scholarly journals Mediterranean Diet and Risk of Dementia and Alzheimer’s Disease in the EPIC-Spain Dementia Cohort Study

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 700
Author(s):  
María Encarnación Andreu-Reinón ◽  
María Dolores Chirlaque ◽  
Diana Gavrila ◽  
Pilar Amiano ◽  
Javier Mar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Mediterranean Diet ◽  
Protective Role ◽  
Cox Models ◽  
Hazard Ratios ◽  
Dementia Incidence ◽  
Diet History ◽  
Large Prospective Cohort Study ◽  
Adjusted Model ◽  
Incident Cases

The Mediterranean diet (MD) has shown to reduce the occurrence of several chronic diseases. To evaluate its potential protective role on dementia incidence we studied 16,160 healthy participants from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Spain Dementia Cohort study recruited between 1992–1996 and followed up for a mean (±SD) of 21.6 (±3.4) years. A total of 459 incident cases of dementia were ascertained through expert revision of medical records. Data on habitual diet was collected through a validated diet history method to assess adherence to the relative Mediterranean Diet (rMED) score. Hazard ratios (HR) of dementia by rMED levels (low, medium and high adherence levels: ≤6, 7–10 and ≥11 points, respectively) were estimated using multivariable Cox models, whereas time-dependent effects were evaluated using flexible parametric Royston-Parmar (RP) models. Results of the fully adjusted model showed that high versus low adherence to the categorical rMED score was associated with a 20% (HR = 0.80, 95%CI: 0.60–1.06) lower risk of dementia overall and HR of dementia was 8% (HR = 0.92, 0.85–0.99, p = 0.021) lower for each 2-point increment of the continuous rMED score. By sub-types, a favorable association was also found in women for non-AD (HR per 2-points = 0.74, 95%CI: 0.62–0.89), while not statistically significant in men for AD (HR per 2-points = 0.88, 0.76–1.01). The association was stronger in participants with lower education. In conclusion, in this large prospective cohort study MD was inversely associated with dementia incidence after accounting for major cardiovascular risk factors. The results differed by dementia sub-type, sex, and education but there was no significant evidence of effect modification.

scholarly journals Sense of coherence and risk of breast cancer

eLife ◽  
2020 ◽  
Vol 9 ◽  
Author(s):  
Kejia Hu ◽  
Mikael Eriksson ◽  
Yvonne Wengström ◽  
Kamila Czene ◽  
Per Hall ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Sense Of Coherence ◽  
Standard Deviation Increase ◽  
Cox Models ◽  
Hazard Ratios ◽  
Risk Of Cancer ◽  
Incident Cases ◽  
Incident Breast Cancer

Sense of coherence (SoC) is the origin of health according to Antonovsky. The link between SoC and risk of cancer has however rarely been assessed. We performed a cohort study of 46,436 women from the Karolinska Mammography Project for Risk Prediction of Breast Cancer (Karma). Participants answered a SoC-13 questionnaire at recruitment to Karma and were subsequently followed up for incident breast cancer. Multivariate Cox models were used to assess the hazard ratios (HRs) of breast cancer in relation to SoC. We identified 771 incident cases of breast cancer during follow-up (median time: 5.2 years). No association was found between SoC, either as a categorical (strong vs. weak SoC, HR: 1.08, 95% CI: 0.90–1.29) or continuous (HR: 1.08; 95% CI: 1.00–1.17 per standard deviation increase of SoC) variable, and risk of breast cancer. In summary, we found little evidence to support an association between SoC and risk of breast cancer.

scholarly journals May the Mediterranean diet attenuate the risk of type 2 diabetes associated with obesity: the Seguimiento Universidad de Navarra (SUN) cohort

2017 ◽  
Vol 117 (10) ◽  
pp. 1478-1485 ◽  
Author(s):  
Sonia Eguaras ◽  
Maira Bes-Rastrollo ◽  
Miguel Ruiz-Canela ◽  
Silvia Carlos ◽  
Pedro de la Rosa ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Adverse Effects ◽  
Mediterranean Diet ◽  
Weight Changes ◽  
Product Term ◽  
Hazard Ratios ◽  
The Mediterranean ◽  
Incident Cases

AbstractIt is likely that the Mediterranean diet (MedDiet) may mitigate the adverse effects of obesity on the incidence of type 2 diabetes mellitus (T2DM). We assessed this hypothesis in a cohort of 18 225 participants initially free of diabetes (mean age: 38 years, 61 % women). A validated semi-quantitative 136-item FFQ was used to assess dietary intake and to build a 0–9 score of adherence to MedDiet. After a median of 9·5-year follow-up, 136 incident cases of T2DM were confirmed during 173 591 person-years follow-up. When MedDiet adherence was low (≤4 points), the multivariable-adjusted hazard ratios (HR) were 4·07 (95 % CI 1·58, 10·50) for participants with BMI 25–29·99 kg/m2 and 17·70 (95 % CI 6·29, 49·78) kg/m2 for participants with BMI≥30 kg/m2, (v.<25 kg/m2). In the group with better adherence to the MedDiet (>4 points), these multivariable-adjusted HR were 3·13 (95 % CI 1·63, 6·01) and 10·70 (95 % CI 4·98, 22·99) for BMI 25–30 and ≥30 kg/m2, respectively. The P value for the interaction was statistically significant (P=0·002). When we assessed both variables (BMI and MedDiet) as continuous, the P value for their interaction product-term was marginally significant (P=0·051) in fully adjusted models. This effect modification was not explained by weight changes during follow-up. Our results suggest that the MedDiet may attenuate the adverse effects of obesity on the risk of T2DM.

scholarly journals COVID-19 vaccine effectiveness among healthcare workers in Portugal: results from a hospital-based cohort study, December 2020 to November 2021

2022 ◽  
Author(s):  
Vânia Gaio ◽  
Adriana Silva ◽  
Palmira Amaral ◽  
João Faro Viana ◽  
Pedro Pinto Leite ◽  
...  
Keyword(s):  
Cohort Study ◽  
Healthcare Workers ◽  
Vaccine Effectiveness ◽  
Symptomatic Infection ◽  
Cox Models ◽  
Mainland Portugal ◽  
Hazard Ratios ◽  
Group Sex ◽  
Tagus Valley

Introduction: Healthcare workers (HCW) were amongst the first prioritized for COVID-19 vaccination but data on COVID–19 vaccine effectiveness among HCW is still limited. This study aims to estimate the COVID–19 vaccine effectiveness (VE) against SARS–CoV–2 symptomatic infection among HCW from Portuguese hospitals. Methods: In this prospective cohort study, we analysed data from HCW (all professional categories) from two central hospitals in the Lisbon and Tagus Valley and Centre regions of mainland Portugal between December 2020 and November 2021. VE against symptomatic SARS–CoV–2 infection was estimated as one minus the confounder adjusted hazard ratios by Cox models considering age group, sex, presence of chronic disease and occupational exposure to patients diagnosed with COVID–19 as adjustment variables. Results: During the 11 months of follow up, the 2213 HCW contributed a total of 1950 person-years at risk and 171 SARS–CoV–2 events occurred. The COVID–19 incidence rate for unvaccinated HCW was 348.7 per 1000 person-years while for fully vaccinated HCW was 43.0 per 1000 person-years. We observed a VE against symptomatic SARS–CoV–2 infection of 73.9% (95% CI: 26.2–90.8%) for complete vaccination status. Conclusion: This cohort study found a high COVID-19 VE against symptomatic SARS–CoV–2 infection in Portuguese HCW, which is in concordance with previous studies from other countries. Monitoring of VE in this HCW cohort continues during the winter 2021/2022 to evaluate potential VE decay and booster vaccine effect. Keywords: Vaccine effectiveness, SARS–CoV–2 , COVID–19, symptomatic infection, healthcare workers.

scholarly journals Simultaneous temporal trends in dementia incidence and prevalence, 2005–2013: a population-based retrospective cohort study in Saskatchewan, Canada

2016 ◽  
Vol 28 (10) ◽  
pp. 1643-1658 ◽  
Author(s):  
Julie G. Kosteniuk ◽  
Debra G. Morgan ◽  
Megan E. O'Connell ◽  
Andrew Kirk ◽  
Margaret Crossley ◽  
...  
Keyword(s):  
Cohort Study ◽  
Incidence Rate ◽  
Retrospective Cohort Study ◽  
Time Trends ◽  
Retrospective Cohort ◽  
Temporal Trends ◽  
Population Based ◽  
Dementia Incidence ◽  
Administrative Health Databases ◽  
Incident Cases

ABSTRACTBackground:Original studies published over the last decade regarding time trends in dementia report mixed results. The aims of the present study were to use linked administrative health data for the province of Saskatchewan for the period 2005/2006 to 2012/2013 to: (1) examine simultaneous temporal trends in annual age- and sex-specific dementia incidence and prevalence among individuals aged 45 and older, and (2) stratify the changes in incidence over time by database of identification.Methods:Using a population-based retrospective cohort study design, data were extracted from seven provincial administrative health databases linked by a unique anonymized identification number. Individuals 45 years and older at first identification of dementia between April 1, 2005 and March 31, 2013 were included, based on case definition criteria met within any one of four administrative health databases (hospital, physician, prescription drug, and long-term care).Results:Between 2005/2006 and 2012/2013, the 12-month age-standardized incidence rate of dementia declined significantly by 11.07% and the 12-month age-standardized prevalence increased significantly by 30.54%. The number of incident cases decreased from 3,389 to 3,270 and the number of prevalent cases increased from 8,795 to 13,012. Incidence rate reductions were observed in every database of identification.Conclusions:We observed a simultaneous trend of decreasing incidence and increasing prevalence of dementia over a relatively short 8-year time period from 2005/2006 to 2012/2013. These trends indicate that the average survival time of dementia is lengthening. Continued observation of these time trends is warranted given the short study period.

scholarly journals Heart rate, intelligence in adolescence, and Parkinson’s disease later in life

2021 ◽  
Author(s):  
Elisa Longinetti ◽  
Yiqiang Zhan ◽  
Mizuki Sata ◽  
Henrik Larsson ◽  
Brian M. D′Onofrio ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Heart Rate ◽  
Parkinson's Disease ◽  
Physical Fitness ◽  
Late Adolescence ◽  
Stress Resilience ◽  
Cox Models ◽  
Hazard Ratios ◽  
Incident Cases

AbstractTo investigate whether physical and cognitive fitness measured in late adolescence was associated with future risk of Parkinson’s disease (PD). The cohort included 1,259,485 Swedish men with physical fitness, body mass index (BMI), resting heart rate (RHR), blood pressure, intelligence quotient (IQ), and stress resilience measured at the age of 17–20 in relation to conscription. Incident cases of PD were ascertained from the Swedish Patient Register. Hazard ratios were estimated from Cox models, after controlling for multiple confounders. We further performed Mendelian randomization (MR) analyses to assess the causality of the associations, using GWAS summary statistics with > 800,000 individuals. During follow-up, we identified 1,034 cases of PD (mean age at diagnosis = 53). Men with an RHR > 100 beats per minute had a higher risk of PD compared to men with an RHR of 60–100 beats per minute (HR = 1.47; 95% CI = 1.08–1.99). Men with IQ above the highest tertile had a higher risk of PD compared to men with an IQ below the lowest tertile (HR = 1.46; 95% CI = 1.19–1.79). We found no association for physical fitness, BMI, blood pressure, or stress resilience. A causal relationship was suggested by the MR analysis between IQ and PD, but not between RHR and PD. RHR and IQ in late adolescence were associated with a higher risk of PD diagnosed at relatively young age. The association of IQ with PD is likely causal, whereas the association of RHR with PD suggests that altered cardiac autonomic function might start before 20 years of age in PD.

scholarly journals Emotional demands at work and risk of long-term sickness absence among 1.5 million Danish employees

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
E Framke ◽  
J K Sørensen ◽  
I E H Madsen ◽  
R Rugulies
Keyword(s):  
Cohort Study ◽  
Confidence Intervals ◽  
Sickness Absence ◽  
Cox Regression ◽  
Job Exposure Matrix ◽  
Future Studies ◽  
Hazard Ratios ◽  
Emotional Demands ◽  
Adjusted Model

Abstract Background Emotional demands concern aspects of work requiring an emotional effort of employees and have been associated with risk of depression and long-term sickness absence (LTSA) in previous studies. Associations may, however, partly be affected by reporting bias. Further, previous studies have primarily been conducted using smaller samples in selected job groups or sectors. We, therefore, examined the association between emotional demands and LTSA using a job exposure matrix (JEM) in a nationwide cohort. Methods We included all employed individuals in Denmark who were 30 to 59 years old in 2000. We assessed emotional demands at work with a JEM. JEM values were categorized into quartiles based on the distribution within each year and updated annually from 2000 to 2009. LTSA was register-based, defined as ≥ 6 weeks and assessed until 2015. Individuals with LTSA from 1998 to 2000 were excluded, yielding a sample of 1,521,352 individuals. Exposure in year t was related to outcome in year t + 1 until 2009. We estimated hazard ratios (HR) and 95% confidence intervals (95%CI) using Cox regression adjusted for age, sex, income and ergonomic job demands. Results During 15,453,980 person-years, we identified 594,858 LTSA cases. In the fully adjusted model, individuals in the highest emotional demands quartile had a HR of 1.30 (95%CI: 1.29-1.31) compared to individuals the lowest quartile Repeating the analysis separately for women and men showed similar results. Conclusions Emotional demands at work were prospectively associated with an increased LTSA risk in this JEM based nationwide cohort study. Key messages This study found that emotional demands at work predict risk of long-term sickness absence. Future studies should focus on factors that may buffer the association between emotional demands at work and long-term sickness absence.

scholarly journals Associations Between Physical Activity and Incident Hypertension Across Strata of Body Mass Index: A Prospective Investigation in a Large Cohort of French Women

2020 ◽  
Vol 9 (23) ◽  
Author(s):  
Conor‐James MacDonald ◽  
Anne‐Laure Madika ◽  
Martin Lajous ◽  
Nasser Laouali ◽  
Fanny Artaud ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Mass Index ◽  
Body Mass ◽  
High Body Mass Index ◽  
Healthy Weight ◽  
Cox Models ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Diet History Questionnaire ◽  
Diet History

Background High body mass index (BMI) and low physical activity are associated with increased risk of hypertension. Few studies have assessed their joint impact or the relation of physical activity and hypertension among individuals within a healthy BMI range. The objective of this study was to investigate the associations between physical activity and hypertension across strata of BMI. Methods and Results We used data from the E3N (Etude Epidémiologique de femmes de la Mutuelle Générale de l´Education) cohort, a French prospective study of women aged 40 to 65 years. We included participants who completed a diet history questionnaire and who did not have prevalent hypertension at baseline, resulting in a total of 41 607 women. Questionnaires assessed time spent undertaking various types of physical activity. Hypertension cases were self‐reported. Cox models were used to calculate hazard ratios (HRs) for physical activity. Associations were assessed over strata of BMI. Among the 41 607 included women, 10 182 cases of hypertension were identified in an average follow‐up time of 14.5 years. Total physical activity was associated with a lower hypertension risk in women within the high‐normal BMI range (BMI, 22.5–24.9) (HR Quartile 1–Quartile 4 , 0.89; 95% CI, 0.79–0.99). An inverse relationship was observed between sports (HR sports >2 hours , 0.87; 95% CI, 0.83–0.93), walking (HR walk >6.5 hours , 0.94; 95% CI, 0.90–1.00), and gardening (HR gardening >2.5 hours , 0.94; 95% CI, 0.89–0.99). Sports were associated with a reduced risk of hypertension in women with a healthy weight, but evidence was weaker in overweight/obese or underweight women. Conclusions Women with a healthy weight were those who could benefit most from practicing sports, and sports provided the largest risk reduction compared with other types of activity.

Migraine as a predictor of mortality: The HUNT study

Cephalalgia ◽  
2015 ◽  
Vol 36 (4) ◽  
pp. 351-357 ◽  
Author(s):  
Anders Nikolai Åsberg ◽  
Lars Jacob Stovner ◽  
John-Anker Zwart ◽  
Bendik Slagsvold Winsvold ◽  
Ingrid Heuch ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cardiovascular Mortality ◽  
Cox Regression ◽  
Population Based ◽  
Risk Of Death ◽  
Hazard Ratios ◽  
All Cause Mortality ◽  
Large Prospective Cohort Study ◽  
Migrainous Headache

Background There is conflicting evidence for the association between migraine and increased mortality risk. The aim of this study was to investigate the relationship between migraine and non-migrainous headache, and all-cause mortality and cardiovascular mortality. Methods In this prospective population-based cohort study from Norway, we used baseline data from the second Nord-Trøndelag Health Survey (HUNT2), performed between 1995 and 1997 in the County of Nord-Trøndelag. These data were linked with a comprehensive mortality database with follow-up through the year 2011. A total of 51,853 (56% of invited) people were categorized based on their answers to the headache questions in HUNT2 (headache free, migraine or non-migrainous headache). Hazard ratios (HRs) of mortality during a mean of 14.1 years of follow-up were estimated using Cox regression. Results During the follow-up period 9408 died, 4321 of these from cardiovascular causes. There was no difference in all-cause mortality between individuals with migraine and non-migrainous headache compared to those without headache or between headache status and mortality by cardiovascular disease. There was, however, among men with migraine without aura a reduced risk of death by cardiovascular diseases (HR 0.72, 95% confidence interval 0.56–0.93). This relationship was not evident in women. Conclusion In this large, prospective cohort study there was no evidence for a higher all-cause mortality or cardiovascular mortality among individuals with migraine.

scholarly journals Risk of depression, suicide and psychosis with hydroxychloroquine treatment for rheumatoid arthritis: a multinational network cohort study

Rheumatology ◽  
2020 ◽  
Author(s):  
Jennifer C E Lane ◽  
James Weaver ◽  
Kristin Kostka ◽  
Talita Duarte-Salles ◽  
Maria Tereza F Abrahao ◽  
...  
Keyword(s):  
Cohort Study ◽  
Suicidal Ideation ◽  
Medical Records ◽  
Negative Control ◽  
Short Term ◽  
Cox Models ◽  
Hazard Ratios ◽  
Full Study ◽  
Propensity Score Stratification

Abstract Objectives Concern has been raised in the rheumatology community regarding recent regulatory warnings that HCQ used in the coronavirus disease 2019 pandemic could cause acute psychiatric events. We aimed to study whether there is risk of incident depression, suicidal ideation or psychosis associated with HCQ as used for RA. Methods We performed a new-user cohort study using claims and electronic medical records from 10 sources and 3 countries (Germany, UK and USA). RA patients ≥18 years of age and initiating HCQ were compared with those initiating SSZ (active comparator) and followed up in the short (30 days) and long term (on treatment). Study outcomes included depression, suicide/suicidal ideation and hospitalization for psychosis. Propensity score stratification and calibration using negative control outcomes were used to address confounding. Cox models were fitted to estimate database-specific calibrated hazard ratios (HRs), with estimates pooled where I2 &lt;40%. Results A total of 918 144 and 290 383 users of HCQ and SSZ, respectively, were included. No consistent risk of psychiatric events was observed with short-term HCQ (compared with SSZ) use, with meta-analytic HRs of 0.96 (95% CI 0.79, 1.16) for depression, 0.94 (95% CI 0.49, 1.77) for suicide/suicidal ideation and 1.03 (95% CI 0.66, 1.60) for psychosis. No consistent long-term risk was seen, with meta-analytic HRs of 0.94 (95% CI 0.71, 1.26) for depression, 0.77 (95% CI 0.56, 1.07) for suicide/suicidal ideation and 0.99 (95% CI 0.72, 1.35) for psychosis. Conclusion HCQ as used to treat RA does not appear to increase the risk of depression, suicide/suicidal ideation or psychosis compared with SSZ. No effects were seen in the short or long term. Use at a higher dose or for different indications needs further investigation. Trial registration Registered with EU PAS (reference no. EUPAS34497; http://www.encepp.eu/encepp/viewResource.htm? id=34498). The full study protocol and analysis source code can be found at https://github.com/ohdsi-studies/Covid19EstimationHydroxychloroquine2.

scholarly journals Dietary Anti-Oxidant Capacity, Dietary Inflammation Index, and the Risk of Stroke in a Large Prospective Cohort Study.

2021 ◽  
Author(s):  
Conor-James MacDonald ◽  
Nasser Laouali ◽  
Anne-Laure Madika ◽  
Gianluca Severi ◽  
Sharmila sagnier ◽  
...  
Keyword(s):  
Dose Response ◽  
P Value ◽  
Cox Models ◽  
Inflammatory Index ◽  
Hazard Ratios ◽  
Clear Dose Response ◽  
Study Population ◽  
Diet History Questionnaire ◽  
Anti Oxidant ◽  
Large Prospective Cohort Study

Abstract BackgroundWhilst the Western and Mediterranean/prudent diets have long been associated with the risk of stroke, it is less clear if increased inflammation and reduction of oxidations are their respective mechanisms. This study aimed to understand the associations between the dietary inflammatory index (DII), and total anti-oxidant capacity of the diet (TAC), with regards to stroke risk.MethodsThe study population included 71,460 women free of cardiovascular disease at baseline from the E3N cohort, who completed a diet history questionnaire which was used to estimate the dietary pattern scores. Scores were considered grouped as quintiles and as splines in order to determine the dose-response shape. Hazard ratios (HRs) and 95% confidence intervals (95% CI) for hypertension were estimated with multivariate Cox models with age as the time scale, and adjusted for potential confounding factors. After Bonferroni correction, a p-value of 0.013 was considered significant.ResultsOver 14.5 years of follow-up, 414 cases of incident stroke were identified. The Western, and Prudent dietary patterns were both highly associated with the risk of stroke (Western HRQ1Q4 = 1.85 [1.27: 2.69], p-trend = 0.002, Prudent HRQ1Q4 = 0.59 [0.44: 0.78], p-trend < 0.001), as was TAC from non-coffee sources (HRQ1Q4 = 0.47 [0.33: 0.68], p-trend < 0.001). All three showed a clear dose-response, and the associations with the Western and Prudent scores were consistent in sensitivity analysis. Weaker evidence was observed for DII (HRQ1Q4 = 1.33 [1.01: 1.78], p-trend = 0.03), which did not show a clear dose-response. TAC from coffee was not associated with the risk of stroke.ConclusionThese results suggest that diets high in anti-oxidants are associated with a reduced risk of stroke, but that inflammation from the diet does not play as large a part in the risk of stroke. Factors other than inflammation may be driving associations with stroke and western diet.

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