Incidence of fractures and changes over time among the aged in a Finnish municipality: a population-based 12-year follow-up

2007 ◽  
Vol 19 (4) ◽  
pp. 269-276 ◽  
Author(s):  
Maarit Piirtola ◽  
Tero Vahlberg ◽  
Raimo Isoaho ◽  
Pertti Aarnio ◽  
Sirkka-Liisa Kivelä
Keyword(s):  
Population Based ◽  
Changes Over Time ◽  
Over Time

scholarly journals Evolution of impulsive–compulsive behaviors and cognition in Parkinson’s disease

2019 ◽  
Vol 267 (1) ◽  
pp. 259-266
Author(s):  
Aleksander H. Erga ◽  
Guido Alves ◽  
Ole Bjørn Tysnes ◽  
Kenn Freddy Pedersen
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Short Form ◽  
Population Based ◽  
Self Report ◽  
Cognitive Changes ◽  
Compulsive Behaviors ◽  
Changes Over Time ◽  
Over Time

Abstract The longitudinal course of ICBs in patients with Parkinson’s disease (PwP) relative to controls has not been explored as of yet. The aim of this study is to determine the frequency, evolution and associated cognitive and clinical features of impulsive and compulsive behaviors (ICBs) over 4 years of prospective follow-up in a population-based cohort with early Parkinson’s disease (PD). We recruited 124 cognitively intact participants with early PD and 156 matched controls from the Norwegian ParkWest study. ICBs were assessed using the self-report short form version of the Questionnaire for Impulsive–Compulsive Disorders in PD. Cognitive changes were examined in PwP with and without ICBs who completed the 4-year follow-up. Generalized linear mixed modelling and mixed linear regression were used to analyze clinical factors and cognitive changes associated with ICBs in PwP over time. ICBs were more common in PwP than controls at all visits, with an age-adjusted odds ratio (OR) varying between 2.5 (95% CI 1.1–5.6; p = 0.022) and 5.1 (95% CI 2.4–11.0; p < 0.001). The 4-year cumulative frequency of ICBs in PwP was 46.8% and 23.3% developed incident ICBs during the study period, but the presence of ICBs was non-persistent in nearly 30%. ICBs were independently associated with younger age (OR 0.95, 95% CI 0.91–0.99: p = 0.008) and use of dopamine agonist (OR 4.1, 95% CI 1.56–10.69). Cognitive changes over time did not differ between patients with and without ICBs. In conclusion, ICBs are common in PwP, but are often non-persistent and not associated with greater cognitive impairment over time.

scholarly journals High Circulating Free Thyroxine Levels May Increase the Risk of Frailty: The Rotterdam Study

2017 ◽  
Vol 103 (1) ◽  
pp. 328-335 ◽  
Author(s):  
Arjola Bano ◽  
Layal Chaker ◽  
Josje Schoufour ◽  
M Arfan Ikram ◽  
Maryam Kavousi ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Frailty Index ◽  
Population Based ◽  
Free Thyroxine ◽  
Rotterdam Study ◽  
Prediction And Prevention ◽  
Increased Risk ◽  
Changes Over Time ◽  
Over Time

Abstract Context Thyroid hormones affect metabolism in various tissues, organs, and systems. However, the overall impact of thyroid function on an individual’s vulnerability to adverse outcomes remains unclear. Objective To investigate the cross-sectional and prospective association of thyroid function with the frailty index, a well-established measure of overall health. Design and Setting The Rotterdam Study, a population-based, prospective cohort study. Participants and Main Outcome Measurements Participants with baseline measurements of thyroid function and the frailty index were eligible. The frailty index was measured at baseline and after a median follow-up time of 10.1 years (interquartile range, 5.7 to 10.8 years). A higher frailty index indicated a worse health state. We assessed the association of thyroid function with frailty at baseline, frailty at follow-up, and frailty changes over time, adjusting for age, sex, cohort, smoking, alcohol, and education. Results We included 9640 participants (mean age, 64.9 years). There was a U-shaped association of thyrotropin (TSH; P &lt; 0.0003) and free thyroxine (FT4; P &lt; 0.0001) with frailty at baseline. There was no association of TSH, but a positive association of FT4 with frailty at follow-up and frailty changes over time (β, 1.22; confidence interval, 0.73 to 1.72 per 1 unit FT4). Conclusion In this population-based study, participants with low and high thyroid function were more likely to be frail than participants with normal thyroid function. However, only those with higher FT4 levels had an increased risk of becoming more frail over time. The identification of FT4 as a potential marker of health deterioration could have future implications regarding the prediction and prevention of frailty.

scholarly journals Stress-related inflammation and social withdrawal in mothers after childhood cancer diagnosis

2021 ◽  
Author(s):  
Emily K Lindsay ◽  
Tristen K. Inagaki ◽  
Catherine Walsh ◽  
Berhane Messay ◽  
Linda Ewing ◽  
...  
Keyword(s):  
Social Network ◽  
Social Behavior ◽  
Systemic Inflammation ◽  
Cancer Diagnosis ◽  
Social Roles ◽  
Social Changes ◽  
Related Stress ◽  
Changes Over Time ◽  
Over Time

Objective: Acute inflammation-induced sickness behavior involves changes in social behavior that are believed to promote recovery. Whether chronic inflammation can influence social behaviors in ways that promote recovery is unknown. In a sample of mothers of a child with cancer, this report explores the relationship between inflammation that accompanies the stress of diagnosis and changes in social network, cancer-related stress, and inflammation across one year. Three hypotheses were tested, that (1) initial stress would associate with initial inflammation, (2) initial inflammation would predict social changes over time, and (3) social changes over time would buffer stress and inflammation over time. Methods: Cancer-related stress (Impact of Events Scale), social network (social roles and contacts from the Social Network Inventory), and systemic inflammation (circulating IL-6) were assessed in 120 mothers three times after their child’s cancer diagnosis: following diagnosis (T1), 6-month follow-up (T2), and 12-month follow-up (T3). Results: Consistent with predictions, greater cancer-related stress following diagnosis (T1) was associated with higher IL-6 following diagnosis (T1; b=.014, p=.008). In turn, higher IL-6 following diagnosis (T1) was associated with a decrease in social roles over time (T1--&gt;T3; B=-.030, p=.041), particularly peripheral social roles. Finally, dropping social roles over time (T1--&gt;T3) was associated with decreases in cancer-related stress (B=21.83, p=.040) and slower increases in IL-6 (B=.940, p=.036) over time.Conclusions: This study provides a first indication that chronic stress-related systemic inflammation may predict changes in social behavior that associate with stress recovery and slower increases in inflammation in the year following a major life stressor.

scholarly journals Natural history of excessive daytime sleepiness: a population-based 5-year longitudinal study

SLEEP ◽  
2019 ◽  
Vol 43 (3) ◽  
Author(s):  
I Jaussent ◽  
C M Morin ◽  
H Ivers ◽  
Y Dauvilliers
Keyword(s):  
Sleep Duration ◽  
Excessive Daytime Sleepiness ◽  
Daytime Sleepiness ◽  
Adult Population ◽  
Population Based ◽  
Normal Weight ◽  
Point Reduction ◽  
Nighttime Sleep ◽  
Over Time

Abstract Study Objectives To document the rates of persistent, remitted, and intermittent excessive daytime sleepiness (EDS) in a longitudinal 5-year community study of adults and to assess how changes in risk factors over time can predict improvement of daytime sleepiness (DS). Methods Participants were recruited in 2007–2008 as part of a population-based epidemiological study implemented in Canada. They completed postal assessments at baseline and at each yearly follow-up. An Epworth Sleepiness Scale total score &gt;10 indicated clinically significant EDS; a 4-point reduction between two consecutive evaluations defined DS improvement. Socio-demographic, lifestyle, health characteristics, and sleep-related measures (e.g. insomnia symptoms, sleep duration, sleep medication) were self-reported at each time point. Cox proportional-hazard models were used to predict EDS and DS remissions over 5 years. Results Among the 2167 participants, 33% (n = 714) met criteria for EDS at baseline, of whom 33% had persistent EDS, 44% intermittent EDS, and 23% remitted EDS over the follow-up. Furthermore, 61.4% of 2167 initial participants had stable DS, 27.1% sustained DS improvement and 8.5% transient improvement over the follow-up. The main predictors of EDS remission or DS improvement were normal weight, taking less hypnotics, having hypertension, increased nighttime sleep duration, and decreased insomnia, and depressive symptoms. Conclusions EDS waxes and wanes over time with frequent periods of remission and is influenced by behavioral characteristics and changes in psychological, metabolic, and nighttime sleep patterns. Targeting these predictors in future interventions is crucial to reduce DS in the general adult population.

scholarly journals P295 VALIDation of the IBD-Disk instrument for assessing disability in inflammatory bowel diseases in a population-based cohort: The VALIDate study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S299-S301
Author(s):  
C Le Berre ◽  
A Bourreille ◽  
M Flamant ◽  
G Bouguen ◽  
L Siproudhis ◽  
...  
Keyword(s):  
Internal Consistency ◽  
Inflammatory Bowel Diseases ◽  
Population Based ◽  
Large Cohort ◽  
Inactive Disease ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Physician Patient ◽  
Over Time

Abstract Background Inflammatory bowel diseases (IBD) are disabling disorders. The IBD-Disability Index (IBD-DI) was developed for quantifying disability in IBD patients but is difficult to use. The IBD-Disk is a shortened and visual adaptation of the IBD-DI. It has not been validated yet. The main objectives were to validate the IBD-Disk in a large cohort of IBD patients and to assess its variability over time. Methods From March 2018 to July 2019, IBD patients from three university-affiliated hospitals responded twice to both IBD-Disk and IBD-DI at 3–12 months intervals (NCT03590639). Validation included concurrent validity, reproducibility, internal consistency, and evaluation of IBD-Disk correlation with IBD activity. Variability was assessed by comparing scores between baseline and follow-up visits. Results A total of 559 patients (73% Crohn’s disease, 27% ulcerative colitis) were included and 389 were followed up (Table 1). There was a good correlation between IBD-Disk and IBD-DI scores (r = 0.75, p &lt; 0.001) (Figure 1). The IBD-Disk was significantly higher in patients with active disease according to Physician/Patient Global Assessment (Figure 2), clinical scores (Figure 3), and biomarkers levels, compared with patients with inactive disease. Reproducibility was excellent (intra-class correlation coefficient = 0.90), as well as internal consistency (Cronbach’s α = 0.89). The IBD-Disk score significantly decreased in patients becoming inactive over time. Conclusion This is the first study to validate the IBD-Disk in a large cohort of IBD patients, demonstrating that it is a valid and reliable tool for quantifying disability in clinical practice. Further studies are warranted to assess its correlation with endoscopic activity, to explore its responsiveness to change, and to evaluate the factors associated with disability.

Changes in Voice- and Swallowing-Related Symptoms After Thyroidectomy: One-Year Follow-Up Study

2018 ◽  
Vol 127 (3) ◽  
pp. 171-177 ◽  
Author(s):  
Young Min Park ◽  
Kyung Ho Oh ◽  
Jae-Gu Cho ◽  
Seung-Kuk Baek ◽  
Soon-Young Kwon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Symptom Relief ◽  
Temporal Changes ◽  
Rehabilitation Programs ◽  
Significant Difference ◽  
One Year ◽  
Associated Risk Factors ◽  
Changes Over Time ◽  
Over Time

Objective: We analyzed the changes in voice- and swallowing-related symptoms that occurred over time in patients who underwent thyroidectomy and identified any associated risk factors. Methods: One hundred and three patients who underwent thyroidectomy were enrolled. Results: The mean thyroidectomy voice-related questionnaire (TVQ) score before surgery was 12.41 ± 12.19; it significantly increased to 28.24 ± 18.01 ( P < .001) 1 month postoperatively, decreased to 24.02 ± 17.30 ( P = .014) and 20.66 ± 15.29 ( P = .023) 3 and 6 months postoperatively, respectively. It was continuously decreased to 18.83 ± 14.63 twelve months postoperatively. The temporal changes in TVQ scores between patients who underwent total thyroidectomy or lobectomy were significantly different. There was a statistically significant difference in the temporal changes in TVQ according to whether neck dissection was performed. The temporal changes in TVQ in patients with and without extrathyroidal extension were significantly different. Conclusions: Voice- and swallowing-related discomfort in patients who received thyroidectomy showed dynamic changes over time. There was a significant difference in the degree of change according to clinicopathological factors. Patients with these risk factors may benefit from appropriate patient education and various rehabilitation programs for symptom relief.

OS09.4.A Health-related quality of life in low-grade glioma survivors 26 years after diagnosis

2021 ◽  
Vol 23 (Supplement_2) ◽  
pp. ii12-ii12
Author(s):  
F W Boele ◽  
J C Reijneveld ◽  
P C de Witt Hamer ◽  
H F van Thuijl ◽  
P Wesseling ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Low Grade ◽  
Group Level ◽  
Related Quality ◽  
Health Related ◽  
Changes Over Time ◽  
Over Time

Abstract BACKGROUND Many patients with low-grade gliomas (LGGs) continue to survive for many years, yet little is known about patients’ health-related quality of life (HRQOL) in long-term survivorship. We previously investigated HRQOL in LGG patients diagnosed on average 6 years prior to assessment (T1, N=195) with a follow-up in stable patients on average 12 years after diagnosis (T2, N=65). We present a final follow-up of LGG survivors (T3), now decades after diagnosis. MATERIAL AND METHODS We invited patients who participated in our previous assessment (N=65), regardless of disease status. Patients completed questionnaires to assess HRQOL, fatigue, and depressive symptoms: Short Form-36 Health Survey (SF-36), European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Brain Tumour Module (EORTC BN20), Checklist Individual Strength (CIS), and the Center for Epidemiological Studies Depression Scale (CES-D). Changes over time (T1-T2-T3) on group level and participant level were assessed. RESULTS Of the 65 patients, 18 (27.7%) were deceased, 3 (4.6%) experienced tumour progression to WHO III, 7 (10.8%) declined, and 3 (4.6%) could not be contacted. Thirty-four patients (52.3%) participated. Of these, 2 had missing HRQOL data, with 32 patients included in analysis. Survivors were M=52.0 (sd=11.3) years old and diagnosed M=26.2 (sd=3.7, range 19–35) years prior. On group level, a statistically significant (but not clinically relevant) improvement in mental health (p=0.049), and a clinically relevant (but not statistically significant) decline in emotional role functioning was found. No other group-level changes over time in HRQOL were found. Minimal detectable change in HRQOL scale scores over time was observed in individual participants (28.1% only improvement; 25.0% only decline; 21.9% both improvement and decline) with 25.0% remaining completely stable. At T3, 25.0% of survivors scored above the cut-off for high risk of clinical depression (≥16 CES-D), and 53.1% of survivors classed as severely fatigued (≥35 CIS). CONCLUSION In this cohort of LGG survivors, assessed decades after diagnosis and treatment, HRQOL does not appear to be greatly impacted during survivorship. However, depressive symptoms and fatigue remain relatively common. Findings can help inform patients, their families, and clinicians and can serve as a benchmark for treatment trials evaluating interventions that can have very long-term effects.

Abstract 2145: The Long-term Trajectory Of Functional Decline Before And After Stroke: The Northern Manhattan Study

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Mandip Dhamoon ◽  
Yeseon P Moon ◽  
Myunghee C Paik ◽  
Consuelo McLaughlin-Mora ◽  
Ralph L Sacco ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Functional Status ◽  
Functional Decline ◽  
Population Based ◽  
Insurance Status ◽  
Population Based Study ◽  
Before And After ◽  
Over Time

Background: Previous research in our population showed a steeper long-term decline in functional status after first ischemic stroke among those with Medicaid or no insurance compared to those with Medicare or private insurance. With only post-stroke data, it was unknown whether these findings were caused by the stroke. We sought to compare the long-term trajectory of functional status before and after ischemic stroke. Methods: The Northern Manhattan Study contains a prospective, population-based study of stroke-free individuals >40 years of age, followed for a median of 10 years. The Barthel index (BI) was assessed annually. Generalized estimating equations were used to assess functional decline over time before and after stroke. The 6 months after stroke were ignored, since the course of recovery during this period is well documented, and our interest was the long-term course of functional status. Follow-up was censored at the time of recurrent stroke. Sociodemographic and medical risk factors were included and results were stratified by insurance status. Linearity of the curves was evaluated by plotting residuals against time and with a lowess curve. Results: Among 3298 participants, 261 had an ischemic stroke during follow-up, of which 51 died within 6 months of stroke. Among the remaining 210 participants, mean age at stroke (standard deviation) was 77+9 years, 38% were male, 52% were Hispanic, 37% had diabetes, and 31% had coronary artery disease. There was no difference in functional decline over time before and after stroke (p= 0.51), with a decline of 0.96 BI points per year before stroke (p<.0001) and 1.24 after stroke (p=0.001). However, when stratified by insurance status, among those with Medicaid or no insurance, in a fully adjusted model, there was a difference in slope before and after stroke (p=0.04), with a decline of 0.58 BI points per year before stroke (p=0.02) and 1.94 after stroke (p=0.001). Other predictors of worse functional status were increasing age, female sex, diabetes, and being married. Conclusion: In this large, prospective, population-based study with long-term follow-up, there was a significantly steeper decline in functional status after ischemic stroke compared to before stroke among those with Medicaid or no insurance, after adjusting for confounders. The cause of this differential decline is not known but may be related to poor control of risk factors, silent strokes, or an effect of socioeconomic status.

La valutazione RM della sclerosi tuberosa

2003 ◽  
Vol 16 (3) ◽  
pp. 547-550
Author(s):  
C. Uggetti
Keyword(s):  
Tuberous Sclerosis ◽  
Neoplastic Transformation ◽  
Pathogenetic Mechanism ◽  
Clinical Correlations ◽  
Asymptomatic Subjects ◽  
Changes Over Time ◽  
Over Time ◽  
Subependymal Nodules ◽  
Rule Out

The myriad brain abnormalities characterising tuberous sclerosis are all the result of the same pathogenetic mechanism, a genetic impairment of the germinative matrix. MR scanning plays a major role in the diagnosis and follow-up of patients who must be monitored up to the age of twenty to rule out the possible neoplastic transformation of subependymal nodules. MR scans should also be offered to the parents of children with tuberous sclerosis to disclose asymptomatic subjects. Starting from a total of 36 scans in a personal series of 24 patients, we describe the best sequences for brain investigation, the different MR findings and their changes over time with possible clinical correlations.

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