternal age and severe maternal morbidities. The secondary objective was to compare these associations with those for adverse fetal/infant outcomes. This was a population-based retrospective cohort study, including all singleton births to women residing in Washington State, US, 1 January 2003-31 December 2013 (n = 828,269). We compared age-specific rates of maternal mortality/severe morbidity (e.g., obstetric shock) and adverse fetal/infant outcomes (e.g., perinatal death). Logistic regression was used to adjust for parity, body mass index, assisted conception, and other potential confounders. We compared crude odds ratios (ORs) and adjusted ORs (AORs) and risk differences and their 95% CIs. Severe maternal morbidity was significantly higher among teenage mothers than among those 25-29 y (crude OR = 1.5, 95% CI 1.5-1.6) and increased exponentially with maternal age over 39 y, from OR = 1.2 (95% CI 1.2-1.3) among women aged 35-39 y to OR = 5.4 (95% CI 2.4-12.5) among women aged ≥50 y. The elevated risk of severe morbidity among teen mothers disappeared after adjustment for confounders, except for maternal sepsis (AOR = 1.2, 95% CI 1.1-1.4). Adjusted rates of severe morbidity remained increased among mothers ≥35 y, namely, the rates of amniotic fluid embolism (AOR = 8.0, 95% CI 2.7-23.7) and obstetric shock (AOR = 2.9, 95% CI 1.3-6.6) among mothers ≥40 y, and renal failure (AOR = 15.9, 95% CI 4.8-52.0), complications of obstetric interventions (AOR = 4.7, 95% CI 2.3-9.5), and intensive care unit (ICU) admission (AOR = 4.8, 95% CI 2.0-11.9) among those 45-49 y. The

  20. Mortality ascertainment of women veterans: a comparison of sources of vital status information, 1979-2002.

    Science.gov (United States)

    Savas, Lara S; del Junco, Deborah J; Bastian, Lori A; Vernon, Sally W

    2009-01-01

    To support health research on the unique cohort of women with a history of military service, this study assessed the completeness of mortality ascertainment for Texas women veterans in Department of Veterans Affairs (VA) and non-VA databases. We examined female veteran-specific mortality ascertainment comparing the VA Beneficiary Identification and Records Locator Subsystem Death File (BIRLS DF), VA Patient Treatment Files (PTF), and Social Security Administration-Death Master File (SSA-DMF) with Texas death certificate data. Databases were deterministically cross-linked, using female sex and social security numbers. Deterministic and probabilistic linkage methods were also compared. Of 6,297 decedents identified by death certificates, SSA-DMF, BIRLS DF, and PTF databases identified 97.5% collectively and 94%, 77%, and 5% individually. Compared with Texas death certificates, sensitivity of VA and SSA databases improved with increasing age. This study highlights that although the VA and SSA administrative databases have less complete ascertainment for younger decedents, combined these electronic databases provide nearly complete ascertainment for women veterans. Challenges related to large female-specific cross-linkage studies are explored, and a need to examine methods for female-specific health research studies in the general population is identified.

  1. Gender as a Moderator of the Relation Between Age Cohort and Three-Dimensional Wisdom in Iranian Culture.

    Science.gov (United States)

    Cheraghi, Fereshte; Kadivar, Parvin; Ardelt, Monika; Asgari, Ali; Farzad, Valiollah

    2015-07-01

    This study examined whether gender moderated the association between age cohort and the cognitive, reflective, and compassionate dimensions of wisdom, using an Iranian sample of 439 adults from three age cohorts: young (18-34), middle-aged (35-54), and older (55 and above). Results indicated that the interaction effect between gender and age cohort was significant for three-dimensional wisdom and all three wisdom dimensions. Compared with younger women and older men, older women tended to have less education and to score lower on the cognitive wisdom dimension, but they had similar average scores as older men on the compassionate wisdom dimension. Overall, the association between age and wisdom was only positive for men, due mainly to the positive relation between age and the reflective and compassionate wisdom dimensions for men after adjusting for education. The results are interpreted with reference to generation gaps, socialization of men versus women, and life experiences and opportunities. © The Author(s) 2015.

  2. The Milan Geriatrics 75+ Cohort Study : unravelling the determinants of healthy ageing and longevity

    NARCIS (Netherlands)

    Ogliari, Giulia

    2016-01-01

    Current evidence on older adults is derived from population-based cohort studies and randomized controlled trials, which may not include frail individuals. Data are lacking on older outpatients, a potentially diverse population. Therefore, we initiated the Milan Geriatrics 75+ Cohort Study, a

  3. The longitudinal age and birth cohort trends of regular exercise among adults aged 16-63 years in Sweden: a 24-year follow-up study.

    Science.gov (United States)

    Leijon, Matti; Midlöv, Patrik; Sundquist, Jan; Sundquist, Kristina; Johansson, Sven-Erik

    2015-01-01

    The aim of this study is to analyze longitudinally, based on four measurements at intervals of eight years, the annual effect of age group and birth cohort on regular exercise in the Swedish population from 1980-1981 to 2004-2005. We followed a randomly drawn subsample of individuals aged 16-63 years, interviewed by professional interviewers, from the Swedish Annual Level of Living Survey. We applied a mixed model with a random intercept and a random slope in order to analyze the annual effects. The prevalence of regular exercise increased annually by 0.3 % among men and 0.7 % among women. For every one-unit increase in BMI, the odds of regular physical activity decreased by 6 % among men and 5 % among women. While the female birth cohorts all increased over time the male birth cohorts showed a different pattern, as only the three oldest birth cohorts (1926-1933, 1934-1941, 1942-1949) showed an increase in regular exercise. The three youngest birth cohorts (1958-1965, 1966-1973, 1974-1981) instead showed a decreased prevalence of regular exercise. There was an inverse relationship between regular exercise and age, although the differences between age groups tended to decrease over time. Differences related to educational level increased over time as the prevalence of exercise among those with higher educational attainment increased more than among those with lower educational attainment. The most dramatic relative increase in exercise over time (almost two-fold) was found among those who were obese or who reported a poor health status. The prevalence of regular exercise increased in all studied sub-groups. However, the increased difference related to education level is worrying. To reduce the risk for ill health in these groups, there is a need for targeted interventions.

  4. National Coalition for Homeless Veterans

    Science.gov (United States)

    ... Continues Support of National Campaign to End Veteran Homelessness Nov. 14, 2017 This Veterans Day, Harbor Freight ... support of the national campaign to end veteran homelessness through generous contributions to the National Coalition for ...

  5. Exposure to any antenatal corticosteroids and outcomes in preterm infants by gestational age: prospective cohort study.

    Science.gov (United States)

    Travers, Colm P; Clark, Reese H; Spitzer, Alan R; Das, Abhik; Garite, Thomas J; Carlo, Waldemar A

    2017-03-28

    Objective To determine whether exposure to any antenatal corticosteroids is associated with a lower rate of death at each gestational age at which administration is currently recommended.Design Prospective cohort study.Settings 300 participating neonatal intensive care units of the Pediatrix Medical Group in the United States.Participants 117 941 infants 23 0/7 to 34 6/7 weeks' gestational age born between 1 January 2009 and 31 December 2013.Exposure Any antenatal corticosteroids.Main outcomes measures Death or major hospital morbidities analyzed by gestational age and exposure to antenatal corticosteroids with models adjusted for birth weight, sex, mode of delivery, and multiple births.Results Infants exposed to antenatal corticosteroids (n=81 832) had a significantly lower rate of death before discharge at each gestation 29 weeks or less, 31 weeks, and 33-34 weeks compared with infants without exposure (range of adjusted odds ratios 0.32 to 0.55). The number needed to treat with antenatal corticosteroids to prevent one death before discharge increased from six at 23 and 24 weeks' gestation to 798 at 34 weeks' gestation. The rate of survival without major hospital morbidity was higher among infants exposed to antenatal corticosteroids at the lowest gestations. Infants exposed to antenatal corticosteroids had lower rates of severe intracranial hemorrhage or death, necrotizing enterocolitis stage 2 or above or death, and severe retinopathy of prematurity or death compared with infants without exposure at all gestations less than 30 weeks and most gestations for infants born at 30 weeks' gestation or later.Conclusion Among infants born from 23 to 34 weeks' gestation, antenatal exposure to corticosteroids compared with no exposure was associated with lower mortality and morbidity at most gestations. The effect size of exposure to antenatal corticosteroids on mortality seems to be larger in infants born at the lowest gestations. Published by the BMJ

  6. Veterans Administration Databases

    Science.gov (United States)

    The Veterans Administration Information Resource Center provides database and informatics experts, customer service, expert advice, information products, and web technology to VA researchers and others.

  7. Changing Attitudes Toward Euthanasia and Suicide for Terminally Ill Persons, 1977 to 2016: An Age-Period-Cohort Analysis.

    Science.gov (United States)

    Attell, Brandon K

    2017-01-01

    Several longitudinal studies show that over time the American public has become more approving of euthanasia and suicide for terminally ill persons. Yet, these previous findings are limited because they derive from biased estimates of disaggregated hierarchical data. Using insights from life course sociological theory and cross-classified logistic regression models, I better account for this liberalization process by disentangling the age, period, and cohort effects that contribute to longitudinal changes in these attitudes. The results of the analysis point toward a continued liberalization of both attitudes over time, although the magnitude of change was greater for suicide compared with euthanasia. More fluctuation in the probability of supporting both measures was exhibited for the age and period effects over the cohort effects. In addition, age-based differences in supporting both measures were found between men and women and various religious affiliations.

  8. Brain aging, cognition in youth and old age and vascular disease in the Lothian Birth Cohort 1936: rationale, design and methodology of the imaging protocol.

    Science.gov (United States)

    Wardlaw, Joanna M; Bastin, Mark E; Valdés Hernández, Maria C; Maniega, Susana Muñoz; Royle, Natalie A; Morris, Zoe; Clayden, Jonathan D; Sandeman, Elaine M; Eadie, Elizabeth; Murray, Catherine; Starr, John M; Deary, Ian J

    2011-12-01

    As the population of the world ages, age-related cognitive decline is becoming an ever-increasing problem. However, the changes in brain structure that accompany normal aging, and the role they play in cognitive decline, remain to be fully elucidated. This study aims to characterize changes in brain structure in old age, and to investigate relationships between brain aging and cognitive decline using the Lothian Birth Cohort 1936. Here, we report the rationale, design and methodology of the brain and neurovascular imaging protocol developed to study this cohort. An observational, longitudinal study of the Lothian Birth Cohort 1936, which comprises 1091 relatively healthy individuals now in their 70s and living in the Edinburgh area. They are surviving participants of the Scottish Mental Survey 1947, which involved a test of general intelligence taken at age 11 years. At age 70 years, the Lothian Birth Cohort 1936 undertook detailed cognitive, medical and genetic testing, and provided social, family, nutritional, quality of life and physical activity information. At mean age 73 years they underwent detailed brain MRI and neurovascular ultrasound imaging, repeat cognitive and other testing. The MRI protocol is designed to provide qualitative and quantitative measures of gray and white matter atrophy, severity and location of white matter lesions, enlarged perivascular spaces, brain mineral deposits, microbleeds and integrity of major white matter tracts. The neurovascular ultrasound imaging provides velocity, stenosis and intima-media thickness measurements of the carotid and vertebral arteries. This valuable imaging dataset will be used to determine which changes in brain structural parameters have the largest effects on cognitive aging. Analysis will include multimodal image analysis and multivariate techniques, such as factor analysis and structural equation modelling. Especially valuable is the ability within this sample to examine the influence that early life

  9. US veterans and their unique issues: enhancing health care professional awareness.

    Science.gov (United States)

    Olenick, Maria; Flowers, Monica; Diaz, Valerie J

    2015-01-01

    United States veterans are a multifaceted population with a distinct culture that includes, but is not limited to, values, customs, ethos, selfless duty, codes of conduct, implicit patterns of communication, and obedience to command. Veterans experience mental health disorders, substance use disorders, post-traumatic stress, and traumatic brain injury at disproportionate rates compared to their civilian counterparts. Eighteen to 22 American veterans commit suicide daily and young veterans aged 18-44 are most at risk. Health care professionals must be aware of patients' military history and be able to recognize suicide-risk factors, regardless of age. Advancement in medical technology has allowed servicemen to survive their injuries but, for many, at the cost of a traumatic limb amputation and associated mental scarring. Health care professionals must be able to address physical safety concerns, as well as, emotional health of veterans. Approximately 49,933 American veterans are homeless and face the same difficulties as non-veterans in addition to service-related matters. Separation from military service and issues related to complex multiple deployments are among specifically identified veteran issues. Successful veteran reintegration into civilian life rests upon providing veterans with training that builds on their military knowledge and skill, employment post-separation from service, homelessness prevention, and mental health programs that promote civilian transition. Preparing health care providers to meet the complex needs of a vast veteran population can be facilitated by implementing veteran content into curricula that includes veteran patient simulations and case studies, and utilizes veteran clinical faculty.

  10. Impact of the age at menarche on body composition in adulthood: results from two birth cohort studies

    Directory of Open Access Journals (Sweden)

    Susana Bubach

    2016-09-01

    Full Text Available Abstract Background Evidence suggests that early menarche is positively associated with adiposity in adulthood. However, it is important to assess whether this association is due to early menarche or to the association of adiposity in late childhood with age at menarche. We evaluated the association between age at menarche and body composition in adolescence and adulthood, among subjects who have been prospectively followed in two Brazilian birth cohort studies. Methods In 1982 and 1993, the hospitals births in Pelotas were identified, and these subjects have been followed for several times. Information on age at menarche was obtained from the women (1982 cohort and their mothers (1993 cohort. At 30 and 18 years, the following body composition measures were evaluated: body mass index, waist circumference, fat-free mass index and fat mass index measured by dual-energy x-ray absorptiometry, and thickness of the abdominal visceral fat layer measured by ultrasound. The analyses were adjusted for: birth weight, maternal pregestational weight, gestational age, family income, household score index, maternal schooling, weight-for-height z-score at 4 years (1982, and body mass index at 11 years (1993. Results At 30 and 18 years, 2045 and 2092 women were evaluated, respectively. The prevalence of early menarche (≤11 years of age was 24.7 % in the 1982 and 27.6 % in the 1993 cohort. In the 1982 cohort, early menarche was positively associated with all body composition variables compared to those with late menarche (≥14 years of age even after adjusting for confounders (fat mass index: 2.33 kg/m2, 95 % Confidence interval: 1.64; 3.02. However, in the 1993 cohort, after adjusting for body mass index at 11 years, the regression coefficient for the association with fat mass index decreased from 2.2 kg/m2 (95 % Confidence interval: 1.7; 2.6 to 0.26 (95 % Confidence interval: −0.08; 0.60. Conclusions The association between age at menarche

  11. Posttraumatic Stress Disorder, Antipsychotic Use and Risk of Dementia in Veterans.

    Science.gov (United States)

    Roughead, Elizabeth E; Pratt, Nicole L; Kalisch Ellett, Lisa M; Ramsay, Emmae N; Barratt, John D; Morris, Philip; Killer, Graeme

    2017-07-01

    To examine the risk of dementia associated with posttraumatic stress disorder (PTSD) and the contribution of antipsychotic use to this risk. Retrospective cohort study SETTING: Australia. Administrative claims data from the Australian Government Department of Veterans' Affairs were used. Male Vietnam veterans aged 55 to 65 at baseline (2001-02) with no preexisting dementia diagnosis (N = 15,612). The association between PTSD and dementia was assessed over 12 years of follow-up. Dementia was identified as a hospital diagnosis, dementia record in service disability data, or dispensing of medicines for dementia. Cox-proportional hazards models were used, with age as the time-scale. Results were stratified according to baseline antipsychotic use. No greater risk of dementia was observed with PTSD. In veterans who received antipsychotics, dementia risk was significantly higher than in those who did not (hazard ratio (HR) = 2.1, 95% confidence interval (CI) = 1.4-3.3). Dementia risk was significantly greater in veterans hospitalized for PTSD who received antipsychotics (HR = 2.2, 95% CI = 1.1-4.6) and veterans without PTSD who received antipsychotics (HR = 4.3, 95% CI = 2.1-8.6) than in those without PTSD with no antipsychotic use. Antipsychotic use may be a contributor to dementia risk. These findings should be interpreted with caution because the study design was observational. Further research using prospective study designs in settings where diagnostic data, cognitive function, and disease severity are available are required. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  12. Exposure reconstruction for the TCDD-exposed NIOSH cohort using a concentration- and age-dependent model of elimination

    Energy Technology Data Exchange (ETDEWEB)

    Aylward, L. [Exponent, Inc., Alexandria, VA (United States); Brunet, R. [Montreal Univ., QC (Canada); Starr, T. [TBS Associates, Raleigh, NC (United States); Delzell, E.; Cheng, H.; Beall, C. [Alabama Birmingham Univ., AL (United States)

    2004-09-15

    Estimates of cumulative exposure to TCDD have been developed for several occupationally exposed cohorts by integrating job exposure matrices based on work histories with measured serum lipid TCDD levels. These efforts relied on the assumption that elimination of TCDD occurred via a first-order process with a half-life of 7.1 to 8.7 years. Serum lipid levels measured years after last exposure for a subset of each cohort were combined with estimates of exposure intensity over time during employment to derive maximum likelihood estimates (MLEs) of the dose associated with one unit of the exposure index. These dose rates were then applied to the job exposure histories of each member of the full cohort to estimate cumulative exposures (termed either area under the curve [AUC] or cumulative serum lipid concentration [CSLC]). A meta-analysis combined such dose estimates and SMR measures from three cohorts to estimate the carcinogenic potency of TCDD in these populations. Recent studies have demonstrated that the elimination of TCDD occurs via a concentration-dependent process: elimination occurs at a greater rate when body concentrations are relatively high, with effective elimination half-lives of less than 3 years at serum lipid levels above 1,000 ppt. In addition, analysis of serial sampling data from subjects exposed to dioxin during the 1976 chemical reactor accident in Seveso, Italy, demonstrated an age-dependent slowing of elimination. Here we present some results from application of a concentration- and agedependent model of elimination (CADM) described by Aylward et al. to the job exposure matrix data for the cohort of TCDD-exposed chemical manufacturing workers studied by the U.S. National Institute for Occupational Safety and Health (the ''NIOSH cohort''). Herein we describe the process of exposure reconstruction, the impact of the CADM on dose estimates for the cohort, and the variability in the dose estimates obtained.

  13. Do social inequalities in health widen or converge with age? Longitudinal evidence from three cohorts in the West of Scotland

    Directory of Open Access Journals (Sweden)

    Benzeval Michaela

    2011-12-01

    Full Text Available Abstract Background Existing studies are divided as to whether social inequalities in health widen or converge as people age. In part this is due to reliance on cross-sectional data, but also among longitudinal studies to differences in the measurement of both socioeconomic status (SES and health and in the treatment of survival effects. The aim of this paper is to examine social inequalities in health as people age using longitudinal data from the West of Scotland Twenty-07 Study to investigate the effect of selective mortality, the timing of the SES measure and cohort on the inequality patterns. Methods The Twenty-07 Study has followed three cohorts, born around 1932, 1952 and 1972, from 1987/8 to 2007/8; 4,510 respondents were interviewed at baseline and, at the most recent follow-up, 2,604 were interviewed and 674 had died. Hierarchical repeated-measures models were estimated for self-assessed health status, with and without mortality, with baseline or time-varying social class, sex and cohort. Results Social inequalities in health emerge around the age of 30 after which they widen until the early 60s and then begin to narrow, converging around the age of 75. This pattern is a result of those in manual classes reporting poor health at younger ages, with the gap narrowing as the health of those in non-manual classes declines at older ages. However, employing a more proximal measure of SES reduces inequalities in middle age so that convergence of inequalities is not apparent in old age. Including death in the health outcome steepens the health trajectories at older ages, especially for manual classes, eliminating the convergence in health inequalities, suggesting that healthy survival effects are important. Cohort effects do not appear to affect the pattern of inequalities in health as people age in this study. Conclusions There is a general belief that social inequalities in health appear to narrow at older ages; however, taking account of

  14. Antihypertensive treatment during pregnancy and functional development at primary school age in a historical cohort study.

    NARCIS (Netherlands)

    Pasker-de Jong, P.C.M.; Zielhuis, G.A.; Gelder, M.M.H.J. van; Pellegrino, A.; Gabreëls, F.J.M.; Eskes, T.K.A.B.

    2010-01-01

    OBJECTIVE: To determine the functional development of children born after treatment of mild-to-moderate gestational hypertension with labetalol versus methyldopa, and no antihypertensive treatment. DESIGN: Historical cohort study. SETTING: Twelve Dutch hospital departments of obstetrics. POPULATION:

  15. Mortality of colorectal cancer in Taiwan, 1971-2010: temporal changes and age-period-cohort analysis.

    Science.gov (United States)

    Su, Shih-Yung; Huang, Jing-Yang; Jian, Zhi-Hong; Ho, Chien-Chang; Lung, Chia-Chi; Liaw, Yung-Po

    2012-12-01

    Colorectal cancer (CRC) is the second most common cause of cancer death in developed countries among men (after lung cancer) and the third most common among women. This study thus examines the long-term trends of CRC mortality in Taiwan. CRC cases were collective between patients aged 30 years or older and younger than 85 years from the Taiwan death registries during 1971-2010. Standard descriptive techniques such as age-standardized mortality rates (ASMR), aural percent change, and age-period-cohort analyses were used. The increase of percentage change by each age group in men was higher than in women. The ASMR of CRC increased 2-fold for men and almost 1.5-fold for women during the periods 1971-1975 and 2006-2010. For age-period-cohort analysis, the estimated mortality rate increased steadily with age in both sexes, and plateaued at 175.29 per 100,000 people for men and 128.14 per 100,000 for women in the 80- to 84-year-old group. Period effects were weak in both sexes. Cohort effects were strong. Between 30 and 59 years of age, the sex ratio showed that the female CRC mortality rate was higher than that of their male counterparts. Conversely, the mortality risk of CRC in men was higher than that in women when they were between 60 and 84 years old. The current findings showed a consistent increase in mortality from CRC over the years. Changes in the patient sex ratio indicated an important etiological role of sex hormones, especially in women aged 60 years or younger.

  16. Do people who experience incarceration age more quickly? Exploratory analyses using retrospective cohort data on mortality from Ontario, Canada.

    Directory of Open Access Journals (Sweden)

    Fiona G Kouyoumdjian

    Full Text Available We aimed to explore whether mortality data are consistent with the view that aging is accelerated for people with a history of incarceration compared to the general population, using data on mortality rates and life expectancy for persons in Ontario, Canada.We obtained data from the Ontario Ministry of Community Safety and Correctional Services on all adults admitted to provincial correctional facilities in Ontario in 2000, and linked these data with death records from provincial vital statistics between January 1, 2000 and December 31, 2012. We used life table methods to calculate mortality rates and life expectancies for this cohort by sex and 5-year age group. We similarly generated population comparison rates using publicly available data for the general population of Ontario in 2006 as the midpoint of the follow up period. We compared these mortality indices between the 2000 Ontario prison cohort and the general population by age group and sex.The difference in all-cause mortality rates between the 2000 Ontario prison cohort and the general population was greatest for younger adults, with the prison cohort experiencing rates of death that would be expected for persons at least 15 years older at ages 20 to 44 for men and ages 20 to 59 for women. Life expectancy in the 2000 Ontario prison cohort was most similar to life expectancy of persons five years older in the general population at age intervals 20 to 45 in men and 20 to 30 in women.For most of adulthood, life expectancy and mortality rates are worse for adults with a history of incarceration than for the general population in Ontario, Canada. However, the association between mortality and incarceration status is modified by age, with the greatest relative burden of mortality experienced by younger persons with a history of incarceration and modified by sex, with worse relative mortality in women. Future research should explore the association between incarceration status and markers of

  17. Health returns to education by family socioeconomic origins, 1980-2008: Testing the importance of gender, cohort, and age.

    Science.gov (United States)

    Andersson, Matthew A

    2016-12-01

    Recent studies find that health returns to education are elevated among those who come from disadvantaged families. These findings suggest that education may be a health resource that compensates or "substitutes" for lower parental socioeconomic status. Alternatively, some studies find support for a cumulative (dis)advantage perspective, such that educational health returns are higher among those who already were advantaged, widening initial health (dis)advantages across the life course. However, it remains unclear whether these findings are dependent on gender or cohort, and this is a fundamental oversight given marked differences between men and women in educational and health inequalities across the twentieth century. Drawing on national US data (1980-2002 General Social Survey with 2008 National Death Index Link), I indeed find that the presence or strength of resource substitution or cumulative (dis)advantage depends upon health measure as well as gender and cohort. For self-rated health, cumulative (dis)advantage explains educational health disparities, but among men only. Cumulative (dis)advantage in avoiding fair or poor health is partly explained by cohort and age variation in health returns to education, and cumulative (dis)advantage in excellent health is more robust in earlier cohorts and at older ages. For mortality, resource substitution is instead supported, but for women only. Among those from disadvantaged families, educational mortality buffering increases with cohort but diminishes with age. Taken together, these findings confirm prior research showing that adult health inequalities linked to education depend on family background, and extend this work by demonstrating that the nature and extent of these dynamics differ considerably depending on the health outcome being assessed and on an individual's historical context, life course stage, and gender.

  18. Changing perceived importance of religion in mainland China, 1990-2012: An age-period- cohort analysis.

    Science.gov (United States)

    Hu, Anning

    2017-08-01

    The comprehensive social reform and relaxation of religious regulation in mainland China have encouraged scholars to propose a revival thesis of religion, predicting a rising prevalence of religious adherence in the Reform Era. This study extends the revival thesis by focusing attention on people's subjective religiosity, and investigates age, period, and cohort effects on the transition in perceived importance of religion from 1990 to 2012. Capitalizing on the repeated cross-sectional data of the China sample in the World Values Survey, this study shows that (1) The senior population, relative to the younger counterpart, attaches greater importance to religion. (2) The net period effect suggests that Chinese citizens' perceived importance of religion follows an upward trend by the early 2000s, but no significant growth is detected henceforward. (3) The cohorts who experienced the anti-religion Mao's Era in their adolescent life course stage have an evidently lower probability of viewing religion to be important, in relation to the cohorts of the Reform Era. Theoretical implications of the empirical age-period-cohort patterns for the religious economies theory and change of Chinese religious landscape are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. US veterans and their unique issues: enhancing health care professional awareness

    Directory of Open Access Journals (Sweden)

    Olenick M

    2015-12-01

    Full Text Available Maria Olenick,1 Monica Flowers,1 Valerie J Diaz1,21Nicole Wertheim College of Nursing and Health Science, Florida International University, Miami, FL, USA; 2Operational Health Support Unit Jacksonville, United States Navy Nurse Corps, Jacksonville, FL, USAAbstract: United States veterans are a multifaceted population with a distinct culture that includes, but is not limited to, values, customs, ethos, selfless duty, codes of conduct, implicit patterns of communication, and obedience to command. Veterans experience mental health disorders, substance use disorders, post-traumatic stress, and traumatic brain injury at disproportionate rates compared to their civilian counterparts. Eighteen to 22 American veterans commit suicide daily and young veterans aged 18–44 are most at risk. Health care professionals must be aware of patients' military history and be able to recognize suicide-risk factors, regardless of age. Advancement in medical technology has allowed servicemen to survive their injuries but, for many, at the cost of a traumatic limb amputation and associated mental scarring. Health care professionals must be able to address physical safety concerns, as well as, emotional health of veterans. Approximately 49,933 American veterans are homeless and face the same difficulties as non-veterans in addition to service-related matters. Separation from military service and issues related to complex multiple deployments are among specifically identified veteran issues. Successful veteran reintegration into civilian life rests upon providing veterans with training that builds on their military knowledge and skill, employment post-separation from service, homelessness prevention, and mental health programs that promote civilian transition. Preparing health care providers to meet the complex needs of a vast veteran population can be facilitated by implementing veteran content into curricula that includes veteran patient simulations and case studies

  20. Arthritis and Veterans

    Centers for Disease Control (CDC) Podcasts

    2015-11-09

    One in three veterans has arthritis. This podcast provides information on how veterans can improve their quality of life with physical activity and other arthritis management strategies.  Created: 11/9/2015 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 11/9/2015.

  1. Antiepileptic drug prescribing patterns in Iraq and Afghanistan war veterans with epilepsy.

    Science.gov (United States)

    Rohde, Natalie N; Baca, Christine B; Van Cott, Anne C; Parko, Karen L; Amuan, Megan E; Pugh, Mary Jo

    2015-05-01

    We examined patterns of antiepileptic drug (AED) use in a cohort of Iraq/Afghanistan war veterans (IAVs) who were previously identified as having epilepsy. We hypothesized that clinicians would be more likely to prescribe newer AEDs and would select specific AEDs to treat seizures based on patient characteristics including gender and comorbidities. From the cohort of IAVs previously identified with epilepsy between fiscal years 2009 and 2010, we selected those who received AEDs from the Veterans Health Administration in FY2010. Regimens were classified as monotherapy or polytherapy, and specific AED use was examine overall and by gender. Multivariable logistic regression examined associations of age; gender; race/ethnicity; medical, psychiatric, and neurological comorbidities; and receipt of neurology specialty care associated with the six most commonly used AEDs. Among 256,284 IAVs, 2123 met inclusion criteria (mean age: 33years; 89% men). Seventy-two percent (n=1526) received monotherapy, most commonly valproate (N=425) and levetiracetam (n=347). Sixty-one percent of those on monotherapy received a newer AED (levetiracetam, topiramate, lamotrigine, zonisamide, oxcarbazepine). Although fewer women than men received valproate, nearly 90% (N=45) were of reproductive age (≤45years). Antiepileptic drug prescribing patterns were associated with posttraumatic stress disorder, bipolar disorder, cerebrovascular disease, dementia/cognitive impairment, headache, and receipt of neurological specialty care (all p<0.01). In this cohort of veterans with epilepsy, most received AED monotherapy and newer AEDs. Prescribing patterns were different for men and women. The patterns observed between AEDs and neurological/psychiatric comorbidities suggest that clinicians are practicing rational prescribing. Copyright © 2015. Published by Elsevier Inc.

  2. Determinants of Growth in Multiunit Housing Demand since the Great Recession: An Age-Period-Cohort Analysis

    Directory of Open Access Journals (Sweden)

    Shiv N. Mehrotra

    2017-01-01

    Full Text Available Following the Great Recession (2007–2009, growth in multiunit housing starts has been exceptionally strong and sustained. In this study, we examine empirical evidence for three possible explanations, namely, the passage of Baby Boomers into senior years, the depressed economic conditions, and rising preference of recent birth cohorts for residing in urban cores. Applying Age-Period-Cohort analysis to census data on multiunit housing occupancy from 1970 to 2010, we find evidence to support the explanations that a sharp increase in demand from Millennials drawn to urban cores and retiring Baby Boomers are contributing to the growth in multiunit housing starts. The results provide weak evidence of a negative relationship between depressed economic conditions and demand for multiunit housing starts. Over the long term, demand for multiunit housing can be expected to moderate as a result of the projected aging of the population.

  3. Maternal Age of Menarche and Blood Pressure in Adolescence: Evidence from Hong Kong's "Children of 1997" Birth Cohort.

    Directory of Open Access Journals (Sweden)

    Tsz Chun Lai

    Full Text Available Age of puberty has declined substantially in developed settings and is now declining in the rest of the world with economic development. Early age of puberty is associated with non-communicable diseases in adulthood, and may be a long-term driver of population health with effects over generations. In a non-Western setting, we examined the association of maternal age of menarche with blood pressure in late childhood/adolescence.We used generalised estimating equations to estimate the adjusted association of maternal age of menarche with age-, sex- and height-adjusted blood pressure z-score from 10 to 16 years in Hong Kong's population-representative birth cohort, "Children of 1997" (n = 8327. We also assessed whether associations were mediated by body mass index (BMI or pubertal stage.Earlier maternal age of menarche was associated with higher systolic blood pressure in adolescence [-0.02 z-score per year older maternal age of menarche, 95% confidence interval (CI -0.04 to -0.003]. The association of maternal age of menarche with systolic blood pressure was mediated by adiposity and/or pubertal stage at 11 years. Maternal age of menarche was not associated with diastolic blood pressure.Earlier maternal age of puberty was associated with higher systolic blood pressure, largely mediated by adiposity, highlighting the importance of tackling childhood obesity as a public health priority in view of the secular trend of declining age of puberty.

  4. Age at exposure and attained age variations of cancer risk in the Japanese A-bomb and radiotherapy cohorts

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Uwe, E-mail: uwe.schneider@uzh.ch [Institute of Physics, Science Faculty, University of Zürich, Zürich 8057, Switzerland and Radiotherapy Hirslanden, Uwe Schneider Institute of Radiotherapy, Witellikerstr. 40, Zürich 8032 (Switzerland); Walsh, Linda [Institute of Physics, Science Faculty, University of Zürich, Zürich 8057, Switzerland and BfS - Federal Office for Radiation Protection, Radiation Protection and Health, Neuherberg 85764 (Germany)

    2015-08-15

    Purpose: Phenomenological risk models for radiation-induced cancer are frequently applied to estimate the risk of radiation-induced cancers at radiotherapy doses. Such models often include the effect modification, of the main risk to radiation dose response, by age at exposure and attained age. The aim of this paper is to compare the patterns in risk effect modification by age, between models obtained from the Japanese atomic-bomb (A-bomb) survivor data and models for cancer risks previously reported for radiotherapy patients. Patterns in risk effect modification by age from the epidemiological studies of radiotherapy patients were also used to refine and extend the risk effect modification by age obtained from the A-bomb survivor data, so that more universal models can be presented here. Methods: Simple log-linear and power functions of age for the risk effect modification applied in models of the A-bomb survivor data are compared to risks from epidemiological studies of second cancers after radiotherapy. These functions of age were also refined and fitted to radiotherapy risks. The resulting age models provide a refined and extended functional dependence of risk with age at exposure and attained age especially beyond 40 and 65 yr, respectively, and provide a better representation than the currently available simple age functions. Results: It was found that the A-bomb models predict risk similarly to the outcomes of testicular cancer survivors. The survivors of Hodgkin’s disease show steeper variations of risk with both age at exposure and attained age. The extended models predict solid cancer risk increase as a function of age at exposure beyond 40 yr and the risk decrease as a function of attained age beyond 65 yr better than the simple models. Conclusions: The standard functions for risk effect modification by age, based on the A-bomb survivor data, predict second cancer risk in radiotherapy patients for ages at exposure prior to 40 yr and attained ages

  5. Associations between Specific Redox Biomarkers and Age in a Large European Cohort: The MARK-AGE Project

    Directory of Open Access Journals (Sweden)

    Daniela Weber

    2017-01-01

    Full Text Available Oxidative stress and antioxidants play a role in age-related diseases and in the aging process. We here present data on protein carbonyls, 3-nitrotyrosine, malondialdehyde, and cellular and plasma antioxidants (glutathione, cysteine, ascorbic acid, uric acid, α-tocopherol, and lycopene and their relation with age in the European multicenter study MARK-AGE. To avoid confounding, only data from countries which recruited subjects from all three study groups (five of eight centers and only participants aged ≥55 years were selected resulting in data from 1559 participants. These included subjects from (1 the general population, (2 members from long-living families, and (3 their spouses. In addition, 683 middle-aged reference participants (35–54 years served as a control. After adjustment for age, BMI, smoking status, gender, and country, there were differences in protein carbonyls, malondialdehyde, 3-nitrotyrosine, α-tocopherol, cysteine, and glutathione between the 3 study groups. Protein carbonyls and 3-nitrotyrosine as well as cysteine, uric acid, and lycopene were identified as independent biomarkers with the highest correlation with age. Interestingly, from all antioxidants measured, only lycopene was lower in all aged groups and from the oxidative stress biomarkers, only 3-nitrotyrosine was increased in the descendants from long-living families compared to the middle-aged control group. We conclude that both lifestyle and genetics may be important contributors to redox biomarkers in an aging population.

  6. Mortality due to acute myocardial infarction in China from 1987 to 2014: Secular trends and age-period-cohort effects.

    Science.gov (United States)

    Chang, Jie; Liu, Xin; Sun, Yang

    2017-01-15

    In contrast with most developed countries, mortality from acute myocardial infarction (AMI) continues to rise in China. We examined secular trends and age, period, and cohort effects in mortality from AMI in China from 1987 to 2014. Data on deaths from AMI between 1987 and 2014 were obtained from the Chinese Health Statistics Annual Report (1987-2001) and the Chinese Health Statistics Yearbook (2003-2015). We then conducted an age-period-cohort analysis using the intrinsic estimator approach. There was an upward trend in AMI mortality in both urban and rural populations that accelerated from 2004 onwards. AMI mortality increased 5.6-fold from 1987 to 2014. The net age effect on AMI mortality increased exponentially. AMI mortality risk in the 80-84years of age bracket was 220.15 and 190.70 times higher than in the 15-19years of age bracket in urban and rural populations, respectively. There was a V-shaped trend in the net period effect between 1999 and 2009. Meanwhile, although there was a global reduction in the cohort effect in urban and rural AMI mortality, we found a modest increase among urban populations born between 1975 and 1989 and rural populations born between 1990 and 1999. The changes in exposure to lifestyle-related risk factors and triggers such as air pollution have contributed to the increase in AMI mortality in China over recent decades. The sharp increase in AMI mortality since 2004 is primarily attributable to population aging and the rise in AMI deaths among younger generations. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Effect of age at menopause on disease presentation in early rheumatoid arthritis: results from the Canadian Early Arthritis Cohort.

    Science.gov (United States)

    Wong, Lauren E; Huang, Wei-Ti; Pope, Janet E; Haraoui, Boulos; Boire, Gilles; Thorne, J Carter; Hitchon, Carol A; Tin, Diane; Keystone, Edward C; Bykerk, Vivian P

    2015-05-01

    Studies suggest that hormonal states affect disease characteristics in women with rheumatoid arthritis (RA). This study investigated how age at menopause affects disease in women presenting with early RA. This was a cross-sectional study of postmenopausal women with early RA under age 65 years at time of enrollment in the Canadian Early Arthritis Cohort. RA-related disease characteristics in women who had early age at menopause (EM; age at menopause age at menopause (age at menopause ≥45 years). The t-test was applied to continuous variables and the chi-square test to categorical variables. Multivariate logistic regression analysis was used to adjust for age at menopause, smoking, and use of exogenous hormones. A total of 534 women were included; 93 were in the EM group. The age at RA onset was similar between groups. The EM group had higher mean patient global and pain scores and was more likely to be rheumatoid factor (RF) positive and meet the 1987 American College of Rheumatology criteria for RA. Using multivariate logistic regression, the EM group was more likely to be RF positive (odds ratio 2.2 [95% confidence interval 1.3-3.8], P = 0.005). Symptom duration, joint counts, Disease Activity Score in 28 joints, Health Assessment Questionnaire scores, and inflammatory markers did not differ between groups. These data suggest that early age at menopause, compared to usual age at menopause, is associated with seropositivity in women with early RA. © 2015, American College of Rheumatology.

  8. The prevalence of SDQ-measured mental health problems at age 5-7 years and identification of predictors from birth to preschool age in a Danish birth cohort: the Copenhagen Child Cohort 2000

    DEFF Research Database (Denmark)

    Elberling, Hanne; Linneberg, Allan; Olsen, Else Marie

    2010-01-01

    The objective of the study is to investigate the prevalence, distribution and predictors of mental health problems in 5-7-year-old Danish children in the general population. This study is a 5-7-year follow-up study of a birth cohort of 6,090 children, the Copenhagen Child Cohort 2000. The extended...... version of the Strengths and Difficulties Questionnaire (SDQ) was answered by parents and pre-school teachers. Data from Danish national registers included perinatal data, socioeconomic data and data on child mental illness diagnosed at hospital in preschool age. Register data from the first year of life...... risk load and environmental stress given the social and cultural context....

  9. Permanent and Transitory Wage Inequality of British Men, 1975-2001: Year, Age and Cohort Effects

    NARCIS (Netherlands)

    Alessie, R.; Kalwij, A.S.

    2003-01-01

    We examine the variance-covariance structure of log-wages over time and over the lifecycle of British men from 1975 to 2001, hereby controlling for cohort effects. Wage inequality has risen sharply during the 1980’s and early 1990’s and remained fairly constant in the second half of the 1990’s. We

  10. Stuttering, Temperament, and Anxiety: Data from a Community Cohort Ages 2-4 Years

    Science.gov (United States)

    Kefalianos, Elaina; Onslow, Mark; Ukoumunne, Obioha; Block, Susan; Reilly, Sheena

    2014-01-01

    Purpose: The purpose of this study was to ascertain whether and when temperament differences, including precursors of anxiety, emerge before onset and during stuttering development. Method: The authors prospectively studied temperament characteristics of a community cohort of children who stutter (N = 183) and children in the control group (N =…

  11. Modelling regional variation of first-time births in Denmark 1980-1994 by an age-period-cohort model

    DEFF Research Database (Denmark)

    Thygesen, L. C.; Knudsen, Lisbeth B.; Keiding, N.

    2005-01-01

    variation an interaction parameter between age and county is necessary, which provides a surprisingly good description suggesting that the county-specific age-distributions of first-time fertility rates differ. Our results are in general agreement with the 'moral geography' concepts of Tonboe (2001).......Despite the small size of Denmark, there have traditionally been rather consistent regional differences in fertility rates. We apply the statistical age-period-cohort model to include the effect of these three time-related factors thereby concisely illuminating the regional differences of first-time...... births in Denmark. From the Fertility of Women and Couples Dataset we obtain data on number of births by nulliparous women by year (1980-1994), age (15-45) and county of residence. We show that the APC-model describes the fertility rates of nulliparous women satisfactorily. To catch the regional...

  12. [Age, period and birth-cohort effects on marriage rates in Japanese women between 1985 and 2005, and comparison of trends of effects between marriage and birth rates].

    Science.gov (United States)

    Uchida, Hiroyuki; Odagiri, Youichi; Ohtake, Kazuo; Kobayashi, Jun

    2008-07-01

    An age-period-cohort (APC) analysis was performed to provide information about age-, period-, and cohort-specific effects on marriage trends in Japanese women. In addition, the relationships of the trends of age-, period-, and cohort-specific effects between marriage and birth were analyzed. We obtained data regarding marriages of Japanese women aged between 19 and 38 years for the period of 1985 to 2005 from the National Vital Statistics. Population data used were for an estimated population, obtained from the Population Estimates Annual Reports. Standard cohort tables comprising marriage and population data were analyzed using a Bayesian APC model to identify age-, period-, and cohort-specific effects on marriage rate trends. Previously obtained data for a similar APC-analysis of birth trends were used to compare the trends in the effects of age, period, and cohort on marriage and birth patterns. For this purpose, the estimated values for each effect were normalized. With regard to the marriage trends in Japanese women, the effect of age was the greatest, peaking at the age of 25 years. The period effect increased after 1997; however, its effect was relatively limited as compared to the other effects. The cohort effect, which was greater than the period effect and less than the age effect, on marriage trends showed a decreasing slope for birth cohorts born after 1966 and subsequent increase after 1982. Comparison of age, period and cohort effects between the trends in marriage and birth rates showed that the age effect distinctly peaked at 25 and 28 years for marriage and births, respectively. The period effect on marriage and birth showed a decreasing trend until 1991 and subsequent increased in 1992 and 1997 for births and marriage, respectively. With regard to the cohort effect on birth rates, a decreasing trend was observed for the birth cohorts after 1961, with increase after 1977. However, with regard to the cohort effect on marriage rates, the decreasing

  13. Veterans Affairs Suicide Prevention Synthetic Dataset

    Data.gov (United States)

    Department of Veterans Affairs — The VA's Veteran Health Administration, in support of the Open Data Initiative, is providing the Veterans Affairs Suicide Prevention Synthetic Dataset (VASPSD). The...

  14. Trends of Esophageal Cancer Mortality in Rural China from 1989 to 2013: An Age-Period-Cohort Analysis.

    Science.gov (United States)

    Gao, Xudong; Wang, Zhenkun; Kong, Chan; Yang, Fen; Wang, Ying; Tan, Xiaodong

    2017-02-23

    Background: Esophageal cancer is one of the most common cancers in rural China. The aim of this study was to describe the time trends of esophageal cancer mortality in rural China and to better elucidate the causes of these trends. Methods: The mortality data were obtained from the World Health Organization Mortality Database and the China Health Statistical Yearbook Database. The mortality data were analyzed with age-period-cohort (APC) analysis. Results: Our study indicates that the Age-Standardized Mortality Rates (ASMRs) in rural China generally decreased from 1989 to 2003, and thereafter increased until the year 2008 in both sexes. After 2008, the ASMRs decreased again. The results of APC analysis suggest that the general decrease in esophageal cancer mortality in rural China from 1989 to 2003 might be caused by the downtrend of the cohort effects and period effects, while the general increase in mortality from 2004 to 2008 might be caused by the uptrend of the period effects. The decrease in mortality after 2008 may be relevant to the Four Trillion RMB Investment Plan launched by the Chinese Government. Conclusions: The declining cohort effects were probably related to the improvement of socioeconomic status in childhood and the decreasing consumptions of alcohol drinking and smoking, while the trends of the period effects were relevant to the changes in the dietary pattern. Our findings may help predict future changes in esophageal cancer mortality.

  15. Prostate cancer control and survival in Vietnam veterans exposed to Agent Orange.

    Science.gov (United States)

    Everly, Lydia; Merrick, Gregory S; Allen, Zachariah A; Butler, Wayne M; Wallner, Kent; Lief, Jonathan H; Galbreath, Robert W; Adamovich, Edward

    2009-01-01

    In this study, we evaluated the impact of Agent Orange exposure on survival in Vietnam Veterans undergoing prostate brachytherapy. From May 1995 to January 2005, 81 Vietnam veterans (29 with Agent Orange exposure and 52 without) and 433 nonveterans of comparable age (mean age, 58 years) underwent prostate brachytherapy. The mean follow-up was 5.0 years. Biochemical progression-free survival (bPFS) was defined as a prostate-specific antigen (PSA)Agent Orange-exposed men were least likely to remain biochemically controlled (89.5%, 100%, and 97.2% in Agent Orange-exposed, nonexposed veterans, and nonveterans, respectively, p=0.012). No significant differences in cause-specific (CSS) (p=0.832) or overall survival (OS) (p=0.363) were discerned. In multivariate analysis, CSS was best predicted by Gleason Score and day 0 D(90), whereas Gleason Score, % positive biopsies, and D(90) predicted for bPFS. None of the evaluated parameters predicted for OS, however, a trend was identified for better OS in younger patients and those with a higher D(90). In addition, Agent Orange exposure did not predict for any of the survival parameters. To date, 22 patients have died (metastatic prostate cancer two, second malignancies nine, cardiovascular disease eight, trauma two, and pulmonary one). In this cohort of prostate brachytherapy patients, Agent Orange exposure did not statistically impact survival in multivariate analysis.

  16. Suicide Mortality Among Patients Treated by the Veterans Health Administration From 2000 to 2007

    Science.gov (United States)

    Bohnert, Amy S. B.; Ilgen, Mark A.; Ignacio, Rosalinda; McCarthy, John F.; Valenstein, Marcia M.; Knox, Kerry L.

    2012-01-01

    Objectives. We sought to examine rates of suicide among individuals receiving health care services in Veterans Health Administration (VHA) facilities over an 8-year period. Methods. We included annual cohorts of all individuals who received VHA health care services from fiscal year (FY) 2000 through FY 2007 (October 1, 1999–September 30, 2007; N = 8 855 655). Vital status and cause of death were obtained from the National Death Index. Results. Suicide was more common among VHA patients than members of the general US population. The overall rates of suicide among VHA patients decreased slightly but significantly from 2000 to 2007 (P < .001). Male veterans between the ages of 30 and 64 years were at the highest risk of suicide. Conclusions. VHA health care system patients are at elevated risk for suicide and are appropriate for suicide reduction services, although the rate of suicide has decreased in recent years for this group. Comprehensive approaches to suicide prevention in the VHA focus not only on recent returnees from Iraq and Afghanistan but also on middle-aged and older Veterans. PMID:22390612

  17. Multimorbidity and Persistent Depression among Veterans with Diabetes, Heart Disease, and Hypertension

    Science.gov (United States)

    Findley, Patricia; Shen, Chan; Sambamoorthi, Usha

    2011-01-01

    This study investigated the association between multimorbidity and persistent depression among cohorts of veterans with diabetes, heart disease, or hypertension. The retrospective longitudinal analysis used national administrative data on around 1.38 million Veteran Health Administration clinic users merged with Medicare claims data.…

  18. Mortality and Revascularization following Admission for Acute Myocardial Infarction: Implication for Rural Veterans

    Science.gov (United States)

    Abrams, Thad E.; Vaughan-Sarrazin, Mary; Kaboli, Peter J.

    2010-01-01

    Introduction: Annually, over 3,000 rural veterans are admitted to Veterans Health Administration (VA) hospitals for acute myocardial infarction (AMI), yet no studies of AMI have utilized the VA rural definition. Methods: This retrospective cohort study identified 15,870 patients admitted for AMI to all VA hospitals. Rural residence was identified…

  19. Early life determinants of low IQ at age 6 in children from the 2004 Pelotas Birth Cohort: a predictive approach.

    Science.gov (United States)

    Camargo-Figuera, Fabio Alberto; Barros, Aluísio J D; Santos, Iná S; Matijasevich, Alicia; Barros, Fernando C

    2014-12-16

    Childhood intelligence is an important determinant of health outcomes in adulthood. The first years of life are critical to child development. This study aimed to identify early life (perinatal and during the first year of life) predictors of low cognitive performance at age 6. A birth cohort study started in the city of Pelotas, southern Brazil, in 2004 and children were followed from birth to age six. Information on a broad set of biological and social predictors was collected. Cognitive ability-the study outcome-was assessed using the Wechsler Intelligence Scale for Children (WISC). IQ scores were standardized into z-scores and low IQ defined as z height-for-age deficit; head circumference-for-age deficit; parental smoking during pregnancy; and maternal perception of the child's health status. The area under the ROC curve for our final model was 0.8, with sensitivity of 72% and specificity of 74%. Similar results were found when testing external validation by using data from the 1993 Pelotas Birth Cohort. The study results suggest that a child's and her/his family's social conditions are strong predictors of cognitive ability in childhood. Interventions for promoting a healthy early childhood development are needed targeting children at risk of low IQ so that they can reach their full cognitive potential.

  20. Mortality in British military participants in human experimental research into chemical warfare agents at Porton Down: cohort study.

    Science.gov (United States)

    Venables, K M; Brooks, C; Linsell, L; Keegan, T J; Langdon, T; Fletcher, T; Nieuwenhuijsen, M J; Maconochie, N E S; Doyle, P; Beral, V; Carpenter, L M

    2009-03-24

    To investigate any long term effects on mortality in participants in experimental research related to chemical warfare agents from 1941 to 1989. Historical cohort study. Data sources Archive of UK government research facility at Porton Down, UK military personnel records, and national death and cancer records. Participants 18,276 male members of the UK armed forces who had spent one or more short periods (median 4 days between first and last test) at Porton Down and a comparison group of 17,600 non-Porton Down veterans followed to 31 December 2004. Mortality rate ratio of Porton Down compared with non-Porton Down veterans and standardised mortality ratio of each veteran group compared with the general population. Both ratios adjusted for age group and calendar period. Porton Down veterans were similar to non-Porton Down veterans in year of enlistment (median 1951) but had longer military service (median 6.2 v 5.0 years). After a median follow-up of 43 years, 40% (7306) of Porton Down and 39% (6900) of non-Porton Down veterans had died. All cause mortality was slightly greater in Porton Down veterans (rate ratio 1.06, 95% confidence interval 1.03 to 1.10, Pchemical exposure and cause specific mortality. The mortality in both groups of veterans was lower than that in the general population (standardised mortality ratio 0.88, 0.85 to 0.90; 0.82, 0.80 to 0.84). Mortality was slightly higher in Porton Down than non-Porton Down veterans. With lack of information on other important factors, such as smoking or service overseas, it is not possible to attribute the small excess mortality to chemical exposures at Porton Down.

  1. Time trends for prostate cancer mortality in Brazil and its geographic regions: An age-period-cohort analysis.

    Science.gov (United States)

    Braga, Sonia Faria Mendes; de Souza, Mirian Carvalho; Cherchiglia, Mariangela Leal

    2017-10-01

    In the 1980s, an increase in mortality rates for prostate cancer was observed in North America and developed European countries. In the 1990s, however, mortality rates decreased for these countries, an outcome related to early detection of the disease. Conversely, an upward trend in mortality rates was observed in Brazil. This study describe the trends in mortality for prostate cancer in Brazil and geographic regions (North, Northeast, South, Southeast, and Central-West) between 1980 until 2014 and analyze the influence of age, period, and cohort effects on mortality rates. This time-series study used data from the Mortality Information System (SIM) and population data from Brazilian Institute for Geography and Statistics (IBGE). The effects on mortality rates were examined using age-period-cohort (APC) models. Crude and standardized mortality rates showed an upward trend for Brazil and its regions more than 2-fold the last 30 years. Age effects showed an increased risk of death in all regions. Period effects showed a higher risk of death in the finals periods for the North and Northeast. Cohort effects showed risk of death was higher for younger than older generations in Brazil and regions, mainly Northeast (RR Adjusted =3.12, 95% CI 1.29-1.41; RR Adjusted =0.28, 95% CI 0.26-0.30, respectively). The increase in prostate cancer mortality rates in Brazil and its regions was mainly due to population aging. The differences in mortality rates and APC effects between regions are related to demographic differences and access of health services across the country. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Trends in esophageal cancer mortality in China during 1987-2009: age, period and birth cohort analyzes.

    Science.gov (United States)

    Guo, Pi; Li, Ke

    2012-04-01

    Esophageal cancer is one of the most commonly diagnosed malignant tumors in China. The aim of this study was to provide the representative and comprehensive informations about the long-term mortality trends of this disease in China between 1987 and 2009, using joinpoint regression and generalized additive models (GAMs). Age-standardized mortality rates (ASMR), overall and truncated (35-64 years), were calculated using the direct calculation method, and joinpoint regression was performed to obtain the estimated annual percentage changes (EAPC). GAMs were fitted to study the effects of age, period and birth cohort on mortality trends. ASMR exhibited an overall remarked decline for rural females (EAPC=-2.3 95%CI: -3.3, -1.2), urban males (EAPC=-1.8 95%CI: -2.6, -1.0) and urban females (EAPC=-3.7 95%CI: -4.9, -2.4), but a small drop observed was not statistically significant for rural males (EAPC=-0.9 95%CI: -2.0, 0.3). The declines in ASMR were more noticeable for urban residents in recent years. Among all the residents, age effect showed an progressively increasing trend, whereas cohort effect declined steadily after the year corresponding to the maximum risk value. Period effect seemed to remain substantially unchanged throughout the years. Although variations in mortality rates were observed according to sex and area, the overall decreasing trends in esophageal cancer mortality were found in most Chinese people, aside from rural males. The findings could correspond to the changes in age- and cohort-related factors in the population. Further study is required to understand these potential factors. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Amyloid PET in European and North American cohorts; and exploring age as a limit to clinical use of amyloid imaging

    Energy Technology Data Exchange (ETDEWEB)

    Chiotis, Konstantinos [Karolinska Institutet, Department of NVS, Center for Alzheimer Research, Translational Alzheimer Neurobiology, Stockholm (Sweden); Carter, Stephen F. [Karolinska Institutet, Department of NVS, Center for Alzheimer Research, Translational Alzheimer Neurobiology, Stockholm (Sweden); University of Manchester, Wolfson Molecular Imaging Centre, Institute of Brain, Behaviour and Mental Health, Manchester (United Kingdom); Farid, Karim [Karolinska Institutet, Department of NVS, Center for Alzheimer Research, Translational Alzheimer Neurobiology, Stockholm (Sweden); APHP, Hotel-Dieu Hospital, Department of Nuclear Medicine, Paris (France); Savitcheva, Irina [Karolinska University Hospital Huddinge, Department of Radiology, Stockholm (Sweden); Nordberg, Agneta [Karolinska Institutet, Department of NVS, Center for Alzheimer Research, Translational Alzheimer Neurobiology, Stockholm (Sweden); Karolinska University Hospital Huddinge, Department of Geriatric Medicine, Stockholm (Sweden); Collaboration: for the Diagnostic Molecular Imaging (DiMI) network and the Alzheimer' s Disease Neuroimaging Initiative

    2015-09-15

    Several radiotracers that bind to fibrillar amyloid-beta in the brain have been developed and used in various patient cohorts. This study aimed to investigate the comparability of two amyloid positron emission tomography (PET) tracers as well as examine how age affects the discriminative properties of amyloid PET imaging. Fifty-one healthy controls (HCs), 72 patients with mild cognitive impairment (MCI) and 90 patients with Alzheimer's disease (AD) from a European cohort were scanned with [11C]Pittsburgh compound-B (PIB) and compared with an age-, sex- and disease severity-matched population of 51 HC, 72 MCI and 84 AD patients from a North American cohort who were scanned with [18F]Florbetapir. An additional North American population of 246 HC, 342 MCI and 138 AD patients with a Florbetapir scan was split by age (55-75 vs 76-93 y) into groups matched for gender and disease severity. PET template-based analyses were used to quantify regional tracer uptake. The mean regional uptake patterns were similar and strong correlations were found between the two tracers across the regions of interest in HC (ρ = 0.671, p = 0.02), amyloid-positive MCI (ρ = 0.902, p < 0.001) and AD patients (ρ = 0.853, p < 0.001). The application of the Florbetapir cut-off point resulted in a higher proportion of amyloid-positive HC and a lower proportion of amyloid-positive AD patients in the older group (28 and 30 %, respectively) than in the younger group (19 and 20 %, respectively). These results illustrate the comparability of Florbetapir and PIB in unrelated but matched patient populations. The role of amyloid PET imaging becomes increasingly important with increasing age in the diagnostic assessment of clinically impaired patients. (orig.)

  4. Risk factors for tooth loss in middle and older age after up to 10 years: An observational cohort study.

    Science.gov (United States)

    Hassel, Alexander Jochen; Safaltin, Volkan; Grill, Sabine; Schröder, Johannes; Wahl, Hans-Werner; Klotz, Anna-Luisa; Habibi, Edriss; Rammelsberg, Peter; Zenthöfer, Andreas

    2018-02-01

    The objective of this research was to identify risk factors for tooth loss in two birth cohorts, quinquagenarians and septuagenarians, after up to 10 years of clinical observation. One hundred and twenty-three participants were recruited from the Interdisciplinary Study of Adult Development (ILSE) and examined at baseline and up to 10 years after. Thirty-nine and 84 participants belonged to the older (OC; born in 1930/32) cohort and younger (YC; born in 1950/52) cohort, respectively. Each participant underwent a dental examination comprising evaluation of the dental status (number of teeth, prosthetic restorations), Plaque Index (PI), Gingival Index (GI), DMF-S, periodontal probing depths (PD) and tooth mobility (TM). Incidence of tooth loss over the study period was calculated for both cohorts as well as for the grouped dental target variables. A logistic regression model for tooth loss (0=tooth present/1=tooth lost) was compiled with possible binary confounders. During the study period (eight years in mean), 1.2 (1.9) and 2.6 (2.6) teeth were lost in YC and OC, respectively, reflecting correspondent loss rates of 5% and 14% (p1 merged into substantial tooth loss (60% lost). The regression analysis confirmed the bivariate findings. Older age and worse oral health issues were identified as risk factors for tooth loss(ploss over a period of up to 10 years but more in septuagenarians. The predominant predictor for tooth loss seems to be greater tooth mobility. With the rising challenges due to aging in several societies, knowing the risks might help clinicians when weighing treatment strategies and should encourage refining preventive measures for older patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Multicenter cohort association study of SLC2A1 single nucleotide polymorphisms and age-related macular degeneration

    Science.gov (United States)

    Baas, Dominique C.; Ho, Lintje; Tanck, Michael W.T.; Fritsche, Lars G.; Merriam, Joanna E.; van het Slot, Ruben; Koeleman, Bobby P.C.; Gorgels, Theo G.M.F.; van Duijn, Cornelia M.; Uitterlinden, André G.; de Jong, Paulus T.V.M.; Hofman, Albert; ten Brink, Jacoline B.; Vingerling, Johannes R.; Klaver, Caroline C.W.; Dean, Michael; Weber, Bernhard H. F.; Allikmets, Rando; Hageman, Gregory S.

    2012-01-01

    Purpose Age-related macular degeneration (AMD) is a major cause of blindness in older adults and has a genetically complex background. This study examines the potential association between single nucleotide polymorphisms (SNPs) in the glucose transporter 1 (SLC2A1) gene and AMD. SLC2A1 regulates the bioavailability of glucose in the retinal pigment epithelium (RPE), which might influence oxidative stress–mediated AMD pathology. Methods Twenty-two SNPs spanning the SLC2A1 gene were genotyped in 375 cases and 199 controls from an initial discovery cohort (the Amsterdam-Rotterdam-Netherlands study). Replication testing was performed in The Rotterdam Study (the Netherlands) and study populations from Würzburg (Germany), the Age Related Eye Disease Study (AREDS; United States), Columbia University (United States), and Iowa University (United States). Subsequently, a meta-analysis of SNP association was performed. Results In the discovery cohort, significant genotypic association between three SNPs (rs3754219, rs4660687, and rs841853) and AMD was found. Replication in five large independent (Caucasian) cohorts (4,860 cases and 4,004 controls) did not yield consistent association results. The genotype frequencies for these SNPs were significantly different for the controls and/or cases among the six individual populations. Meta-analysis revealed significant heterogeneity of effect between the studies. Conclusions No overall association between SLC2A1 SNPs and AMD was demonstrated. Since the genotype frequencies for the three SLC2A1 SNPs were significantly different for the controls and/or cases between the six cohorts, this study corroborates previous evidence that population dependent genetic risk heterogeneity in AMD exists. PMID:22509097

  6. Less overdiagnosis of kidney cancer? an age-period-cohort analysis of incidence trends in 16 populations worldwide.

    Science.gov (United States)

    Znaor, Ariana; Laversanne, Mathieu; Bray, Freddie

    2017-09-01

    The increasing rates of kidney cancer incidence, reported in many populations globally, have been attributed both to increasing exposures to environmental risk factors, as well as increasing levels of incidental diagnosis due to widespread use of imaging. To better understand these trends, we examine long-term cancer registry data worldwide, focusing on the roles of birth cohort and calendar period, proxies for changes in risk factor prevalence and detection practice respectively. We used an augmented version of the Cancer Incidence in Five Continents series to analyze kidney cancer incidence rates 1978-2007 in 16 geographically representative populations worldwide by sex for ages 30-74, using age-period-cohort (APC) analysis. The full APC model provided the best fit to the data in most studied populations. While kidney cancer incidence rates have been increasing in successive generations born from the early twentieth century in most countries, equivalent period-specific rises were observed from the late-1970s, although these have subsequently stabilized in certain European countries (the Czech Republic, Lithuania, Finland, Spain) as well as Japan from the mid-1990s, and from the mid-2000s, in Colombia, Costa Rica and Australia. Our results indicate that the effects of both birth cohort and calendar period contribute to the international kidney cancer incidence trends. While cohort-specific increases may partly reflect the rising trends in obesity prevalence and the need for more effective primary prevention policies, the attenuations in period-specific increases (observed in 8 of the 16 populations) highlight a possible change in imaging practices that could lead to mitigation of overdiagnosis and overtreatment. © 2017 UICC.

  7. Evidence for cervical cancer mortality with screening program in Taiwan, 1981–2010: age-period-cohort model

    Directory of Open Access Journals (Sweden)

    Su Shih-Yung

    2013-01-01

    Full Text Available Abstract Background Cervical cancer is the most common cancer experienced by women worldwide; however, screening techniques are very effective for reducing the risk of death. The national cervical cancer screening program was implemented in Taiwan in 1995. The objective of this study was to examine and provide evidence of the cervical cancer mortality trends for the periods before and after the screening program was implemented. Methods Data from 1981 to 2010 of the causes of death registered were obtained from the Department of Health, Taiwan. Age-standardized mortality rates, age-specific rates, and age-period-cohort models that employed the sequential method were used to assess temporal changes that occurred between 1981 and 2010, with 1995 used as the separating year. Results The results showed that for both time periods of 1981 to 1995 and 1996 to 2010, age and period had significant effects, whereas the birth cohort effects were insignificant. For patients between 80 and 84 years of age, the mortality rate for 1981 to 1995 and 1996 to 2010 was 48.34 and 68.08. The cervical cancer mortality rate for 1996 to 2010 was 1.0 for patients between 75 and 79 years of age and 1.4 for patients between 80 and 84 years of age compared to that for 1981 to 1995. Regarding the period effect, the mortality trend decreased 2-fold from 1996 to 2010. Conclusions The results of this study indicate a decline in cervical cancer mortality trends after the screening program involving Papanicolaou tests was implemented in 1995. However, the positive effects of the screening program were not observed in elderly women because of treatment delays during the initial implementation of the screening program.

  8. A growth reference for mid upper arm circumference for age among school age children and adolescents, and validation for mortality: growth curve construction and longitudinal cohort study.

    Science.gov (United States)

    Mramba, Lazarus; Ngari, Moses; Mwangome, Martha; Muchai, Lilian; Bauni, Evasius; Walker, A Sarah; Gibb, Diana M; Fegan, Gregory; Berkley, James A

    2017-08-03

    Objectives To construct growth curves for mid-upper-arm circumference (MUAC)-for-age z score for 5-19 year olds that accord with the World Health Organization growth standards, and to evaluate their discriminatory performance for subsequent mortality.Design Growth curve construction and longitudinal cohort study.Setting United States and international growth data, and cohorts in Kenya, Uganda, and Zimbabwe.Participants The Health Examination Survey (HES)/National Health and Nutrition Examination Survey (NHANES) US population datasets (age 5-25 years), which were used to construct the 2007 WHO growth reference for body mass index in this age group, were merged with an imputed dataset matching the distribution of the WHO 2006 growth standards age 2-6 years. Validation data were from 685 HIV infected children aged 5-17 years participating in the Antiretroviral Research for Watoto (ARROW) trial in Uganda and Zimbabwe; and 1741 children aged 5-13 years discharged from a rural Kenyan hospital (3.8% HIV infected). Both cohorts were followed-up for survival during one year.Main outcome measures Concordance with WHO 2006 growth standards at age 60 months and survival during one year according to MUAC-for-age and body mass index-for-age z scores.Results The new growth curves transitioned smoothly with WHO growth standards at age 5 years. MUAC-for-age z scores of -2 to -3 and less than-3, compared with -2 or more, was associated with hazard ratios for death within one year of 3.63 (95% confidence interval 0.90 to 14.7; P=0.07) and 11.1 (3.40 to 36.0; P<0.001), respectively, among ARROW trial participants; and 2.22 (1.01 to 4.9; P=0.04) and 5.15 (2.49 to 10.7; P<0.001), respectively, among Kenyan children after discharge from hospital. The AUCs for MUAC-for-age and body mass index-for-age z scores for discriminating subsequent mortality were 0.81 (95% confidence interval 0.70 to 0.92) and 0.75 (0.63 to 0.86) in the ARROW trial (absolute difference 0.06, 95% confidence

  9. Mental Health and Medical Health Disparities in 5135 Transgender Veterans Receiving Healthcare in the Veterans Health Administration: A Case-Control Study.

    Science.gov (United States)

    Brown, George R; Jones, Kenneth T

    2016-04-01

    There are no large controlled studies of health disparities in transgender (TG) or gender dysphoric patients. The Veterans Health Administration (VHA) is the largest healthcare system in the United States and was an early adopter of electronic health records. We sought to determine whether medical and/or mental health disparities exist in VHA for clinically diagnosed TG veterans compared to matched veterans without a clinical diagnosis consistent with TG status. Using four ICD-9-CM codes consistent with TG identification, a cohort of 5135 TG veterans treated in VHA between 1996 and 2013 was identified. Veterans without one of these diagnoses were matched 1:3 in a case-control design to determine if medical and/or mental health disparities exist in the TG veteran population. In 2013, the prevalence of TG veterans with a qualifying clinical diagnosis was 58/100,000 patients. Statistically significant disparities were present in the TG cohort for all 10 mental health conditions examined, including depression, suicidality, serious mental illnesses, and post-traumatic stress disorder. TG Veterans were more likely to have been homeless, to have reported sexual trauma while on active duty, and to have been incarcerated. Significant disparities in the prevalence of medical diagnoses for TG veterans were also detected for 16/17 diagnoses examined, with HIV disease representing the largest disparity between groups. This is the first study to examine a large cohort of clinically diagnosed TG patients for psychiatric and medical health outcome disparities using longitudinal, retrospective medical chart data with a matched control group. TG veterans were found to have global disparities in psychiatric and medical diagnoses compared to matched non-TG veterans. These findings have significant implications for policy, healthcare screening, and service delivery in VHA and potentially other healthcare systems.

  10. Veterans Health Administration (VHA)

    Data.gov (United States)

    Social Security Administration — The purpose of this agreement is for SSA to verify SSNs and other identifying information for the Department of Veterans Affairs, VHA. DVA will use the information...

  11. Veterans Choice Program

    Data.gov (United States)

    Department of Veterans Affairs — If you are already enrolled in VA health care, the Choice Program allows you to receive health care within your community. Using this program does NOT impact your...

  12. Age of Complementary Foods Introduction and Risk of Anemia in Children Aged 4-6 years: A Prospective Birth Cohort in China.

    Science.gov (United States)

    Wang, Fenglei; Liu, Huijuan; Wan, Yi; Li, Jing; Chen, Yu; Zheng, Jusheng; Huang, Tao; Li, Duo

    2017-03-23

    Age of complementary foods introduction is associated with childhood anemia, but the ideal age for the introduction of complementary foods to infants is a continuing topic of debate. We examined the longitudinal association between complementary foods introduction age and risk of anemia in 18,446 children from the Jiaxing Birth Cohort, who had detailed complementary feeding records at 3 and 6 months of age and had hemoglobin concentrations measured at 4-6 years. Early introduction of complementary foods at 3-6 months of age was significantly associated with a higher risk of anemia (odds ratio = 1.14; 95% confidence interval: 1.01-1.28) and a lower hemoglobin concentration of -0.84 g/L (95% confidence interval: -1.33 to -0.35) in children aged 4-6 years, compared with those fed complementary foods starting at 6 months of age. When it comes to the specific type of complementary foods, early introduction of all plant-based foods was associated with increased anemia risks and lower hemoglobin concentrations, while early introduction of most animal-based foods was not. These findings may be informative regarding the appropriate time to introduce complementary foods in infants.

  13. Age-Related Changes of Intraocular Pressure in Elderly People in Southern China: Lingtou Eye Cohort Study.

    Directory of Open Access Journals (Sweden)

    Xiaotong Han

    Full Text Available To study age-related changes of intraocular pressure (IOP and assess the cohort effect in both cross-sectional and longitudinal settings among elderly Chinese adults.Participants were enrolled from the Lingtou Eye Cohort Study with Chinese government officials aged 40 years and older at baseline and received physical check-up and ocular examinations from 2010 to 2012. IOP was measured using a non-contact tonometer according to standardized protocols, as well as systolic blood pressure (SBP, diastolic blood pressure (DBP and body mass index (BMI. Participants who had attended IOP measurements in both 2010 and 2012 were included in this study. Cross-sectional association of IOP with age was assessed using multivariate liner regression analyses and based on the data of 2010. Longitudinal changes in IOP were assessed by paired t-test.A total of 3372 subjects were enrolled in the current analysis (2010 mean [SD] age, 61.9 [7.1] years; 60.2% men. The mean IOP in 2010 was 15.4 ± 2.3 mmHg for women and 15.2 ± 2.3 mmHg for men with an intersex difference (P = 0.029. Cross-sectional analysis showed that IOP was negatively associated with age (P = 0.003, β = -0.033 for women and P<0.001, β = -0.061 for men adjusted for baseline SBP, DBP and BMI. Paired t-test suggested that IOP was higher in the year 2012 than 2010 in women (P = 0.006 but did not change significantly in men within 2 years (P = 0.345. In addition, the 2-year changes of IOP were not associated with age adjusted for baseline IOP in 2010 (P = 0.249.Cross-sectional data suggests that IOP is lower in people with older age. Longitudinal data does not support such findings and thus the identified decreasing pattern with age in cross-sectional analysis is likely caused by cohort effects.

  14. Self-regulation and household routines at age three and obesity at age eleven: longitudinal analysis of the UK Millennium Cohort Study.

    Science.gov (United States)

    Anderson, S E; Sacker, A; Whitaker, R C; Kelly, Y

    2017-10-01

    To examine, in a population-based cohort of 3-year-old children, the association between self-regulation and exposure to the household routines of regular bedtime, regular mealtime and limits on watching television/video, and to determine whether self-regulation and these routines predict the risk of obesity at age 11. Analyses included 10 955 children in the nationally representative UK Millennium Cohort Study. When children were age 3, parents reported whether children had a regular bedtime and mealtime, and the amount of television/video watched. Emotional and cognitive self-regulation at age 3 were assessed by parent-report with the Child Social Behaviour Questionnaire. Children's height and weight were measured at age 11 and obesity was defined using the International Obesity Task Force (IOTF) criteria. At age 3, 41% of children always had a regular bedtime, 47% always had a regular mealtime and 23% were limited to ⩽1 h television/video daily. At age 11, 6.2% of children were obese. All three household routines were significantly associated with better emotional self-regulation, but not better cognitive self-regulation. In a multi-variable logistic regression model, including emotional and cognitive self-regulation, all routines and controlling for sociodemographic covariates, a 1-unit difference in emotional self-regulation at age 3 was associated with an OR (95% CI) for obesity of 1.38 (1.11, 1.71) at age 11, and inconsistent bedtimes with an OR (95% CI) for obesity of 1.87 (1.39, 2.51) at age 11. There was no evidence that emotional self-regulation mediated the relationship between regular bedtimes and later obesity. Cognitive self-regulation was not associated with later obesity. Three-year-old children who had regular bedtimes, mealtimes and limits on their television/video time had better emotional self-regulation. Lack of a regular bedtime and poorer emotional self-regulation at age 3 were independent predictors of obesity at age 11.

  15. Age at menarche and depression at the age of 31 years: findings from the Northern Finland 1966 Birth Cohort Study.

    Science.gov (United States)

    Herva, Anne; Jokelainen, Jari; Pouta, Anneli; Veijola, Juha; Timonen, Markku; Karvonen, Juha T; Joukamaa, Matti

    2004-10-01

    Early age at menarche has been found to be associated with higher oestrogen levels among girls around the onset of puberty and in early adulthood. The role of oestrogen in depression is not clear, although it affects serotonergic functions in the central nervous system (CNS). We wanted to test the hypothesis that age at menarche is associated with depression in young adulthood. The material consisted of 3952 women born in 1966 in Northern Finland. Depression was defined by the Hopkins Symptom Checklist-25 (HSCL-25), the use of antidepressants and by self-reported lifetime depression diagnosed by physician. Menarcheal age was divided as 9-11, 12-15 and 16 years or over. The prevalence of depression was 1.8-fold in current depression, 2.8-fold in the use of antidepressants and 2.1-fold in self-reported physician-diagnosed depression in women with menarche at the age of 16 years or later. After adjusting for confounders, the significant positive association between current depression and late menarche remained, but the use of antidepressants and depression diagnosed by physician had not statistically significant association with the age of menarche. A possible explanation for the result may be oestrogen as a protective factor against depression.

  16. Age related incidence and early outcomes of hip fractures: a prospective cohort study of 1177 patients.

    Science.gov (United States)

    Pillai, Anand; Eranki, Vivek; Shenoy, Ravikiran; Hadidi, Mahar

    2011-01-24

    Associated with the increase in the aging population, there is an increase in the incidence of hip fractures worldwide. Outcome following such fractures is affected by age of the patient. This study aims to assess the incidence and early outcome of hip fractures, comparing between different age groups. Data of hip fractures collected over a period of five years was analysed. Patients were divided into three groups, group A (patients under the age of 64), group B (patients between 65 and 84 years of age), and group C (patients over the age of 85). Of the 1177 patients included in the study, there were 90 patients in group A, 702 patients in group B and 385 patients in group C. There was a female preponderance across all age groups, and this increased as age advanced (p propioception and shorter operation time.

  17. Age Related Incidence and Early Outcomes of Hip Fractures: A Prospective Cohort Study of 1177 patients

    OpenAIRE

    Shenoy Ravikiran; Eranki Vivek; Pillai Anand; Hadidi Mahar

    2011-01-01

    Abstract Introduction Associated with the increase in the aging population, there is an increase in the incidence of hip fractures worldwide. Outcome following such fractures is affected by age of the patient. This study aims to assess the incidence and early outcome of hip fractures, comparing between different age groups. Methods Data of hip fractures collected over a period of five years was analysed. Patients were divided into three groups, group A (patients under the age of 64), group B ...

  18. Physical activity at age 11 years and chronic disabling fatigue at ages 13 and 16 years in a UK birth cohort.

    Science.gov (United States)

    Collin, Simon M; Norris, Tom; Deere, Kevin C; Jago, Russell; Ness, Andy R; Crawley, Esther

    2018-01-30

    To investigate associations of physical activity at age 11 years with chronic disabling fatigue (CDF) at ages 13 and 16 years. Longitudinal birth cohort. South-West England. Adolescents enrolled in the Avon Longitudinal Study of Parents and Children. We identified adolescents who had disabling fatigue of >6 months' duration without a known cause at ages 13 and 16 years. Total and moderate-to-vigorous physical activity and sedentary time at age 11 years were measured by accelerometry over a 7-day period. A total physical activity level 100 counts/min higher at age 11 years was associated with 25% lower odds of CDF at age 13 years (OR=0.75 (95% CI 0.59 to 0.95)), a 1% increase in the proportion of monitored time spent in moderate-to-vigorous activity was associated with 16% lower odds of CDF (OR=0.84 (95% CI 0.69 to 1.01)) and a 1-hour increase in sedentary time was associated with 35% higher odds of CDF (OR=1.35 (95% CI 1.02 to 1.79)). Disabling fatigue of only 3-5 months' duration at age 13 years had weaker associations with physical activity, and CDF at age 16 years was not associated with physical activity at age 11 years. Children who had chronic disabling fatigue at age 13 years had lower levels of total and moderate-to-vigorous physical activity and more sedentary time 2 years previously, but this association could be explained by reverse causation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Prevalence of premenstrual syndrome and premenstrual dysphoric disorder in a representative cohort of Spanish women of fertile age.

    Science.gov (United States)

    Dueñas, José Luis; Lete, Iñaki; Bermejo, Rafael; Arbat, Agnès; Pérez-Campos, Ezequiel; Martínez-Salmeán, Javier; Serrano, Isabel; Doval, José Luis; Coll, Carme

    2011-05-01

    To assess the prevalence of premenstrual symptoms, premenstrual syndrome and premenstrual dysphoric disorder in a cohort of women of fertile age representative of the general Spanish population. During the period between November 27th and December 22nd, 2008, a cross-sectional nationwide survey was conducted among a cohort of Spanish women aged between 15 and 49 years. Participants were personally interviewed at home and completed the premenstrual symptoms screening tool. Of the 2108 participants, 1554 women (73.7%) complained of some of the premenstrual symptoms during the last 12 menstrual cycles. A total of 1415 (91%) women presented isolated symptoms and 139 (8.9%) a moderate/severe premenstrual syndrome. Twenty-four (1.1%) women fulfilled criteria for a diagnosis of premenstrual dysphoric disorder. The prevalence of premenstrual symptoms (73.7%) and premenstrual dysphoric disorder (1.1%) in Spanish women aged between 15 and 49 years is similar to that reported in other Western countries. Only women with moderate or severe premenstrual syndrome or premenstrual dysphoric disorder, however, had daily life activities significantly impaired by premenstrual symptoms. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  20. Age Related Macular Degeneration and Total Hip Replacement Due to Osteoarthritis or Fracture: Melbourne Collaborative Cohort Study.

    Directory of Open Access Journals (Sweden)

    Elaine W Chong

    Full Text Available Osteoarthritis is the leading cause of total hip replacement, accounting for more than 80% of all total hip replacements. Emerging evidence suggests that osteoarthritis has a chronic inflammatory component to its pathogenesis similar to age-related macular degeneration. We evaluated the association between age-related macular degeneration and total hip replacement as proxy for severe osteoarthritis or fractured neck of femur in the Melbourne Collaborative Cohort Study. 20,744 participants had complete data on both age-related macular degeneration assessed from colour fundus photographs taken during 2003-2007 and total hip replacement. Total hip replacements due to hip osteoarthritis and fractured neck of femur during 2001-2011 were identified by linking the cohort records to the Australian Orthopedic Association National Joint Replacement Registry. Logistic regression was used to examine the association between age-related macular degeneration and risk of total hip replacement due to osteoarthritis and fracture separately, adjusted for confounders. There were 791 cases of total hip replacement for osteoarthritis and 102 cases of total hip replacement due to fractured neck of femur. After adjustment for age, sex, body mass index, smoking, and grouped country of birth, intermediate age-related macular degeneration was directly associated with total hip replacement for osteoarthritis (odds ratio 1.22, 95% CI 1.00-1.49. Late age-related macular degeneration was directly associated with total hip replacement due to fractured neck of femur (odds ratio 5.21, 95% CI2.25-12.02. The association between intermediate age-related macular degeneration and an increased 10-year incidence of total hip replacement due to osteoarthritis suggests the possibility of similar inflammatory processes underlying both chronic diseases. The association of late age-related macular degeneration with an increased 10-year incidence of total hip replacement due to fractured

  1. Age Related Macular Degeneration and Total Hip Replacement Due to Osteoarthritis or Fracture: Melbourne Collaborative Cohort Study.

    Science.gov (United States)

    Chong, Elaine W; Wang, Yuanyuan; Robman, Liubov D; Aung, Khin Zaw; Makeyeva, Galina A; Giles, Graham G; Graves, Stephen; Cicuttini, Flavia M; Guymer, Robyn H

    2015-01-01

    Osteoarthritis is the leading cause of total hip replacement, accounting for more than 80% of all total hip replacements. Emerging evidence suggests that osteoarthritis has a chronic inflammatory component to its pathogenesis similar to age-related macular degeneration. We evaluated the association between age-related macular degeneration and total hip replacement as proxy for severe osteoarthritis or fractured neck of femur in the Melbourne Collaborative Cohort Study. 20,744 participants had complete data on both age-related macular degeneration assessed from colour fundus photographs taken during 2003-2007 and total hip replacement. Total hip replacements due to hip osteoarthritis and fractured neck of femur during 2001-2011 were identified by linking the cohort records to the Australian Orthopedic Association National Joint Replacement Registry. Logistic regression was used to examine the association between age-related macular degeneration and risk of total hip replacement due to osteoarthritis and fracture separately, adjusted for confounders. There were 791 cases of total hip replacement for osteoarthritis and 102 cases of total hip replacement due to fractured neck of femur. After adjustment for age, sex, body mass index, smoking, and grouped country of birth, intermediate age-related macular degeneration was directly associated with total hip replacement for osteoarthritis (odds ratio 1.22, 95% CI 1.00-1.49). Late age-related macular degeneration was directly associated with total hip replacement due to fractured neck of femur (odds ratio 5.21, 95% CI2.25-12.02). The association between intermediate age-related macular degeneration and an increased 10-year incidence of total hip replacement due to osteoarthritis suggests the possibility of similar inflammatory processes underlying both chronic diseases. The association of late age-related macular degeneration with an increased 10-year incidence of total hip replacement due to fractured neck of femur may be

  2. Effect of tobacco smoke exposure during pregnancy and preschool age on growth from birth to adolescence: a cohort study.

    Science.gov (United States)

    Muraro, Ana Paula; Gonçalves-Silva, Regina Maria Veras; Moreira, Naiara Ferraz; Ferreira, Márcia Gonçalves; Nunes-Freitas, André Luis; Abreu-Villaça, Yael; Sichieri, Rosely

    2014-04-10

    There is strong evidence of an association between maternal smoking during pregnancy and restriction of intrauterine growth, but the effects of this exposure on postnatal linear growth are not well defined. Furthermore, few studies have investigated the role of tobacco smoke exposure also after pregnancy on linear growth until adolescence. In this study we investigated the effect of maternal smoking exposure during pregnancy and preschool age on linear growth from birth to adolescence. We evaluated a cohort of children born between 1994 and 1999 in Cuiabá, Brazil, who attended primary health clinics for vaccination between the years 1999 and 2000 (at preschool age) and followed-up after approximately ten years. Individuals were located in public and private schools throughout the country using the national school census. Height/length was measured, and length at birth was collected at maternity departments. Stature in childhood and adolescence was assessed using the height-for-age index sex-specific expressed as z-score from curves published by the World Health Organization. Linear mixed effects models were used to estimate the association between exposure to maternal smoking, during pregnancy and preschool age, and height of children assessed at birth, preschool and school age, adjusted for age of the children. We evaluated 2405 children in 1999-2000, length at birth was obtained from 2394 (99.5%), and 1716 at follow-up (71.4% of baseline), 50.7% of the adolescents were male. The z-score of height-for-age was lower among adolescents exposed to maternal smoking both during pregnancy and childhood (p maternal height, maternal schooling, socioeconomic position at preschool age, and breastfeeding, children exposed to maternal smoking both during pregnancy and preschool age showed persistent lower height-for-age since birth to adolescence (coefficient: -0.32, p maternal smoking not only during pregnancy, but also at early childhood, showed long-term negative effect on

  3. Cost-effectiveness of inactivated seasonal influenza vaccination in a cohort of Thai children ≤60 months of age

    Science.gov (United States)

    Suntarattiwong, Piyarat; Ditsungnoen, Darunee; Pallas, Sarah E.; Abimbola, Taiwo O.; Klungthong, Chonticha; Fernandez, Stefan; Srisarang, Suchada; Chotpitayasunondh, Tawee; Dawood, Fatimah S.; Olsen, Sonja J.; Lindblade, Kim A.

    2017-01-01

    Background Vaccination is the best measure to prevent influenza. We conducted a cost-effectiveness evaluation of trivalent inactivated seasonal influenza vaccination, compared to no vaccination, in children ≤60 months of age participating in a prospective cohort study in Bangkok, Thailand. Methods A static decision tree model was constructed to simulate the population of children in the cohort. Proportions of children with laboratory-confirmed influenza were derived from children followed weekly. The societal perspective and one-year analytic horizon were used for each influenza season; the model was repeated for three influenza seasons (2012–2014). Direct and indirect costs associated with influenza illness were collected and summed. Cost of the trivalent inactivated seasonal influenza vaccine (IIV3) including promotion, administration, and supervision cost was added for children who were vaccinated. Quality-adjusted life years (QALY), derived from literature, were used to quantify health outcomes. The incremental cost-effectiveness ratio (ICER) was calculated as the difference in the expected total costs between the vaccinated and unvaccinated groups divided by the difference in QALYs for both groups. Results Compared to no vaccination, IIV3 vaccination among children ≤60 months in our cohort was not cost-effective in the introductory year (2012 season; 24,450 USD/QALY gained), highly cost-effective in the 2013 season (554 USD/QALY gained), and cost-effective in the 2014 season (16,200 USD/QALY gained). Conclusion The cost-effectiveness of IIV3 vaccination among children participating in the cohort study varied by influenza season, with vaccine cost and proportion of high-risk children demonstrating the greatest influence in sensitivity analyses. Vaccinating children against influenza can be economically favorable depending on the maturity of the program, influenza vaccine performance, and target population. PMID:28837594

  4. Age and education effects and norms on a cognitive test battery from a population-based cohort: the Monongahela-Youghiogheny Healthy Aging Team.

    Science.gov (United States)

    Ganguli, Mary; Snitz, Beth E; Lee, Ching-Wen; Vanderbilt, Joni; Saxton, Judith A; Chang, Chung-Chou H

    2010-01-01

    Performance on cognitive tests can be affected by age, education, and also selection bias. We examined the distribution of scores on several cognitive screening tests by age and educational levels in a population-based cohort. An age-stratified random sample of individuals aged 65+ years was drawn from the electoral rolls of an urban US community. Those obtaining age and education-corrected scores > or = 21/30 on the Mini-Mental State Examination (MMSE) were designated as cognitively normal or only mildly impaired, and underwent a full assessment including a battery of neuropsychological tests. Participants were also rated on the Clinical Dementia Rating (CDR) scale. The distribution of neuropsychological test scores within demographic strata, among those receiving a CDR of 0 (no dementia), are reported here as cognitive test norms. After combining individual test scores into cognitive domain composite scores, multiple linear regression models were used to examine associations of cognitive test performance with age and education. In this cognitively normal sample of older adults, younger age and higher education were associated with better performance in all cognitive domains. Age and education together explained 22% of the variation of memory, and less of executive function, language, attention, and visuospatial function. Older age and lesser education are differentially associated with worse neuropsychological test performance in cognitively normal older adult representatives of the community at large. The distribution of scores in these participants can serve as population-based norms for these tests, and can be especially useful to clinicians and researchers assessing older adults outside specialty clinic settings.

  5. Effect of women's age on embryo morphology, cleavage rate and competence-A multicenter cohort study

    DEFF Research Database (Denmark)

    Grøndahl, Marie Louise; Christiansen, Sofie Lindgren; Kesmodel, Ulrik Schiøler

    2017-01-01

    .0001) with increasing age. Maternal age had no effect on cleavage parameters or on the morphology of the embryo day 2 post insemination. Interestingly, initial hCG value after single embryo transfer followed by ongoing pregnancy was increased with age in both IVF (p = 0.007) and ICSI (p = 0.001) cycles. For the first...... time, we show that a woman's age does impose a significant footprint on early embryo morphological development (3PN). In addition, the developmentally competent embryos were associated with increased initial hCG values as the age of the women increased. Further studies are needed to elucidate......, if this increase in initial hCG value with advancing maternal age is connected to the embryo or the uterus....

  6. Infertility Care Among OEF/OIF/OND Women Veterans in the Department of Veterans Affairs

    Science.gov (United States)

    Mattocks, Kristin; Kroll-Desrosiers, Aimee; Zephyrin, Laurie; Katon, Jodie; Weitlauf, Julie; Bastian, Lori; Haskell, Sally; Brandt, Cynthia

    2015-01-01

    Background An increasing number of young women Veterans seek reproductive health care through the VA, yet little is known regarding the provision of infertility care for this population. The VA provides a range of infertility services for Veterans including artificial insemination, but does not provide in vitro fertilization. This study will be the first to characterize infertility care among OEF/OIF/OND women Veterans using VA care. Methods We analyzed data from the OEF/OIF/OND roster file from the Defense Manpower Data Center (DMDC)—Contingency Tracking System Deployment file of military discharges from October 1, 2001–December 30, 2010, which includes 68,442 women Veterans between the ages of 18 and 45 who utilized VA health care after separating from military service. We examined the receipt of infertility diagnoses and care using ICD-9 and CPT codes. Results Less than 2% (n = 1323) of OEF/OIF/OND women Veterans received an infertility diagnosis during the study period. Compared with women VA users without infertility diagnosis, those with infertility diagnosis were younger, obese, black, or Hispanic, have a service-connected disability rating, a positive screen for military sexual trauma, and a mental health diagnosis. Overall, 22% of women with an infertility diagnosis received an infertility assessment or treatment. Thirty-nine percent of women Veterans receiving infertility assessment or treatment received this care from non-VA providers. Conclusions Overall, a small proportion of OEF/OIF/OND women Veterans received infertility diagnoses from the VA during the study period, and an even smaller proportion received infertility treatment. Nearly 40% of those who received infertility treatments received these treatments from non-VA providers, indicating that the VA may need to examine the training and resources needed to provide this care within the VA. Understanding women’s use of VA infertility services is an important component of understanding VA

  7. Infertility care among OEF/OIF/OND women Veterans in the Department of Veterans Affairs.

    Science.gov (United States)

    Mattocks, Kristin; Kroll-Desrosiers, Aimee; Zephyrin, Laurie; Katon, Jodie; Weitlauf, Julie; Bastian, Lori; Haskell, Sally; Brandt, Cynthia

    2015-04-01

    An increasing number of young women Veterans seek reproductive health care through the VA, yet little is known regarding the provision of infertility care for this population. The VA provides a range of infertility services for Veterans including artificial insemination, but does not provide in vitro fertilization. This study will be the first to characterize infertility care among OEF/OIF/OND women Veterans using VA care. We analyzed data from the OEF/OIF/OND roster file from the Defense Manpower Data Center (DMDC)-Contingency Tracking System Deployment file of military discharges from October 1, 2001-December 30, 2010, which includes 68,442 women Veterans between the ages of 18 and 45 who utilized VA health care after separating from military service. We examined the receipt of infertility diagnoses and care using ICD-9 and CPT codes. Less than 2% (n=1323) of OEF/OIF/OND women Veterans received an infertility diagnosis during the study period. Compared with women VA users without infertility diagnosis, those with infertility diagnosis were younger, obese, black, or Hispanic, have a service-connected disability rating, a positive screen for military sexual trauma, and a mental health diagnosis. Overall, 22% of women with an infertility diagnosis received an infertility assessment or treatment. Thirty-nine percent of women Veterans receiving infertility assessment or treatment received this care from non-VA providers. Overall, a small proportion of OEF/OIF/OND women Veterans received infertility diagnoses from the VA during the study period, and an even smaller proportion received infertility treatment. Nearly 40% of those who received infertility treatments received these treatments from non-VA providers, indicating that the VA may need to examine the training and resources needed to provide this care within the VA. Understanding women's use of VA infertility services is an important component of understanding VA's commitment to comprehensive medical care for

  8. [MESGI50 study: description of a cohort on Maturity and Satisfactory Ageing].

    Science.gov (United States)

    Corominas Barnadas, Josep María; López-Pousa, Secundino; Vilalta-Franch, Joan; Calvó-Perxas, Laia; Juvinyà Canal, Dolors; Garre-Olmo, Josep

    To describe the demographic, health and socio-economic characteristics of the participants in the Study on Maturity and Satisfactory Ageing in Girona (MESGI50 study). Population-based Study linked to the Survey of Health, Ageing, and Retirement in Europe (SHARE). The reference population was the inhabitants of the province of Girona (Spain) aged 50 and over. A probabilistic two-stage stratified cluster sampling according to the number of inhabitants and the degree of ageing of the population was used. Twenty-eight municipalities were randomly selected according to their type (demographically aged or young), and then stratified by the population size. The response rate was 65% with a mean of 1.7 eligible individuals per household and a final sample of 2,065 households and 3,331 participants. The design effect was 1.27. 52.9% were women and the mean age was 66.9 years (SD=11.5). The self-rated health status, hand grip strength, restriction in daily life activities and depressive symptomatology increased with age and more markedly in women. There were differences in alcohol consumption and eating patterns depending on the area of residence. The demographic, health and socio-economic characteristics during the ageing process differ depending on age group, gender, and area of residence. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  9. Age Related Incidence and Early Outcomes of Hip Fractures: A Prospective Cohort Study of 1177 patients

    Directory of Open Access Journals (Sweden)

    Shenoy Ravikiran

    2011-01-01

    Full Text Available Abstract Introduction Associated with the increase in the aging population, there is an increase in the incidence of hip fractures worldwide. Outcome following such fractures is affected by age of the patient. This study aims to assess the incidence and early outcome of hip fractures, comparing between different age groups. Methods Data of hip fractures collected over a period of five years was analysed. Patients were divided into three groups, group A (patients under the age of 64, group B (patients between 65 and 84 years of age, and group C (patients over the age of 85. Results Of the 1177 patients included in the study, there were 90 patients in group A, 702 patients in group B and 385 patients in group C. There was a female preponderance across all age groups, and this increased as age advanced (p Conclusions Hip fractures are more common among females irrespective of age group. Older patients have a higher mortality and a greater deterioration of walking ability after such injuries. Internal fixation of intracapsular fractures have demonstrated satisfactory early outcome in the immediate period. This could be attributed to retention of native bone, better propioception and shorter operation time.

  10. Lifecourse Activity Participation From Early, Mid, and Later Adulthood as Determinants of Cognitive Aging: The Lothian Birth Cohort 1921

    Science.gov (United States)

    Pattie, Alison; Deary, Ian J.

    2017-01-01

    Objectives: To examine potential sensitive periods for activity participation across adulthood to reduce cognitive decline and to determine whether associations persist after accounting for the lifetime stability of cognitive ability. Method: The Lothian Birth Cohort 1921 is a longitudinal study of cognitive aging. Participants were born in 1921 and most completed a mental ability test at the age of 11 years. Cognitive assessments were completed at mean ages 79 (N = 550), 83 (N = 321), 87 (N = 235), and 90 years (N = 129). Participants provided retrospective details of their activity participation for young (20–35 years), mid (40–55 years), and later adulthood (60–75 years), and contemporaneously at age 79. Results: Associations between activity and the level of, and change in, cognitive ability in old age were examined with latent growth curve models. Accounting for demographics and childhood cognitive ability, engagement in leisure activities in midlife was positively associated with cognitive ability level (path coefficient = .32), whereas higher physical activity in later adulthood was associated with less cognitive decline (.27). Discussion: The findings support a lifecourse approach in identifying determinants of cognitive aging; leisure and physical activity during different periods of adulthood may enhance cognitive abilities or reduce decline. PMID:27974473

  11. Improving Psychosocial Well-Being of Older Adults Through Exergaming: The Moderation Effects of Intergenerational Communication and Age Cohorts.

    Science.gov (United States)

    Xu, Xuexin; Li, Jinhui; Pham, Tan Phat; Salmon, Charles T; Theng, Yin-Leng

    2016-12-01

    Exergaming is one way to foster social interaction among older adults and to improve their psychosocial well-being, which is a crucial component of healthy aging. This study examined how exergaming affects older adults' social anxiousness, sociability, and loneliness, and it further analyzed differences in the exergaming effects across different types of game play and between different aging cohorts. A 2 (pre-test vs. post-test) × 2 (young-old vs. old-old) × 3 (play alone vs. play with elderly vs. play with youths) mixed quasi-experiment (N = 89) was conducted in Singapore, and three-way MANOVAs were executed. Results showed a significant three-way interaction effect among exergaming, play type, and age group on older adults' psychosocial well-being. There was a significant decline in social anxiousness and an increase in sociability for young-old participants playing with youths. The sociability improved significantly for old-old participants playing with their peers. There was also a significant decrease in loneliness after exergaming, but little differences were found across different play types or age groups. The findings made contributions to aging research and shed light on our understanding about how to foster social interaction among older adults and, thus, promote healthy and active aging.

  12. Differences in Active and Passive Smoking Exposures and Lung Cancer Incidence Between Veterans and Non-Veterans in the Women's Health Initiative.

    Science.gov (United States)

    Bastian, Lori A; Gray, Kristen E; DeRycke, Eric; Mirza, Shireen; Gierisch, Jennifer M; Haskell, Sally G; Magruder, Kathryn M; Wakelee, Heather A; Wang, Ange; Ho, Gloria Y F; LaCroix, Andrea Z

    2016-02-01

    Women Veterans may have higher rates of both active and passive tobacco exposure than their civilian counterparts, thereby increasing their risk for lung cancer. To compare differences in active and passive smoking exposure and lung cancer incidence among women Veterans and non-Veterans using prospective data from the Women's Health Initiative (WHI). We used data from the WHI, which collected longitudinal demographic, clinical, and laboratory data on 161,808 postmenopausal women. We employed linear and multinomial regression and generalized linear models to compare active and passive smoking exposure between Veterans and non-Veterans and Cox proportional hazards models to estimate differences in lung cancer incidence rates. After adjustment, Veterans had 2.54 additional pack years of smoking compared with non-Veterans (95% confidence interval [CI] 1.68, 3.40). Veterans also had a 1% increase in risk of any passive smoking exposure (95% CI 1.00, 1.02) and a 9% increase in risk of any workplace exposure (95% CI 1.07, 1.11) compared with non-Veterans. After adjustment for age and smoking exposures, Veterans did not have a higher risk of lung cancer compared with non-Veterans (relative risk = 1.06 95% CI 0.86, 1.30). Women Veterans had higher rates of tobacco use and exposure to passive smoking, which were associated with a higher risk for lung cancer compared with non-Veterans. Clinicians who care for Veterans need to be aware that older women Veterans have more exposures to risk factors for lung cancer. Published by Oxford University Press on behalf of the Gerontological Society of America 2016.

  13. Association of Aging-Related Endophenotypes With Mortality in 2 Cohort Studies: the Long Life Family Study and the Health, Aging and Body Composition Study

    Science.gov (United States)

    Singh, Jatinder; Schupf, Nicole; Boudreau, Robert; Matteini, Amy M.; Prasad, Tanushree; Newman, Anne B.; Liu, YongMei; Christensen, Kaare; Kammerer, Candace M.

    2015-01-01

    One method by which to identify fundamental biological processes that may contribute to age-related disease and disability, instead of disease-specific processes, is to construct endophenotypes comprising linear combinations of physiological measures. Applying factor analyses methods to phenotypic data (2006–2009) on 28 traits representing 5 domains (cognitive, cardiovascular, metabolic, physical, and pulmonary) from 4,472 US and Danish individuals in 574 pedigrees from the Long Life Family Study (United States and Denmark), we constructed endophenotypes and assessed their relationship with mortality. The most dominant endophenotype primarily reflected the physical activity and pulmonary domains, was heritable, was significantly associated with mortality, and attenuated the association of age with mortality by 24.1%. Using data (1997–1998) on 1,794 Health, Aging and Body Composition Study participants from Memphis, Tennessee, and Pittsburgh, Pennsylvania, we obtained strikingly similar endophenotypes and relationships to mortality. We also reproduced the endophenotype constructs, especially the dominant physical activity and pulmonary endophenotype, within demographic subpopulations of these 2 cohorts. Thus, this endophenotype construct may represent an underlying phenotype related to aging. Additional genetic studies of this endophenotype may help identify genetic variants or networks that contribute to the aging process. PMID:26582777

  14. MTHFR polymorphisms and cognitive ageing in the ninth decade: the Lothian Birth Cohort 1921.

    NARCIS (Netherlands)

    Schiepers, O. J.; van Boxtel, M. P. J.; Harris, S. E.; Gow, A. J.; Pattie, A.; Brett, C. E.; de Groot, R. H.; Jolles, J.; Starr, J. M.; Deary, I. J.

    2011-01-01

    Low blood levels of B vitamins have been implicated in age-associated cognitive impairment. The present study investigated the association between genetic variation in folate metabolism and age-related cognitive decline in the ninth decade of life. Both the 677C>T (rs1801133) polymorphism and the

  15. Examining the Dutch Trends in the Nineteen-nineties: Age, Period and Cohort Effects

    NARCIS (Netherlands)

    Portrait, F.; Deeg, D.; Alessie, R.

    The paper focuses on changes in the prevalence of disability at older ages in the Netherlands during the nineteen-nineties. Disability is characterized by two self-reported indicators of mild and severe disability and two self-reported and objectivemeasures of functional limitations. Age, period,

  16. Alcohol consumption, smoking and development of visible age-related signs: a prospective cohort study.

    Science.gov (United States)

    Schou, Anne L; Mølbak, Marie-Louise; Schnor, Peter; Grønbæk, Morten; Tolstrup, Janne S

    2017-12-01

    Visible age-related signs indicate biological age, as individuals that appear old for their age are more likely to be at poor health, compared with people that appear their actual age. The aim of this study was to investigate whether alcohol and smoking are associated with four visible age-related signs (arcus corneae, xanthelasmata, earlobe crease and male pattern baldness). We used information from 11 613 individuals in the Copenhagen City Heart Study (1976-2003). Alcohol intake, smoking habits and other lifestyle factors were assessed prospectively and visible age-related signs were inspected during subsequent examinations. The risk of developing arcus corneae, earlobe crease and xanthelasmata increased stepwise with increased smoking as measured by pack-years. For alcohol consumption, a high intake was associated with the risk of developing arcus corneae and earlobe crease, but not xanthelasmata. High alcohol consumption and smoking predict development of visible age-related signs. This is the first prospective study to show that heavy alcohol use and smoking are associated with generally looking older than one's actual age. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Advanced paternal age and risk of fetal death: a cohort study

    DEFF Research Database (Denmark)

    Nybo Andersen, Anne-Marie; Hansen, Kasper Daniel; Andersen, Per Kragh

    2004-01-01

    A possible detrimental paternal age effect on offspring health due to mutations of paternal origin should be reflected in an association between paternal age and fetal loss. The authors used data from a prospective study of 23,821 pregnant women recruited consecutively to the Danish National Birt...

  18. Sex, BMI and age differences in metabolic syndrome : The Dutch Lifelines Cohort Study

    NARCIS (Netherlands)

    Slagter, Sandra N.; van Waateringe, Robert P.; van Beek, Andre P.; van der Klauw, Melanie M.; Wolffenbuttel, Bruce H. R.; van Vliet-Ostaptchouk, Jana V.

    Introduction: To evaluate the prevalence of metabolic syndrome (MetS) and its individual components within sex-, body mass index (BMI)-and age combined clusters. In addition, we used the age-adjusted blood pressure thresholds to demonstrate the effect on the prevalence of MetS and elevated blood

  19. Age of Menarche and Psychosocial Outcomes in a New Zealand Birth Cohort

    Science.gov (United States)

    Boden, Joseph M.; Fergusson, David M.; Horwood, L. John

    2011-01-01

    Objective: This study examined associations between age of menarche and psychosocial outcomes in early adulthood, including sexual behavior, mental health, criminal behavior, and education/employment, to identify the possible causal role of earlier age of menarche in increasing risks of adverse outcomes. Method: Data were gathered from 497 female…

  20. The mental health of sons and daughters of Australian Vietnam veterans.

    Science.gov (United States)

    O'Toole, Brian I; Dadds, Mark; Outram, Sue; Catts, Stanley V

    2018-02-07

    War service increases the risk of post-traumatic stress disorder (PTSD) to combatants, and has been shown to increase the risk of PTSD in their offspring. The extent to which there is an excess compared with the general population is not yet established, nor whether PTSD increases the risk of other psychiatric problems. A national sample of 133 sons and 182 daughters of a cohort of 179 Australian Vietnam veterans' families were assessed in person, using structured psychiatric interviews. The prevalence of trauma exposures, DSM-IV (Diagnostic and Statistical Manual of Mental Disorders Fourth Edition) diagnoses and suicidality were compared with the Australian Bureau of Statistics' 2007 National Survey of Mental Health and Wellbeing data matched for age and sex. The risk of mental health problems potentially attributable to PTSD was also assessed. Sons and daughters were more likely than population expectations to report exposures to natural disasters, fire or explosions and transport accidents, and sons more likely to report exposure to toxic chemicals whereas daughters were more likely to report sexual assault. Sons and daughters had higher prevalences of alcohol and other substance dependence, depression and anxiety, and PTSD, and children's PTSD was associated with substance dependence, depression and suicidal ideation. There were strong associations between children's PTSD and comorbid conditions of substance use disorders, depression and anxiety. Higher rates of mental health problems in veterans' families, together with comorbidity with PTSD and the link between veterans' and children's PTSD, suggest that the effects of trauma may continue into subsequent generations.

  1. Epilepsy Among Iraq and Afghanistan War Veterans - United States, 2002-2015.

    Science.gov (United States)

    Pugh, Mary Jo; Van Cott, Anne C; Amuan, Megan; Baca, Christine; Rutecki, Paul; Zack, Matthew M; Kobau, Rosemarie

    2016-11-11

    The age-adjusted prevalence of seizure disorder in United States veterans deployed in Iraq and Afghanistan conflicts (IAV) is 6.1 per 1,000 persons (1), compared with 7.1 to 10 per 1,000 persons in the general population (2,3). Persons with epilepsy are at risk of excess mortality in part because of comorbidity (4). Although patterns of comorbidity have been associated with mortality in IAV (5), the unique contribution of epilepsy to excess mortality in IAV is unknown. A cohort study was developed using inpatient, outpatient, and pharmacy data from the U.S. Department of Veterans Affairs, Veterans Health Administration (VA) to identify epilepsy, demographic characteristics, and baseline comorbidity for IAV who received VA care in 2010 and 2011. The VA's vital status records were used to identify 5-year mortality (2011-2015). The unadjusted Kaplan-Meier estimator and adjusted proportional hazards regression models tested the hypothesis that excess mortality is associated with epilepsy. IAV with epilepsy were more likely than those without epilepsy to have mental and physical comorbidity, and significantly higher mortality, even after controlling for demographic characteristics and other comorbid conditions (adjusted hazard ratio = 2.6; 95% confidence interval [CI] 2.1-3.2). IAV with epilepsy could benefit from evidence-based chronic disease self-management programs to reduce physical and psychiatric comorbidity, and linkages to VA clinical and other community health and social service providers.

  2. How Hyperarousal and Sleep Reactivity Are Represented in Different Adult Age Groups: Results from a Large Cohort Study on Insomnia.

    Science.gov (United States)

    Altena, Ellemarije; Chen, Ivy Y; Daviaux, Yannick; Ivers, Hans; Philip, Pierre; Morin, Charles M

    2017-04-14

    Hyperarousal is a 24-h state of elevated cognitive and physiological activation, and is a core feature of insomnia. The extent to which sleep quality is affected by stressful events-so-called sleep reactivity-is a vulnerability factor for developing insomnia. Given the increasing prevalence of insomnia with age, we aimed to investigate how hyperarousal and sleep reactivity were related to insomnia severity in different adult age groups. Data were derived from a large cohort study investigating the natural history of insomnia in a population-based sample (n = 1693). Baseline data of the Arousal Predisposition Scale (APS) and Ford Insomnia Response to Stress Test (FIRST) were examined across age and sleep/insomnia subgroups: 25-35 (n = 448), 35-45 (n = 528), and 45-55 year olds (n = 717); good sleepers (n = 931), individuals with insomnia symptoms (n = 450), and individuals with an insomnia syndrome (n = 312). Results from factorial analyses of variance (ANOVA) showed that APS scores decreased with increasing age, but increased with more severe sleep problems. FIRST scores were not significantly different across age groups, but showed the same strong increase as a function of sleep problem severity. The findings indicate that though arousal predisposition and sleep reactivity increase with more severe sleep problems, only arousal decreases with age. How arousing events affect an individual during daytime thus decreases with age, but how this arousal disrupts sleep is equivalent across different adult age groups. The main implication of these findings is that treatment of insomnia could be adapted for different age groups and take into consideration vulnerability factors such as hyperarousal and stress reactivity.

  3. Age-Related Response to Redeemed Antidepressants Measured by Completed Suicide in Older Adults: A Nationwide Cohort Study

    Science.gov (United States)

    Erlangsen, Annette; Conwell, Yeates

    2013-01-01

    Objective To examine if the suicide rate of older adults prescribed antidepressants varies with age and to assess the proportion of older adults who died by suicide that had recently been prescribed antidepressants. Methods A population-based cohort study using a nationwide linkage of individual-level records was conducted on all persons aged 50+ living in Denmark during 1996–2006 (1,215,524 men and 1,343,568 women). Suicide rates by treatment status were calculated using data on all antidepressant prescriptions redeemed at pharmacies. Results Individual-level data covered 9,354,620 and 10,720,639 person-years for men and women, respectively. Men aged 50–59 who received antidepressants had a mean suicide rate of 185 (95% confidence interval [CI]: 160–211) per 100,000, whereas for those aged 80+ the rate was 119 (95% CI: 91–146). For women, the corresponding values were 82 (95% CI: 70–94) and 28 (95% CI: 20–35). Logistic regression showed a 2% and 3% decline in the rate for men and women, respectively, considered in treatment with antidepressants, with each additional year of age. An opposite trend was found for persons not in treatment. Fewer persons aged 80+ dying by suicide had received antidepressant prescriptions during the last months of life than younger persons. Conclusion An age-dependent decline in suicide rate for antidepressant recipients was identified. One reason could be that older adults respond better to antidepressants than younger age groups. Still, the increasing gap with age between estimated prevalence of depression and antidepressant prescription rate in persons dying by suicide underscores the need for assessment of depression in the oldest old. PMID:23567434

  4. Depressive Symptoms on the Geriatric Depression Scale and Suicide Deaths in Older Middle-aged Men: A Prospective Cohort Study.

    Science.gov (United States)

    Yi, Sang-Wook

    2016-05-01

    Prospective evaluations of the associations between depressive symptoms and suicide deaths have been mainly performed in high-risk populations, such as individuals with psychiatric disorders or histories of self-harm. The purpose of this study was to prospectively examine whether more severe depressive symptoms assessed using the Geriatric Depression Scale (GDS) were associated with a greater risk of death from suicide in a general-risk population. A total of 113 478 men from the Korean Veterans Health Study (mean age, 58.9 years) who participated in a postal survey in 2004 were followed up for suicide mortality until 2010. Over 6.4 years of follow-up, 400 men died by suicide (56.7 deaths per 100 000 person-years). More severe depressive symptoms were associated with greater risk of suicide death (p for trend depression were 2.18 for mild depression, 2.13 for moderate depression, 3.33 for severe depression, and 3.67 for extreme depression. After adjusting for potential confounders, men with a potential depressive disorder had an approximate 90% higher mortality from suicide (adjusted HR, 1.92; 95% confidence interval [CI], 1.38 to 2.68; pdepression. Each five-point increase in the GDS score was associated with a higher risk of death by suicide (adjusted HR, 1.22; psuicide deaths was 0.61 (95% CI, 0.58 to 0.64). Depressive symptoms assessed using the GDS were found to be a strong independent predictor of future suicide. However, the estimate of relative risk was weaker than would be expected based on retrospective psychological autopsy studies.

  5. Mortality in Children Aged 0-9 Years: A Nationwide Cohort Study from Three Nordic Countries

    DEFF Research Database (Denmark)

    Yu, Yongfu; Qin, Guoyou; Cnattingius, Sven

    2016-01-01

    Background Mortality in children under five years has been widely studied, whereas mortality at 5–9 years has received little attention. Using unique data from national registers in three Nordic countries, we aimed to characterize mortality directionality in children aged 0 to 9 years. Methods...... boys and girls decreased from 1.25 to 1.21 with the most prominent reduction in children aged 5–9 years (from 1.59 to 1.19). Neoplasms, diseases of the nervous system and transport accidents were the most frequent cause of death after the first year of life. These three leading causes of death declined...... comparing cause-specific mortality, and half of deaths from diseases of the nervous system occurred in infancy. Mortality rate due to transport accidents increased with age and was highest in boys aged 5–9 years. Conclusions Mortality rate in children aged 0–9 years has been decreasing with diminished...

  6. Age-period-cohort effects in the incidence of hip fractures: political and economic events are coincident with changes in risk.

    Science.gov (United States)

    Alves, S Maria; Castiglione, D; Oliveira, C Maria; de Sousa, B; Pina, M Fátima

    2014-02-01

    An age-period cohort model was fitted to analyse time effects on hip fracture incidence rates by sex (Portugal, 2000-2008). Rates increased exponentially with age (age effect). Incidence rates decreased after 2004 for women and were random for men (period effect). New but comprehensive fluctuations in risk were coincident with major political/economic changes (cohort effect). Healthcare improvements have allowed prevention but have also increased life expectancy, resulting in more people being at risk. Our aim was to analyse the separate effects of age, period and cohort on incidence rates by sex in Portugal, 2000-2008. From the National Hospital Discharge Register, we selected admissions (aged ≥ 49 years) with hip fractures (ICD9-CM, codes 820.x) caused by low/moderate trauma (falls from standing height or less), readmissions and bone cancer cases. We calculated person-years at risk using population data from Statistics Portugal. To identify period and cohort effects for all ages, we used an age-period-cohort model (1-year intervals) followed by generalised additive models with a negative binomial distribution of the observed incidence rates of hip fractures. There were 77,083 hospital admissions (77.4 % women). Incidence rates increased exponentially with age for both sexes (age effect). Incidence rates fell after 2004 for women and were random for men (period effect). There was a general cohort effect similar in both sexes; risk of hip fracture altered from an increasing trend for those born before 1930 to a decreasing trend following that year. Risk alterations (not statistically significant) coincident with major political and economic change in the history of Portugal were observed around birth cohorts 1920 (stable-increasing), 1940 (decreasing-increasing) and 1950 (increasing-decreasing only among women). Hip fracture risk was higher for those born during major economically/politically unstable periods. Although bone quality reflects lifetime exposure

  7. Early growth patterns and cardiometabolic function at the age of 5 in a multiethnic birth cohort: the ABCD study

    Directory of Open Access Journals (Sweden)

    Vrijkotte Tanja GM

    2009-03-01

    Full Text Available Abstract Background The relation between fetal growth retardation and cardiovascular and metabolic diseases in later life has been demonstrated in many studies. However, debate exists around the potential independent role of postnatal growth acceleration. Furthermore, it is unknown whether a potential effect of growth acceleration on cardiovascular and metabolic function is confined to certain timeframes. The present study assesses the (predictive role of prenatal and postnatal growth on 5 components of cardiovascular and metabolic function in children aged 5. The potential association of timing of postnatal growth acceleration with these outcomes will be explored. Methods and design Prospective multiethnic community-based cohort study of 8266 pregnancies (Amsterdam Born Children and their Development, ABCD study. Up till now, anthropometry of 5104 children from the original cohort was followed during the first 5 years of life, with additional information about birth weight, pregnancy duration, and various potential confounding variables. At age 5, various components of cardiovascular and metabolic function are being measured. Outcome variables are body size, body composition and fat distribution, insulin sensitivity, lipid profile, blood pressure and autonomic regulation of cardiovascular function. Discussion This study will be one of the first population-based prospective cohort studies to address the association between measures of both prenatal and postnatal growth and various components of cardiovascular and metabolic function. Specific attention is paid to the timing of acceleration in growth and its potential association with the outcome variables. Importantly, the longitudinal design of this study gives us the opportunity to gain more insight into growth trajectories associated with adverse outcomes in later life. If identified as an independent risk factor, this provides further basis for the hypothesis that accelerated growth during

  8. Parental and grandparental ages in the autistic spectrum disorders: a birth cohort study.

    Directory of Open Access Journals (Sweden)

    Jean Golding

    2010-04-01

    Full Text Available A number of studies have assessed ages of parents of children with autistic spectrum disorders (ASD, and reported both maternal and paternal age effects. Here we assess relationships with grandparental ages.We compared the parental and grandparental ages of children in the population-based Avon Longitudinal Study of Parents and Children (ALSPAC, according to their scores in regard to 4 autistic trait measures and whether they had been given a diagnosis of ASD. Mean maternal and paternal ages of ASD cases were raised, but this appears to be secondary to a maternal grandmother age effect (P = 0.006: OR = 1.66[95%CI 1.16, 2.37] for each 10-year increase in the grandmother's age at the birth of the mother. Trait measures also revealed an association between the maternal grandmother's age and the major autistic trait-the Coherence Scale (regression coefficient b = 0.142, [95%CI = 0.057, 0.228]P = 0.001. After allowing for confounders the effect size increased to b = 0.217[95%CI 0.125, 0.308](P<0.001 for each 10 year increase in age.Although the relationship between maternal grandmother's age and ASD and a major autistic trait was unexpected, there is some biological plausibility, for the maternal side at least, given that the timing of female meiosis I permits direct effects on the grandchild's genome during the grandmother's pregnancy. An alternative explanation is the meiotic mismatch methylation (3 M hypothesis, presented here for the first time. Nevertheless the findings should be treated as hypothesis generating pending corroborative results from other studies.

  9. Shopper typologies amongst a Generation Y consumer cohort and variations in terms of age in the fashion apparel market

    Directory of Open Access Journals (Sweden)

    Chengedzai Mafini

    2014-04-01

    Rational: Marketers have ever been concerned with the behaviour of consumers. Generation Y consumers have emerged as an important marketing segment. Consequently, a need exists to investigate behavioural issues pertaining to this age cohort on a continuous basis. Methodology: A survey questionnaire was administered to a convenient sample of 230 Generation Y consumers of fashion apparel. Exploratory factor analysis was used to identify shopper typologies. The Kruskal-Wallis test was used to examine the influence of age on the identified shopper typologies. Findings: The study identified seven shopper typologies that are applicable to the Generation Y cohort. These are quality conscious, brand conscious, novelty seeking, hedonistic, confused by over-choice, habitual, brand loyal and fashion conscious shopper typologies. The study also revealed that younger consumers were found to be more confused by over-choice than their older counterparts. Value of research: These findings may enable marketers to understand and predict the purchase behaviour of Generation Y consumers, thereby facilitating the development and implementation of more effective marketing strategies.

  10. Mother and child characteristics at birth and early age leukemia: a case-cohort population-based study,

    Directory of Open Access Journals (Sweden)

    Rejane de Souza Reis

    Full Text Available Abstract Objective: The population-based cancer registries (PBCR and the Information System on Live Births in Brazil (Sistema de Informações sobre Nascidos Vivos [SINASC] have information that enables the test for risk factors associated with leukemia at an early age. The aim of this study was to identify maternal and birth characteristics associated with early-age acute leukemia (EAL in Brazil. Methods: A case-cohort study was performed using secondary dataset information of PBCR and SINASC. The risk association variables were grouped into (i characteristics of the child at birth and (ii characteristics of maternal exposure during pregnancy. The case-control ratio was 1:4. Linkage was performed using R software; odds ratio (OR and 95% confidence interval (CI were calculated by logistic regression models. Results: EAL was associated with maternal occupational exposure to chemicals (agricultural, chemical, and petrochemical industry; adjOR: 2.18, 95% CI: 1.16-4.10 and with birth defects (adjOR: 3.62, 95% CI: 1.19-11.00. Conclusions: The results of this study, with the identification of EAL risk factors in population-based case-cohort study, strengthen the knowledge and improve databases, contributing to investigations on risk factors associated with childhood leukemia worldwide.

  11. Mother and child characteristics at birth and early age leukemia: a case-cohort population-based study.

    Science.gov (United States)

    Reis, Rejane de Souza; Silva, Neimar de Paula; Santos, Marceli de Oliveira; Oliveira, Julio Fernando Pinto; Thuler, Luiz Claudio Santos; de Camargo, Beatriz; Pombo-de-Oliveira, Maria S

    The population-based cancer registries (PBCR) and the Information System on Live Births in Brazil (Sistema de Informações sobre Nascidos Vivos [SINASC]) have information that enables the test for risk factors associated with leukemia at an early age. The aim of this study was to identify maternal and birth characteristics associated with early-age acute leukemia (EAL) in Brazil. A case-cohort study was performed using secondary dataset information of PBCR and SINASC. The risk association variables were grouped into (i) characteristics of the child at birth and (ii) characteristics of maternal exposure during pregnancy. The case-control ratio was 1:4. Linkage was performed using R software; odds ratio (OR) and 95% confidence interval (CI) were calculated by logistic regression models. EAL was associated with maternal occupational exposure to chemicals (agricultural, chemical, and petrochemical industry; adjOR: 2.18, 95% CI: 1.16-4.10) and with birth defects (adjOR: 3.62, 95% CI: 1.19-11.00). The results of this study, with the identification of EAL risk factors in population-based case-cohort study, strengthen the knowledge and improve databases, contributing to investigations on risk factors associated with childhood leukemia worldwide. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  12. Gestational age assessment in malaria pregnancy cohorts: a prospective ultrasound demonstration project in Malawi.

    Science.gov (United States)

    Wylie, Blair J; Kalilani-Phiri, Linda; Madanitsa, Mwayi; Membe, Gladys; Nyirenda, Osward; Mawindo, Patricia; Kuyenda, Redson; Malenga, Albert; Masonbrink, Abbey; Makanani, Bonus; Thesing, Phillip; Laufer, Miriam K

    2013-06-04

    Malaria during pregnancy is associated with an increased risk for low birth weight (Ballard examination). One hundred and seventy-eight women were enrolled. The majority of images were of good quality (94.3%, 509/540) although a learning curve was apparent with 17.5% (24/135) images of unacceptable quality in the first 25% of scans. Ultrasound was used to date 13% of the pregnancies when menstrual dates were unknown and changed the estimated gestational age for an additional 25%. There was poor agreement between the gestational age at delivery as established by the ultrasound protocol compared to that determined by the Ballard examination (bias 0.8 weeks, limits of agreement -3.5 weeks to 5.1 weeks). The distribution of gestational ages by Ballard suggested a clustering of gestational age around the mean with 87% of the values falling between 39 and 41 weeks. The distribution of gestational age by ultrasound confirmed menstrual dates was more typical. Using ultrasound confirmed dates as the gold standard, 78.5% of preterm infants were misclassified as term and 26.8% of small-for gestational age infants misclassified as appropriately grown by Ballard. Ultrasound should be strongly considered in prospective malaria studies with obstetric endpoints to confirm gestational age and avoid misclassification of infants as premature or growth-restricted. The use of ultrasound does require a significant investment of time to maintain quality image acquisition.

  13. Adult Lifetime Diet Quality and Physical Performance in Older Age: Findings From a British Birth Cohort.

    Science.gov (United States)

    Robinson, Sian M; Westbury, Leo D; Cooper, Rachel; Kuh, Diana; Ward, Kate; Syddall, Holly E; Sayer, Avan A; Cooper, Cyrus

    2017-10-13

    Current evidence that links "healthier" dietary patterns to better measured physical performance is mainly from older populations; little is known about the role of earlier diet. We examined adult diet quality in relation to physical performance at age 60-64 years. Diet quality was defined using principal component analysis of dietary data collected at age 36, 43, 53, and 60-64. Throughout adulthood, diets of higher quality were characterized by higher consumption of fruit, vegetables, and wholegrain bread. Diet quality scores calculated at each age indicated compliance with this pattern. Physical performance was assessed using chair rise, timed-up-and-go, and standing balance tests at age 60-64. The analysis sample included 969 men and women. In gender-adjusted analyses, higher diet quality at each age was associated with better measured physical performance (all p Diet quality scores were highly correlated in adulthood (0.44 ≤ r ≤ 0.67). However, conditional models showed that higher diet quality at age 60-64 (than expected from scores at younger ages), was associated with faster chair rise speed and with longer standing balance time (adjusted: 0.08 [95% CI: 0.02, 0.15] and 0.07 [0.01, 0.14] SD increase in chair rise speed and balance time, respectively, per SD increase in conditional diet quality; both p diet quality across adulthood is associated with better physical performance in older age. Current diet quality may be particularly important for physical performance, suggesting potential for improvements in diet in early older age.

  14. Association between midlife health behaviours and transitions out of employment from midlife to early old age: Whitehall II cohort study

    Directory of Open Access Journals (Sweden)

    Gareth Hagger-Johnson

    2017-01-01

    Full Text Available Abstract Background It is important to determine whether unhealthy behaviours might influence transitions out of employment from midlife to old age, given the anticipated need for adults to work for longer. Our aim was to determine the association between repeated assessments of cigarette smoking, heavy/problem alcohol drinking, low physical activity and poor diet at midlife, in relation to work exit from midlife to old age. Methods Data from 7704 participants (5392 men from the Whitehall II cohort study in employment at midlife were used to evaluate the association between unhealthy behaviours and a subsequent transition out of work during 22 years follow-up, using logistic regression models. Results Men who smoked cigarettes, consistently drank alcohol heavily, or reported problem drinking, were more likely to leave employment over follow-up. Women with a consistently poor diet were more likely to leave employment. Associations were stronger when the reason for leaving was health grounds, and stronger among those with persistently unhealthy behaviours over follow-up. The size of the effects were broadly equivalent to one advancing year of age on employment. Physical health functioning over follow-up only partly accounted for the associations with work exit, whereas physical and mental functioning accounted for most of the associations with work exit on health grounds. Conclusions Unhealthy behaviours in midlife are associated with transitions out of employment into old age. Promoting healthy behaviours at midlife might support current policy initiatives aimed at extending working life. Future research should consider possible mechanisms that link behaviours to transitions out of employment, and consider sex differences in larger cohorts.

  15. Association between midlife health behaviours and transitions out of employment from midlife to early old age: Whitehall II cohort study.

    Science.gov (United States)

    Hagger-Johnson, Gareth; Carr, Ewan; Murray, Emily; Stansfeld, Stephen; Shelton, Nicola; Stafford, Mai; Head, Jenny

    2017-01-17

    It is important to determine whether unhealthy behaviours might influence transitions out of employment from midlife to old age, given the anticipated need for adults to work for longer. Our aim was to determine the association between repeated assessments of cigarette smoking, heavy/problem alcohol drinking, low physical activity and poor diet at midlife, in relation to work exit from midlife to old age. Data from 7704 participants (5392 men) from the Whitehall II cohort study in employment at midlife were used to evaluate the association between unhealthy behaviours and a subsequent transition out of work during 22 years follow-up, using logistic regression models. Men who smoked cigarettes, consistently drank alcohol heavily, or reported problem drinking, were more likely to leave employment over follow-up. Women with a consistently poor diet were more likely to leave employment. Associations were stronger when the reason for leaving was health grounds, and stronger among those with persistently unhealthy behaviours over follow-up. The size of the effects were broadly equivalent to one advancing year of age on employment. Physical health functioning over follow-up only partly accounted for the associations with work exit, whereas physical and mental functioning accounted for most of the associations with work exit on health grounds. Unhealthy behaviours in midlife are associated with transitions out of employment into old age. Promoting healthy behaviours at midlife might support current policy initiatives aimed at extending working life. Future research should consider possible mechanisms that link behaviours to transitions out of employment, and consider sex differences in larger cohorts.

  16. Rural Veterans by State (2014)

    Data.gov (United States)

    Department of Veterans Affairs — This speadsheet contains data from the 2014 American Community Survey and shows the demographic and socioeconomic characteristics of Veterans who live in rural and...

  17. The Veteran Population Projection 2014

    Data.gov (United States)

    Department of Veterans Affairs — VetPop2014 is an actuarial projection model developed by the Office of the Actuary (OACT) for Veteran population projection from Fiscal Year FY2014 to FY2043. Using...

  18. Veteran Religious Affiliation by State

    Data.gov (United States)

    Department of Veterans Affairs — This dataset provide a count of Veteran by their religious affiliation and state of residence. The dataset set covers all 50 states, District of Columbia and other...

  19. Rural Veterans by State (2015)

    Data.gov (United States)

    Department of Veterans Affairs — This spreadsheet contains data from the 2015 American Community Survey and shows the demographic and socioeconomic characteristics of Veterans who live in rural and...

  20. Screening for Prostate Cancer Starting at Age 50-54 Years. A Population-based Cohort Study.

    Science.gov (United States)

    Carlsson, Sigrid; Assel, Melissa; Ulmert, David; Gerdtsson, Axel; Hugosson, Jonas; Vickers, Andrew; Lilja, Hans

    2017-01-01

    Current prostate cancer screening guidelines conflict with respect to the age at which to initiate screening. To evaluate the effect of prostate-specific antigen (PSA) screening versus zero screening, starting at age 50-54 yr, on prostate cancer mortality. This is a population-based cohort study comparing 3479 men aged 50 yr through 54 yr randomized to PSA-screening in the Göteborg population-based prostate cancer screening trial, initiated in 1995, versus 4060 unscreened men aged 51-55 yr providing cryopreserved blood in the population-based Malmö Preventive Project in the pre-PSA era, during 1982-1985. Cumulative incidence and incidence rate ratios of prostate cancer diagnosis, metastasis, and prostate cancer death. At 17 yr, regular PSA-screening in Göteborg of men in their early 50s carried a more than two-fold higher risk of prostate cancer diagnosis compared with the unscreened men in Malmö (incidence rate ratio [IRR] 2.56, 95% confidence interval [CI] 2.18, 3.02), but resulted in a substantial decrease in the risk of metastases (IRR 0.43, 95% CI 0.22, 0.79) and prostate cancer death (IRR 0.29, 95% CI 0.11, 0.67). There were 57 fewer prostate cancer deaths per 10000 men (95% CI 22, 92) in the screened group. At 17 yr, the number needed to invite to PSA-screening and the number needed to diagnose to prevent one prostate cancer death was 176 and 16, respectively. The study is limited by lack of treatment information and the comparison of the two different birth cohorts. PSA screening for prostate cancer can decrease prostate cancer mortality among men aged 50-54 yr, with the number needed to invite and number needed to detect to prevent one prostate cancer death comparable to those previously reported from the European Randomized Study of Screening for Prostate Cancer for men aged 55-69 yr, at a similar follow-up. Guideline groups could consider whether guidelines for PSA screening should recommend starting no later than at ages 50-54 yr. Guideline

  1. The longitudinal course of insomnia symptoms: inequalities by sex and occupational class among two different age cohorts followed for 20 years in the west of Scotland.

    Science.gov (United States)

    Green, Michael J; Espie, Colin A; Hunt, Kate; Benzeval, Michaela

    2012-06-01

    The natural history of insomnia symptomatology is poorly understood. Cross-sectional associations have been demonstrated among socioeconomic disadvantage, female sex, and poor sleep but it is unclear how these social factors predict patterns of insomnia symptoms over time. The aim of this article is to describe longitudinal patterns of insomnia symptoms as people age and investigate how they vary by sex and occupational class. A prospective cohort study with 20 yr of follow-up from 1987 to 1988. West of Scotland. One cohort approximately 36 yr of age at baseline aging to 57 yr (n = 1,444), and another aging from approximately 56 to 76 yr (n = 1,551). N/A. At approximately 5-yr intervals, respondents self-reported trouble initiating and maintaining sleep. Latent class analysis identified 4 main sleep patterns: a healthy pattern with little sleeping trouble across the 20 yr; an episodic pattern, characterized by trouble maintaining sleep; a chronic pattern with trouble maintaining and initiating sleep throughout the study; and a pattern where symptoms developed during the 20-yr follow-up. Chronic patterns were more likely in the older cohort than the younger one, for women than men in the older cohort, and for those from a manual rather than a nonmanual occupational class in both cohorts. In the middle-aged cohort a developing pattern was more likely for women than men. Chronic symptoms, characterized by both trouble maintaining and initiating sleep, are patterned by social factors.

  2. VA Is Here for the People Who Support Our Veterans

    Science.gov (United States)

    ... Expect Resource Locator Veterans Live Chat Veterans Text Homeless Veterans Live Chat Military Live Chat Deaf - Hard of ... word about the Veterans Crisis Line. Access confidential Homeless Veterans Chat and see resources for homeless Veterans . Network ...

  3. Veterans Crisis Line: Videos About Reaching out for Help

    Medline Plus

    Full Text Available ... Expect Resource Locator Veterans Live Chat Veterans Text Homeless Veterans Live Chat Military Live Chat Deaf - Hard of ... Expect Resource Locator Veterans Live Chat Veterans Text Homeless Veterans Live Chat Military Live Chat Deaf - Hard of ...

  4. [Size at birth and mental health problems at 11 years of age in a Brazilian birth cohort].

    Science.gov (United States)

    Gallo, Erika Alejandra Giraldo; Anselmi, Luciana; Dumith, Samuel C; Scazufca, Marcia; Menezes, Ana M B; Hallal, Pedro C; Matijasevich, Alicia

    2011-08-01

    The aim of this study was to evaluate the association between size at birth and mental health problems at 11 years of age in the 1993 Pelotas (Brazil) Birth Cohort Study. Newborns were weighed and measured, and anthropometric indices were calculated. At 11 years of age, mental health problems were assessed using the Strengths and Difficulties Questionnaire (SDQ). Prevalence of mental health problems was 32% (95%CI: 31-33). After adjusting for potential confounders, newborns with weight and body mass index (BMI) for age z-scores mental health problems at age 11 years than those born with normal scores. Newborns with BMI and head circumference for age z-scores > +2 SD were at 34% (95%CI: 6-71) and 19% (95%CI: 1-40) greater risk, respectively, of developing mental health problems than those with normal scores. The results suggest that early factors that are reflected as size measurements at birth can cause mental health problems later in life.

  5. Dietary patterns of children at 3.5 and 7 years of age: a New Zealand birth cohort study.

    Science.gov (United States)

    Wall, Clare R; Thompson, John M D; Robinson, Elizabeth; Mitchell, Edwin A

    2013-02-01

    To describe the dietary patterns of children at 3.5 and 7 years born small for gestational age (SGA) and appropriate for gestational age (AGA) and the association of dietary patterns with socio-demographic and obstetric factors. Children from a New Zealand birth cohort study were followed up at 3.5 (n = 550) and 7 (n = 591) years. Dietary information was collected using a Food Frequency Questionnaire. Three dietary patterns were defined in these children ('traditional', 'junk' and 'healthy'). Factors associated with dietary patterns were examined in multivariable analyses. At 3.5 years, 'junk' was associated with maternal smoking in pregnancy, no attendance at antenatal classes, maternal BMI and a younger maternal age. At 3.5 years, 'healthy' was associated with being married when pregnant. At 7 years, 'traditional' was associated with being born SGA, smoking in pregnancy, a younger maternal age and being male. Maternal socio-demographic, obstetric factors and birth size were associated with dietary patterns. The associations were not consistent with each dietary pattern across age groups. To examine the impact of diet in childhood on growth and health outcomes, factors influencing dietary patterns should be assessed at regular intervals throughout childhood. ©2012 The Author(s)/Acta Paediatrica ©2012 Foundation Acta Paediatrica.

  6. Bullying at age eight and criminality in adulthood: findings from the Finnish Nationwide 1981 Birth Cohort Study.

    Science.gov (United States)

    Sourander, Andre; Brunstein Klomek, Anat; Kumpulainen, Kirsti; Puustjärvi, Anita; Elonheimo, Henrik; Ristkari, Terja; Tamminen, Tuula; Moilanen, Irma; Piha, Jorma; Ronning, John A

    2011-12-01

    There are no prospective population-based studies examining predictive associations between childhood bullying behavior and adult criminality. To study predictive associations between bullying and victimization at age eight and adult criminal offenses. Nationwide birth cohort study from age 8 to 26 years. The sample consists of 5,351 Finnish children born in 1981 with information about bullying and victimization at age eight from parents, teachers, and the children themselves. National police register information about criminal offenses at age 23-26 years. When controlled for the parental education level and psychopathology score, bullying sometimes and frequently independently predicted violent (OR 3.9, 95% CI 1.9-7.9, p bullying frequently and more than five crimes during the 4-year period (OR 6.6, 95% CI 2.8-15.3, p bullying were the strongest predictor of adult criminality. In adjusted analyses, male victimization did not independently predict adult crime. Among girls, bullying or victimization at age eight were not associated with adult criminality. Bullying among boys signals an elevated risk of adult criminality.

  7. Trends in lifestyle among three cohorts of adults aged 55-64 years in 1992/1993, 2002/2003 and 2012/2013.

    Science.gov (United States)

    Reinders, Ilse; van Schoor, Natasja M; Deeg, Dorly J H; Huisman, Martijn; Visser, Marjolein

    2017-10-13

    Unhealthy lifestyle factors, such as obesity, smoking, excessive alcohol consumption and physical inactivity, are associated with increased morbidity and mortality risk, even in older age. We investigated trends in lifestyle among three cohorts of adults aged 55-64 years from the Netherlands. Data from the Longitudinal Aging Study Amsterdam were used. This study consisted of three randomly selected samples of men and women. Lifestyle data were collected in 1992/1993 (cohort 1, n = 988), in 2002/2003 (cohort 2, n = 1002) and in 2012/2013 (cohort 3, n = 1023). Trends in lifestyle across cohorts were tested using multivariable regression analyses. Complete lifestyle data were available for 834 participants from cohort 1, 861 from cohort 2 and 845 from cohort 3. Among men, but not in women, mean BMI and prevalence of obesity increased over time. The mean minutes per day spent being physically active decreased among both men and women, from 130 ± 107 and 230 ± 122 (1992/1993) to 114 ± 100 and 192 ± 109 (2002/2003), and 126 ± 98 and 187 ± 112 (2012/2013), respectively. The percentage of men and women defined as excessive drinkers (>7 alcoholic consumptions per week) increased from 54.9%, 62.3% to 65.4% (men) and 22.7%, 36.1% to 37.4% (women), in 1992/1993, 2002/2003 and 2012/2013, respectively. The percentage of non-smoking men and women increased over time. The lifestyle of Dutch adults aged 55-64 years was less healthy in 2012/2013 compared with 2002/2003 and 1992/1993. Political attention regarding healthy ageing should target the prevention of overweight, physical inactivity and excessive alcohol consumption in middle-aged persons.

  8. Birth weight, early childhood growth and lung function in middle to early old age: 1946 British birth cohort.

    Science.gov (United States)

    Cai, Yutong; Shaheen, Seif O; Hardy, Rebecca; Kuh, Diana; Hansell, Anna L

    2016-10-01

    Findings from previous studies investigating the relationship between birth weight and adult lung function have been inconsistent, and data on birth weight and adult lung function decline are lacking. Few studies have investigated the relation between early childhood growth and adult lung function. FEV1 and FVC were measured at ages 43 years, 53 years and 60-64 years in the 1946 British birth cohort study. Multiple linear regression models were fitted to study associations with birth weight and weight gain at age 0-2 years. Multilevel models assessed how associations changed with age, with FEV1 and FVC as repeated outcomes. 3276 and 3249 participants were included in FEV1 and FVC analyses, respectively. In women, there was a decreasing association between birth weight and FVC with age. From the multilevel model, for every 1 kg higher birth weight, FVC was higher on average by 66.3 mL (95% CI 0.5 to 132) at 43 years, but significance was lost at 53 years and 60-64 years. Similar associations were seen with FEV1, but linear change (decline) from age 43 years lost statistical significance after full adjustment. In men, associations with birth weight were null in multilevel models. Higher early life weight gain was associated with higher FEV1 at age 43 years in men and women combined but not in each sex. Birth weight is positively associated with adult lung function in middle age, particularly in women, but the association diminishes with age, potentially due to accumulating environmental influences over the life course. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Metabolic syndrome, sarcopenia and role of sex and age: cross-sectional analysis of Kashiwa cohort study.

    Directory of Open Access Journals (Sweden)

    Shinya Ishii

    Full Text Available Recent epidemiological evidence suggests that effects of cardiovascular risk factors may vary depending on sex and age. In this study, we assessed the associations of metabolic syndrome (MetS with sarcopenia and its components in older adults, and examined whether the associations vary by sex and age. We also tested if any one of the MetS components could explain the associations. We conducted a cross-sectional analysis of the baseline data from the cohort study conducted in Kashiwa city, Chiba, Japan in 2012 which included 1971 functionally-independent, community-dwelling Japanese adults aged 65 years or older (977 men, 994 women. Sarcopenia was defined based on appendicular skeletal muscle mass, grip strength and usual gait speed. MetS was defined based on the National Cholesterol Education Program's Adult Treatment Panel-III criteria. The prevalence of sarcopenia was 14.2% in men and 22.1% in women, while the prevalence of MetS was 43.6% in men and 28.9% in women. After adjustment for potential confounders, MetS was positively associated with sarcopenia in men aged 65 to 74 years (odds ratio 5.5; 95% confidence interval 1.9-15.9 but not in older men or women. Among the sarcopenia components, MetS was associated with lower muscle mass and grip strength, particularly in men aged 65 to 74 years. The associations of MetS with sarcopenia and its components were mainly driven by abdominal obesity regardless of sex or age. In conclusion, MetS is positively associated with sarcopenia in older men. The association is modified by sex and age, but abdominal obesity is the main contributor to the association across sex and age.

  10. Breast cancer risk factors and age at diagnosis: An Icelandic cohort study

    National Research Council Canada - National Science Library

    Tryggvadóttir, Laufey; Tulinius, Hrafn; Eyfjord, Jórunn E; Sigurvinsson, Trausti

    2002-01-01

    An increasing number of studies indicates that the strength and even direction of association between breast cancer and established risk factors differ according to the woman's age when she develops the disease...

  11. Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort

    DEFF Research Database (Denmark)

    Fernández-Friera, Leticia; Peñalvo, José L; Fernández-Ortiz, Antonio

    2015-01-01

    BACKGROUND: Data are limited on the presence, distribution, and extent of subclinical atherosclerosis in middle-aged populations. METHODS AND RESULTS: The PESA (Progression of Early Subclinical Atherosclerosis) study prospectively enrolled 4184 asymptomatic participants 40 to 54 years of age (mea......-risk individuals, suggesting added value of imaging for diagnosis and prevention. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01410318....

  12. Psychosocial Equine Program for Veterans.

    Science.gov (United States)

    Ferruolo, David M

    2016-01-01

    Nearly half of all combat veterans suffer from serious psychological disorders and reintegration issues. Veterans shy away from typical talk therapy and are seeking alternative treatments. Equine-facilitated mental health therapy has shown promise in treating veterans with depressive and anxiety disorders and reintegration issues. This article reports on an institutional review board-approved pilot program designed to address the mental health needs of veterans. Furthermore, this article discusses future directions for evolving development of equine treatment programming.

  13. Association of Aortic Stiffness With Cognition and Brain Aging in Young and Middle-Aged Adults: The Framingham Third Generation Cohort Study.

    Science.gov (United States)

    Pase, Matthew P; Himali, Jayandra J; Mitchell, Gary F; Beiser, Alexa; Maillard, Pauline; Tsao, Connie; Larson, Martin G; DeCarli, Charles; Vasan, Ramachandran S; Seshadri, Sudha

    2016-03-01

    Aortic stiffness is associated with cognitive decline and cerebrovascular disease late in life, although these associations have not been examined in young adults. Understanding the effects of aortic stiffness on the brain at a young age is important both from a pathophysiological and public health perspective. The aim of this study was to examine the cross-sectional associations of aortic stiffness with cognitive function and brain aging in the Framingham Heart Study Third Generation cohort (47% men; mean age, 46 years). Participants completed the assessment of aortic stiffness (carotid-femoral pulse wave velocity), a neuropsychological test battery assessing multiple domains of cognitive performance and magnetic resonance imaging to examine subclinical markers of brain injury. In adjusted regression models, higher aortic stiffness was associated with poorer processing speed and executive function (Trail Making B-A; β±SE, -0.08±0.03; Pbrain injury in young to middle-aged adults. Prospective studies are needed to examine whether aortic stiffening in young adulthood is associated with vascular cognitive impairment later in life. © 2016 American Heart Association, Inc.

  14. The war veteran identity

    Directory of Open Access Journals (Sweden)

    Marković-Savić Olivera S.

    2015-01-01

    Full Text Available The paper discusses how war veterans perceive themselves and how they answer the question 'Who am I?'. War veterans face many challenges in the process of re-socialization from a state of war and war traumatization to a peacetime society. There are several reasons why their re-socialization is a slow process: the first one is that a war engagement is in itself a highly stressful situation which carries traumas of different degrees, the other reason is the changed system of values in relation to war engagement. Namely, at the time they went to war, they had a strong social support, but at the time of their return and today this support is lost to the point of judgment. And the third reason which limits their re-socialization is the situation of social transition they found on their return from war, which specifically means that a large percentage of the population in general, and thus the war veterans after returning from the war, lost their jobs, creating a large social group of 'transition losers'. Such a condition often generates an identity crisis. This set of socio-cultural circumstances together with the ontological insecurity carried by war trauma generate an identity crisis, which is manifested among the respondents in nihilistic answers when responding to questions about their own personality. Studying the identity of war veterans, it was found that a strong attachment to the veteran identity is dominant. In fact, this paper discusses the different ways in which this attachment is refracted in the personality and identity of subjects, from negative attitudes to the pride in belonging to a group of war veterans and personal fulfillment in the activism in associations of war participants.

  15. Five-Year Incidence of Visual Impairment in Middle-Aged Iranians: The Shahroud Eye Cohort Study.

    Science.gov (United States)

    Hashemi, Hassan; Mehravaran, Shiva; Emamian, Mohammad Hassan; Fotouhi, Akbar

    2017-02-01

    To study the 5-year incidence of visual impairment and its causes and risk factors, in the middle-aged Iranian sample of the Shahroud Eye Cohort Study (ShECS). Data from subjects who had participated in both phases of the ShECS were used to determine age- and sex-specific incidence rates of visual impairment using the World Health Organization (WHO) definitions for bilateral low vision (visual acuity, VA, >0.5 and ≤1.3 LogMAR in the better eye) and blindness (VA worse than 1.3 LogMAR in the better eye). Risk ratios (RR) and 95% confidence intervals (CIs) were calculated using multivariable log-binomial regression. Of the 5079 ShECS I survivors, 4737 (93.3%) completed the 5-year follow-up. Their mean age at baseline was 50.9 ± 6.2 years, and 58.9% were female. The incidence of visual impairment was 1.12% (95% CI 0.82-1.42%) by presenting VA and 0.19% (95% CI 0.07-0.32%) by best-corrected VA; leading causes of the former were uncorrected refractive error (81.3%) and diabetic retinopathy (15.1%). In the multivariable model, risk factors for incident visual impairment by presenting VA were older age (RR 1.05, p = 0.044), lower education (RR 0.89, p = 0.002), and diabetes (RR 3.74, p visual impairment in a middle-aged Iranian population. Since age is a major risk factor, the number of visually impaired is expected to increase as the population ages, and less treatable causes such as diabetic retinopathy begin to surface. Measures for tackling uncorrected refractive error and enhancing diabetes screening and preventive programs are recommended.

  16. More active pre-school children have better motor competence at school starting age: an observational cohort study.

    Science.gov (United States)

    Barnett, Lisa M; Salmon, Jo; Hesketh, Kylie D

    2016-10-10

    Almost half of young children do not achieve minimum recommendations of 60 daily minutes in physical activity. Physical activity is potentially an important determinant of the development of motor competence in children. This study is one of very few longitudinal studies in this area and the first to investigate early childhood physical activity as a predictor of subsequent motor skill competence. Children were assessed as part of the Melbourne InFANT Program longitudinal cohort study at 19 months, 3.5 years and 5 years. Moderate-to-vigorous physical activity (MVPA) (accelerometry) was assessed at each time point. At age 5, children were also assessed in actual (Test of Gross Motor Development-2) and perceived motor competence (Pictorial Scale of Perceived Movement Skill Competence). General linear models were performed with all 12 skills (six object control and six locomotor skills), both actual and perceived, at age 5 as the respective outcome variables. Predictor variables alternated between MVPA at 19 months, 3.5 years and 5 years. Based on standardized TGMD-2 scores most children were average or below in their skill level at age 5. MVPA at 19 months was not a predictor of actual or perceived skill at age 5. MVPA at 3.5 years was associated with actual locomotor skill (B = 0.073, p = 0.033) and perceived total skill at 5 years of age (B = 0.059, p = 0.044). MVPA was not a predictor of actual or perceived object control skill at any age. Parents and preschool staff should be informed that more time in MVPA as a preschool child contributes to locomotor skill and to perceptions of skill ability in a child of school starting age. Understanding this relationship will assist in intervention development.

  17. More active pre-school children have better motor competence at school starting age: an observational cohort study

    Directory of Open Access Journals (Sweden)

    Lisa M. Barnett

    2016-10-01

    Full Text Available Abstract Background Almost half of young children do not achieve minimum recommendations of 60 daily minutes in physical activity. Physical activity is potentially an important determinant of the development of motor competence in children. This study is one of very few longitudinal studies in this area and the first to investigate early childhood physical activity as a predictor of subsequent motor skill competence. Methods Children were assessed as part of the Melbourne InFANT Program longitudinal cohort study at 19 months, 3.5 years and 5 years. Moderate-to-vigorous physical activity (MVPA (accelerometry was assessed at each time point. At age 5, children were also assessed in actual (Test of Gross Motor Development-2 and perceived motor competence (Pictorial Scale of Perceived Movement Skill Competence. General linear models were performed with all 12 skills (six object control and six locomotor skills, both actual and perceived, at age 5 as the respective outcome variables. Predictor variables alternated between MVPA at 19 months, 3.5 years and 5 years. Results Based on standardized TGMD-2 scores most children were average or below in their skill level at age 5. MVPA at 19 months was not a predictor of actual or perceived skill at age 5. MVPA at 3.5 years was associated with actual locomotor skill (B = 0.073, p = 0.033 and perceived total skill at 5 years of age (B = 0.059, p = 0.044. MVPA was not a predictor of actual or perceived object control skill at any age. Conclusion Parents and preschool staff should be informed that more time in MVPA as a preschool child contributes to locomotor skill and to perceptions of skill ability in a child of school starting age. Understanding this relationship will assist in intervention development.

  18. The trend in age at menarche in Indonesia: birth cohorts 1944–1988.

    Science.gov (United States)

    Sohn, Kitae

    2015-05-01

    Employing the Indonesian Family Life Survey, this paper depicts the trend in age at menarche in Indonesia for women born in 1944–1988. Mean age at menarche decreased from 14.39 years for birth year 1944 to 13.18 years for birth year 1988. Subsequently, this trend is related to the improvement in material conditions, measured by GDP per capita in childhood. The OLS results indicate that this decrease is largely explained by the improvement in material conditions. If age at menarche is considered an indicator of biological standard of living, these results suggest that the improvement in material conditions during the period converted to an improvement in biological standard of living.

  19. Studying variability in human brain aging in a population-based German cohort – Rationale and design of 1000BRAINS

    Directory of Open Access Journals (Sweden)

    Svenja eCaspers

    2014-07-01

    Full Text Available The ongoing 1000 brains study (1000BRAINS is an epidemiological and neuroscientific investigation of structural and functional variability in the human brain during aging. The two recruitment sources are the 10-year follow-up cohort of the German Heinz Nixdorf Recall (HNR Study, and the HNR MultiGeneration Study cohort, which comprises spouses and offspring of HNR subjects. The HNR is a longitudinal epidemiological investigation of cardiovascular risk factors, with a comprehensive collection of clinical, laboratory, socioeconomic, and environmental data from population-based subjects aged 45-75 years on inclusion. HNR subjects underwent detailed assessments in 2000, 2006, and 2011, and completed annual postal questionnaires on health status. 1000BRAINS accesses these HNR data and applies a separate protocol comprising: neuropsychological tests of attention, memory, executive functions & language; examination of motor skills; ratings of personality, life quality, mood & daily activities; analysis of laboratory and genetic data; and state-of-the-art magnetic resonance imaging (MRI, 3 Tesla of the brain. The latter includes (i 3D-T1- and 3D-T2-weighted scans for structural analyses and myelin mapping; (ii three diffusion imaging sequences optimized for diffusion tensor imaging, high-angular resolution diffusion imaging for detailed fibre tracking and for diffusion kurtosis imaging; (iii resting-state and task-based functional MRI; and (iv fluid-attenuated inversion recovery and MR angiography for the detection of vascular lesions and the mapping of white matter lesions. The unique design of 1000BRAINS allows: (i comprehensive investigation of various influences including genetics, environment and health status on variability in brain structure and function during aging; and (ii identification of the impact of selected influencing factors on specific cognitive subsystems and their anatomical correlates.

  20. Studying variability in human brain aging in a population-based German cohort-rationale and design of 1000BRAINS.

    Science.gov (United States)

    Caspers, Svenja; Moebus, Susanne; Lux, Silke; Pundt, Noreen; Schütz, Holger; Mühleisen, Thomas W; Gras, Vincent; Eickhoff, Simon B; Romanzetti, Sandro; Stöcker, Tony; Stirnberg, Rüdiger; Kirlangic, Mehmet E; Minnerop, Martina; Pieperhoff, Peter; Mödder, Ulrich; Das, Samir; Evans, Alan C; Jöckel, Karl-Heinz; Erbel, Raimund; Cichon, Sven; Nöthen, Markus M; Sturma, Dieter; Bauer, Andreas; Jon Shah, N; Zilles, Karl; Amunts, Katrin

    2014-01-01

    The ongoing 1000 brains study (1000BRAINS) is an epidemiological and neuroscientific investigation of structural and functional variability in the human brain during aging. The two recruitment sources are the 10-year follow-up cohort of the German Heinz Nixdorf Recall (HNR) Study, and the HNR MultiGeneration Study cohort, which comprises spouses and offspring of HNR subjects. The HNR is a longitudinal epidemiological investigation of cardiovascular risk factors, with a comprehensive collection of clinical, laboratory, socioeconomic, and environmental data from population-based subjects aged 45-75 years on inclusion. HNR subjects underwent detailed assessments in 2000, 2006, and 2011, and completed annual postal questionnaires on health status. 1000BRAINS accesses these HNR data and applies a separate protocol comprising: neuropsychological tests of attention, memory, executive functions and language; examination of motor skills; ratings of personality, life quality, mood and daily activities; analysis of laboratory and genetic data; and state-of-the-art magnetic resonance imaging (MRI, 3 Tesla) of the brain. The latter includes (i) 3D-T1- and 3D-T2-weighted scans for structural analyses and myelin mapping; (ii) three diffusion imaging sequences optimized for diffusion tensor imaging, high-angular resolution diffusion imaging for detailed fiber tracking and for diffusion kurtosis imaging; (iii) resting-state and task-based functional MRI; and (iv) fluid-attenuated inversion recovery and MR angiography for the detection of vascular lesions and the mapping of white matter lesions. The unique design of 1000BRAINS allows: (i) comprehensive investigation of various influences including genetics, environment and health status on variability in brain structure and function during aging; and (ii) identification of the impact of selected influencing factors on specific cognitive subsystems and their anatomical correlates.

  1. Risk factors for small-for-gestational-age infants by customised birthweight centiles: data from an international prospective cohort study.

    Science.gov (United States)

    McCowan, L M E; Roberts, C T; Dekker, G A; Taylor, R S; Chan, E H Y; Kenny, L C; Baker, P N; Moss-Morris, R; Chappell, L C; North, R A

    2010-12-01

    To identify clinical and ultrasound variables associated with the birth of small-for-gestational-age (SGA) infants by customised centiles, subclassified according to whether their mothers were normotensive or developed hypertensive complications. Prospective, multicentre cohort study. Participating centres of the Screening for Pregnancy Endpoints (SCOPE) study in Auckland, New Zealand, Adelaide, Australia, Manchester and London, UK, and Cork, Ireland. The 3513 nulliparous participants of the SCOPE study. Women were interviewed at 15 ± 1 weeks, and had ultrasound growth measurements and umbilical and uterine Doppler studies at 20 ± 1 weeks. Variables associated with SGA infants were identified using logistic regression. Small for gestational age (i.e. a birthweight of less than the tenth customised centile), normotensive-SGA and hypertensive-SGA. Comparison groups for statistical analyses were non-SGA, normotensive non-SGA and hypertensive non-SGA. Among 376 (10.7%) SGA infants, 281 (74.7%) were normotensive-SGA and 95 (25.3%) were hypertensive-SGA. Independent risk factors for normotensive-SGA were low maternal birthweight, low fruit intake pre-pregnancy, cigarette smoking, increasing maternal age, daily vigorous exercise, being a tertiary student, head and abdominal circumference of less than the tenth centile and increasing uterine artery Doppler indices at the 20-week scan. Protective factors were: high green leafy vegetable intake pre-pregnancy, and rhesus-negative blood group. Risk factors for hypertensive-SGA were conception by in vitro fertilisation, previous early pregnancy loss and femur length of less than tenth centile at the 20-week scan. Risk factors for infants who are SGA by customised centiles have been identified in a cohort of healthy nulliparous women. A number of these factors are modifiable; however, further studies are needed to replicate these findings. © 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of

  2. Maternal and early postnatal nutrition and mental health of offspring by age 5 years: a prospective cohort study.

    Science.gov (United States)

    Jacka, Felice N; Ystrom, Eivind; Brantsaeter, Anne Lise; Karevold, Evalill; Roth, Christine; Haugen, Margaretha; Meltzer, Helle Margrete; Schjolberg, Synnve; Berk, Michael

    2013-10-01

    Diet quality is related to the risk for depression and anxiety in adults and adolescents; however, the possible impact of maternal and early postnatal nutritional exposures on children's subsequent mental health is unexplored. The large prospective Norwegian Mother and Child Cohort Study recruited pregnant women between 1999 and 2008. Data were collected from mothers during pregnancy and when children were 6 months and 1.5, 3, and 5 years of age. Latent growth curve models were used to model linear development in children's internalizing and externalizing problems from 1.5 to 5 years of age as a function of diet quality during pregnancy and at 1.5 and 3 years. Diet quality was evaluated by dietary pattern extraction and characterized as "healthy" or "unhealthy." The sample comprised 23,020 eligible women and their children. Adjustments were made for variables including sex of the child, maternal depression, maternal and paternal age, maternal educational attainment, household income, maternal smoking before and during pregnancy, mothers' parental locus of control, and marital status. Higher intakes of unhealthy foods during pregnancy predicted externalizing problems among children, independently of other potential confounding factors and childhood diet. Children with a high level of unhealthy diet postnatally had higher levels of both internalizing and externalizing problems. Moreover, children with a low level of postnatal healthy diet also had higher levels of both internalizing and externalizing problems. Among this large cohort of mothers and children, early nutritional exposures were independently related to the risk for behavioral and emotional problems in children. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  3. Prevalence of age-related hearing loss, including sex differences, in older adults in a large cohort study.

    Science.gov (United States)

    Homans, Nienke C; Metselaar, R Mick; Dingemanse, J Gertjan; van der Schroeff, Marc P; Brocaar, Michael P; Wieringa, Marjan H; Baatenburg de Jong, Rob J; Hofman, Albert; Goedegebure, André

    2017-03-01

    To obtain actual status of age-related hearing loss in a general unscreened population of older Dutch adults and to investigate whether the prevalence or degree has changed over time. To investigate the prevalence and degree of hearing loss, we conducted a large prospective cohort study of older adults between February 2011 and July 2015. Pure-tone air- and bone-conduction thresholds were measured for 4,743 participants. Results were compared to previous cohort studies. As expected, hearing loss increased with age. We found a correlation of R2 = 0.317 for men and R2 = 0.354 for women (right ears). A prevalence of hearing loss greater than 35 dB hearing level the average of 0.5/1/2/4 kHz in the better ear, was found in 33% of the male and almost 29% of the female participants aged 65 years and older. Compared with previous studies, men had less hearing loss at the frequencies of 2 kHz and above. Hearing thresholds in women were significantly higher at 4 and 8 kHz. The difference in hearing loss between men and women is significantly less than in earlier studies. Our study confirms that hearing loss is highly prevalent in the general unscreened population of older adults. However, the difference in hearing between sexes was considerably less than previously reported. This is probably due to changing lifestyle and environmental circumstances, LEVEL OF EVIDENCE: 2b Laryngoscope, 127:725-730, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  4. Three Generations, Three Wars: African American Veterans.

    Science.gov (United States)

    Black, Helen K

    2016-02-01

    This article emerged from pilot research exploring experiences of war and suffering among African American veterans who served in World War II, Korean War, and Vietnam War. Men's experiences as soldiers reflected both racism and the social change that occurred in the Unites States while they served. We used techniques of narrative elicitation, conducting qualitative, ethnographic interviews with each of five veterans in his home. Interviews focused on unique and shared experiences as an African American man and a soldier. Three important themes emerged: (a) Expectations related to War--Although men viewed service to country as an expected part of life, they also expected equal treatment in war, which did not occur; (b) Suffering as an African American--Informants interpreted experiences of suffering in war as related to the lower status of African American servicemen; and (c) Perception of present identity--Each man was honed by the sum of his experiences, including those of combat, racism, and postwar opportunities and obstacles. From 40 to 70 years after the wars were fought, there are few scholarly narrative studies on African American veterans, despite the fact that Korean War Veterans are entering old-old age and few World War II Veterans are alive. The value of pilot research that offers narratives of unheard voices is significant; larger studies can interview more African American veterans to advance knowledge that might soon be lost. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Seasonal variations of neuromotor development by 14 months of age: Hamamatsu Birth Cohort for mothers and children (HBC Study.

    Directory of Open Access Journals (Sweden)

    Kenji J Tsuchiya

    Full Text Available The present study aimed at investigating whether neuromotor development, from birth to 14 months of age, shows seasonal, cyclic patterns in association with months of birth. Study participants were 742 infants enrolled in the Hamamatsu Birth Cohort (HBC Study and followed-up from birth to the 14th month of age. Gross motor skills were assessed at the ages of 6, 10, and 14 months, using Mullen Scales of Early Learning. The score at each assessment was regressed onto a trigonometric function of months of birth, with an adjustment for potential confounders. Gross motor scores at the 6th and 10th months showed significant 1-year-cycle variations, peaking among March- and April-born infants, and among February-born infants, respectively. Changes in gross motor scores between the 10th and 14th months also showed a cyclic variation, peaking among July- and August-born infants. Due to this complementary effect, gross motor scores at the 14th month did not show seasonality. Neuromotor development showed cyclic seasonality during the first year of life. The effects brought about by month of birth disappeared around 1 year of age, and warmer months seemed to accelerate the neuromotor development.

  6. Metabolic syndrome and incidence of breast cancer in middle-aged Korean women: a nationwide cohort study.

    Science.gov (United States)

    Lee, Jung Ah; Yoo, Jung Eun; Park, Hye Soon

    2017-04-01

    To evaluate the risk of breast cancer in middle-aged women with metabolic syndrome using the National Health Insurance Service-National Sample Cohort (NHIS-NSC). We analyzed 23,820 women aged 50-64 years who participated in the NHIS-NCS in 2008 and 2009. We excluded subjects with any previous history of cancer or with inadequate information regarding metabolic syndrome. Participated subjects underwent anthropometric measurements and provided fasting blood samples for the assessment of glucose and lipid profiles, and answered a lifestyle questionnaire. Cox regression analysis was performed to evaluate relative risks (RRs) and 95% confidence intervals (CIs) for the association between metabolic syndrome and breast cancer. During the 5-year follow-up, 131 subjects were newly diagnosed with breast cancer (incidence, 10.86 per 10,000 person years). After adjusting for age and body mass index, the RR for incident breast cancer in participants with metabolic syndrome versus those without it was 1.47 (95% CI 1.01-2.13). For those individuals of metabolic syndrome, hyperglycemia was most primarily related with the incidence of breast cancer (RR 1.44, 95% CI 1.02-2.04). Among the study individuals who were middle-aged Korean women, metabolic syndrome is highly related with the risk of breast cancer. Therefore, it needs to be managed or prevented to reduce the incidence of breast cancer.

  7. Ageing and Dementia in a Longitudinal Study of a Cohort with Down Syndrome

    Science.gov (United States)

    Carr, Janet; Collins, Suzanne

    2014-01-01

    Background: A population sample of people with Down syndrome has been studied from infancy and has now been followed up again at age 47 years. Methods: Intelligence and language skills were tested and daily living skills assessed. Memory/cognitive deterioration was examined using two test instruments. Results: Scores on verbal tests of…

  8. Policy-maker attitudes to the ageing of the HIV cohort in Botswana

    African Journals Online (AJOL)

    2017-09-19

    Sep 19, 2017 ... (Report, 2010; Republic of Botswana Ministry of Heath et al.,. 2013; United Nations Development Programme, 2012). The quality of life of adults aging with HIV, however, is in question due to medical complications, poorer mental health, social isolation and stigmatization from health care providers and.

  9. Early-Onset Thrombocytopenia in Small-For-Gestational-Age Neonates: A Retrospective Cohort Study

    NARCIS (Netherlands)

    Fustolo-Gunnink, S. F.; Vlug, R. D.; Smits-Wintjens, V. E. H. J.; Heckman, E. J.; te Pas, A. B.; Fijnvandraat, K.; Lopriore, E.

    2016-01-01

    Thrombocytopenia is a common finding in small for gestational age (SGA) neonates and is thought to result from a unique pathophysiologic mechanism related to chronic intrauterine hypoxia. Our objective was to estimate the incidence and severity of early-onset thrombocytopenia in SGA neonates, and to

  10. Age at natural menopause and risk of type 2 diabetes : A prospective cohort study

    NARCIS (Netherlands)

    T. Muka (Taulant); E. Asllanaj (Eralda); N. Avazverdi (Naim); L. Jaspers (Loes); N. Stringa (Najada); J. Milic (Jelena); S. Ligthart (Symen); M.K. Ikram (Kamran); J.S.E. Laven (Joop); M. Kavousi (Maryam); A. Dehghan (Abbas); O.H. Franco (Oscar)

    2017-01-01

    markdownabstract__Aims/hypothesis__ In this study, we aimed to examine the association between age at natural menopause and risk of type 2 diabetes, and to assess whether this association is independent of potential mediators. __Methods__ We included 3639 postmenopausal women from the

  11. Policy-maker attitudes to the ageing of the HIV cohort in Botswana

    African Journals Online (AJOL)

    2017-09-19

    Sep 19, 2017 ... Mots-clés: vieillissement de la population, politique de VIH, plue adultes, PVVIH. Introduction. The policy considerations of ageing – economic security, health, disability and living conditions – are concerns through- out the world, but the nature of the problem differs consider- ably from continent to continent, ...

  12. Age-period-cohort analysis in the 1870s: Diagrams, stereograms, and the basic differential equation

    DEFF Research Database (Denmark)

    Keiding, Niels

    2011-01-01

    The period 1868–1880 saw a dramatic development in analytical and graphical descriptions of mortality, varying with time and age; this took place almost entirely in the German language. This report attempts a survey of these developments with brief notes on other graphical representations and on ...

  13. Policy-maker attitudes to the ageing of the HIV cohort in Botswana ...

    African Journals Online (AJOL)

    Background: The roll out of antiretroviral therapy in Botswana, as in many countries with near universal access to treatment, has transformed HIV into a complex yet manageable chronic condition and has led to the emergence of a population aging with HIV. Although there has been some realization of this development at ...

  14. Cognitive Function and Health Literacy Decline in a Cohort of Aging English Adults.

    Science.gov (United States)

    Kobayashi, Lindsay C; Wardle, Jane; Wolf, Michael S; von Wagner, Christian

    2015-07-01

    Low health literacy is common among aging patients and is a risk factor for morbidity and mortality. We aimed to describe health literacy decline during aging and to investigate the roles of cognitive function and decline in determining health literacy decline. Data were from 5,256 non-cognitively impaired adults aged ≥ 52 years in the English Longitudinal Study of Ageing. Health literacy was assessed using a four-item reading comprehension assessment of a fictitious medicine label, and cognitive function was assessed in a battery administered in-person at baseline (2004-2005) and at follow-up (2010-2011). Overall, 19.6% (1,032/5,256) of participants declined in health literacy score over the follow-up. Among adults aged ≥ 80 years at baseline, this proportion was 38.2% (102/267), compared to 14.8% (78/526) among adults aged 52-54 years (OR = 3.21; 95% CI: 2.26-4.57). Other sociodemographic predictors of health literacy decline were: male sex (OR = 1.20; 95% CI: 1.04-1.38), non-white ethnicity (OR = 2.42; 95% CI: 1.51-3.89), low educational attainment (OR = 1.58; 95% CI: 1.29-1.95 for no qualifications vs. degree education), and low occupational class (OR = 1.67; 95% CI: 1.39-2.01 for routine vs. managerial occupations). Higher baseline cognitive function scores protected against health literacy decline, while cognitive decline (yes vs. no) predicted decline in health literacy score (OR = 1.59; 95% CI: 1.35-1.87 for memory decline and OR = 1.56; 95% CI: 1.32-1.85 for executive function decline). Health literacy decline appeared to increase with age, and was associated with even subtle cognitive decline in older non-impaired adults. Striking social inequalities were evident, whereby men and those from minority and deprived backgrounds were particularly vulnerable to literacy decline. Health practitioners must be able to recognize limited health literacy to ensure that clinical demands match the literacy skills of diverse patients.

  15. Increased Mortality Among Older Veterans Admitted to VA Homelessness Programs.

    Science.gov (United States)

    Schinka, John A; Bossarte, Robert M; Curtiss, Glenn; Lapcevic, William A; Casey, Roger J

    2016-04-01

    National Death Index data were examined to describe mortality patterns among older veterans who are homeless. Homelessness and health care records from the U.S. Department of Veterans Affairs were used to identify old (ages 55-59) and older (ages ≥60) veterans who were (N=4,475) or were not (N=20,071) homeless. Survival functions and causes of death of the two samples over an 11-year follow-up period were compared. Substantially more veterans who were homeless (34.9%) died compared with the control sample (18.2%). Veterans who were homeless were approximately 2.5 years younger at time of death compared with the control sample. Older veterans who were homeless had the lowest survival rate (58%). No disease category appeared to be critical in reducing survival time. Suicide was twice as frequent in the homeless (.4%) versus the control (.2%) sample. Older veterans who were homeless experienced excess mortality and increased suicide risk.

  16. Recruitment and retention of young adult veteran drinkers using Facebook.

    Directory of Open Access Journals (Sweden)

    Eric R Pedersen

    Full Text Available The objective of this study was to describe the feasibility of using Facebook as a platform to recruit and retain young adult veteran drinkers into an online-alcohol use intervention study. Facebook's wide accessibility and popularity among the age group that comprises the majority of veterans from the conflicts in Iraq and Afghanistan make it a compelling resource through which research can extend its reach to this otherwise hard-to-reach group. We developed a series of Facebook advertisement campaigns to reach veteran drinkers not specifically searching for alcohol treatment. In doing so, we recruited 793 valid veteran participants in approximately two weeks for an advertising cost of $4.53 per obtained participant. The study sample consisted primarily of male veterans, between 19 and 34 years of age, who were drinking at moderate to heavy levels. Although about half of the sample reported mental health comorbidity, few had received any mental health or substance use treatment in the past year. Facebook appears to be a valuable mechanism through which to recruit young veterans with unmet behavioral health needs, although more specific efforts may be needed to engage certain types of veterans after initial study enrollment.

  17. Recruitment and retention of young adult veteran drinkers using Facebook.

    Science.gov (United States)

    Pedersen, Eric R; Naranjo, Diana; Marshall, Grant N

    2017-01-01

    The objective of this study was to describe the feasibility of using Facebook as a platform to recruit and retain young adult veteran drinkers into an online-alcohol use intervention study. Facebook's wide accessibility and popularity among the age group that comprises the majority of veterans from the conflicts in Iraq and Afghanistan make it a compelling resource through which research can extend its reach to this otherwise hard-to-reach group. We developed a series of Facebook advertisement campaigns to reach veteran drinkers not specifically searching for alcohol treatment. In doing so, we recruited 793 valid veteran participants in approximately two weeks for an advertising cost of $4.53 per obtained participant. The study sample consisted primarily of male veterans, between 19 and 34 years of age, who were drinking at moderate to heavy levels. Although about half of the sample reported mental health comorbidity, few had received any mental health or substance use treatment in the past year. Facebook appears to be a valuable mechanism through which to recruit young veterans with unmet behavioral health needs, although more specific efforts may be needed to engage certain types of veterans after initial study enrollment.

  18. Recruitment and retention of young adult veteran drinkers using Facebook

    Science.gov (United States)

    Pedersen, Eric R.; Naranjo, Diana; Marshall, Grant N.

    2017-01-01

    The objective of this study was to describe the feasibility of using Facebook as a platform to recruit and retain young adult veteran drinkers into an online-alcohol use intervention study. Facebook’s wide accessibility and popularity among the age group that comprises the majority of veterans from the conflicts in Iraq and Afghanistan make it a compelling resource through which research can extend its reach to this otherwise hard-to-reach group. We developed a series of Facebook advertisement campaigns to reach veteran drinkers not specifically searching for alcohol treatment. In doing so, we recruited 793 valid veteran participants in approximately two weeks for an advertising cost of $4.53 per obtained participant. The study sample consisted primarily of male veterans, between 19 and 34 years of age, who were drinking at moderate to heavy levels. Although about half of the sample reported mental health comorbidity, few had received any mental health or substance use treatment in the past year. Facebook appears to be a valuable mechanism through which to recruit young veterans with unmet behavioral health needs, although more specific efforts may be needed to engage certain types of veterans after initial study enrollment. PMID:28249027

  19. Use of health services and medicines amongst Australian war veterans: a comparison of young elderly, near centenarians and centenarians.

    Science.gov (United States)

    Roughead, Elizabeth E; Kalisch, Lisa M; Ramsay, Emmae N; Ryan, Philip; Gilbert, Andrew L

    2010-11-04

    Age and life expectancy of residents in many developed countries, including Australia, is increasing. Health resource and medicine use in the very old is not well studied. The purpose of this study was to identify annual use of health services and medicines by very old Australian veterans; those aged 95 to 99 years (near centenarians) and those aged 100 years and over (centenarians). The study population included veterans eligible for all health services subsidised by the Department of Veterans' Affairs (DVA) aged 95 years and over at August 1st 2006. A cohort of veterans aged 65 to 74 years was identified for comparison. Data were sourced from DVA claims databases. We identified all claims between August 1st 2006 and July 31st 2007 for medical consultations, pathology, diagnostic imaging and allied health services, hospital admissions, number of prescriptions and unique medicines. Chi squared tests were used to compare the proportion of centenarians (those aged 100 years and over) and near centenarians (those aged 95 to 99 years) who accessed medicines and health services with the 65 to 74 year age group. For those who accessed health services during follow up, Poisson regression was used to compare differences in the number of times centenarians and near centenarians accessed each health service compared to 65 to 74 year olds. A similar proportion (98%) of centenarians and near centenarians compared to those aged 65 to 74 consulted a GP and received prescription medicine during follow up. A lower proportion of centenarians and near centenarians had claims for specialist visits (36% and 57% respectively), hospitalisation (19% and 24%), dental (12% and 18%), physiotherapy (13% and 15%), pathology(68% and 78%) and diagnostic imaging services (51% and 68%) (p < 0.0001) and a higher proportion had claims for care plans (19% and 25%), occupational therapy (15% and 17%) and podiatry services (54% and 58%) (p < 0.0001). Compared to those aged 65 to 74, a lower proportion

  20. Partial sight and blindness in children of the 1970 birth cohort at 10 years of age.

    Science.gov (United States)

    Stewart-Brown, S L; Haslum, M N

    1988-01-01

    The prevalence and causes of partial sight and blindness (best corrected distant visual acuity of 6/24 or less) have been studied in a nationally representative sample of 15,000 10-year-old children. The prevalence of blindness (acuity less than 6/60) was between 3.4 and 4.0/10,000. All these children had been registered as blind; less than half were in schools for the blind, the remainder were all in other special schools. The prevalence of partial sight (acuity less than or equal to 6/24 greater than or equal to 6/60) was between 5.4 and 8.7/10,000; less than half of these children were in schools for the visually handicapped or partially sighted; most were in ordinary schools; half were neither registered as partially sighted nor ascertained as in need of special education for visual handicap. The most common cause of partial sight or blindness in this cohort was congenital cataract; the second most common was congenital nystagmus. The study identified a number of children whose best acuity on examination was 6/24 or less who had either no ophthalmological diagnosis or who had been diagnosed as suffering from a refractive error. These children have been included in the study because at the time of the survey they had either not been prescribed spectacles or they had spectacles which they were not wearing; the functional visual level of these children was therefore equivalent to that of those defined as partially sighted. PMID:3418281

  1. Early life body mass trajectories and mortality in older age: findings from the Helsinki Birth Cohort Study.

    Science.gov (United States)

    von Bonsdorff, Mikaela B; Törmäkangas, Timo; Rantanen, Taina; Salonen, Minna K; Osmond, Clive; Kajantie, Eero; Eriksson, Johan G

    2015-02-01

    Overweight and obesity in childhood have been linked to an increased risk of adult mortality, but evidence is still scarce. We identified trajectories of body mass index (BMI) development in early life and investigated their mortality risk. Data come from the Helsinki Birth Cohort Study, in which 4943 individuals, born 1934-1944, had serial measures of weight and height from birth to 11 years extracted from health care records, weight and height data in adulthood, and register-based mortality data for 2000-2010. Three early BMI trajectories (increasing, average, and average-to-low for men and increasing, average, and low-to-high BMI for women) were identified. Women with an increasing or low-to-high BMI (BMI lower in early childhood, later exceeded average) trajectory had an increased risk of all-cause mortality compared to those with an average BMI trajectory (HR 1.55, 95% CI 1.07-2.23; and HR 1.57, 95% CI 1.04-2.37, respectively). Similar associations were observed for cancer mortality. Among men, BMI trajectories were not associated with all-cause mortality, but those with average-to-low BMI (BMI first similar then dropped below average) had an increased risk of cancer mortality. An increasing BMI in early life may shorten the lifespan of maturing cohorts as they age, particularly among women.

  2. 38 CFR 59.40 - Maximum number of nursing home care and domiciliary care beds for veterans by State.

    Science.gov (United States)

    2010-07-01

    ... projection of demand for nursing home and domiciliary care by veterans who at such time are 65 years of age... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Maximum number of nursing... ACQUISITION OF STATE HOMES § 59.40 Maximum number of nursing home care and domiciliary care beds for veterans...

  3. Supporting School Success for Homeless Children of Veterans and Military Service Members. Best Practices in Interagency Collaboration Brief Series

    Science.gov (United States)

    National Center for Homeless Education at SERVE, 2015

    2015-01-01

    According to research (Fargo et al, 2012) and federal data (U.S. Department of Housing and Urban Development [HUD], 2015), veterans experience homelessness at a higher rate than non-veterans. Many veterans experience homelessness as individuals, while others experience homelessness with their families (2015), which may include school-age children.…

  4. Trends in participation rates for wildlife-associated outdoor recreation activities by age and race/ethnicity: implications for cohort-component projection models

    Science.gov (United States)

    John F. Dwyer; Allan Marsinko

    1998-01-01

    Cohort-component projection models have been used to explore the implications of increased aging and growth of racial/ethnic minority groups on number of participants in outdoor recreation activities in the years ahead. Projections usually assume that participation rates by age and race/ethnicity remain constant over time. This study looks at trends in activity...