Incidence of dementia: evidence for an effect modification by gender. The ILSA Study

2013 ◽  
Vol 25 (11) ◽  
pp. 1867-1876 ◽  
Author(s):  
Marianna Noale ◽  
Federica Limongi ◽  
Sabina Zambon ◽  
Gaetano Crepaldi ◽  
Stefania Maggi

ABSTRACTBackground:Gender differences for incidence of dementia among elderly people have been usually investigated considering gender as a predictor and not as a stratification variable.Methods:Analyses were based on data collected by the Italian Longitudinal Study on Aging (ILSA), which enrolled 5,632 participants aged 65–84 years between 1992 and 2000. During a median follow-up of 7.8 years, there were 194 cases of incident dementia in the participants with complete data. Cox proportional hazard models for competing risks, stratified by sex, were defined to determine risk factors in relation to developing dementia.Results:The incidence rate of dementia increased from 5.57/1,000 person-years at 65–69 years of age to 30.06/1,000 person-years at 80–84 years. Cox proportional hazard models for competing risks of incidence of dementia and death revealed that, among men, significant risk factors were heart failure, Parkinson's disease, family history of dementia, mild depressive symptomatology and age, while triglycerides were associated with a lower risk of developing dementia. Significant risk factors in women were age, both mild and severe depressive symptomatology, glycemia ≥109 mg/dL, and a BMI < 24.1 kg/m2. Even as little as three years of schooling was found to be a significant protective factor against the incidence of dementia only for women.Conclusions:Our results suggest that there is an effect modification by gender in our study population in relation to the association between low education level, lipid profile, BMI, and glycemia and dementia.

2021 ◽  
pp. neurintsurg-2020-016985
Author(s):  
Jin Liu ◽  
Jing Tang ◽  
Zuchao Gu ◽  
Yu Zhang ◽  
Shenghui Yu ◽  
...  

BackgroundIt is unclear whether the sandwich vertebra, is at higher risk of new symptomatic fractures (NSFs), and whether prophylactic augmentation might benefit patients with sandwich vertebrae.ObjectiveTo compare fracture-free probabilities of sandwich, ordinary-adjacent, and non-adjacent vertebrae, and identify predictors of NSFs.MethodsData were retrospectively analyzed for patients who had undergone vertebral augmentation resulting in sandwich vertebrae. NSF rates were determined and predictors were identified using Cox proportional hazard models.ResultsThe analysis included 1408 untreated vertebrae (147 sandwich, 307 ordinary-adjacent, 954 non-adjacent vertebrae) in 125 patients. NSFs involved 19 sandwich, 19 ordinary-adjacent, and 16 non-adjacent vertebrae. The NSF rate was significantly higher in the patients with sandwich vertebrae (27.2%) than among all patients (14.8%). At the vertebra-specific level, the NSFs rate was 12.9% for sandwich vertebrae, significantly higher than 6.2% for ordinary-adjacent and 1.7% for non-adjacent vertebrae. The corresponding fracture-free probabilities of sandwich, ordinary-adjacent, and non-adjacent vertebrae were 0.89, 0.95, and 0.99 at 1 year, and 0.85, 0.92, and 0.98 at 5 years (p<0.05). Cox modeling identified the following as predictors for occurrence of an NSF in a given vertebra: vertebra location, type of vertebrae, number of augmented vertebrae, and puncture method.ConclusionSandwich vertebrae are at higher risk of NSFs than ordinary-adjacent and non-adjacent vertebrae, and several NSF risk factors were identified. Since 85% of sandwich vertebrae are fracture-free for 5 years and NSF risk increases with the number of augmented vertebrae, prophylactic augmentation of every sandwich vertebra may be unnecessary.


2021 ◽  
Vol 20 ◽  
pp. 153303382110049
Author(s):  
Tao Ran ◽  
ZhiJi Chen ◽  
LiWen Zhao ◽  
Wei Ran ◽  
JinYu Fan ◽  
...  

Background and Objective: Gastric cancer (GC) is a common tumor malignancy with high incidence and poor prognosis. Laminin is an indispensable component of basement membrane and extracellular matrix, which is responsible for bridging the internal and external environment of cells and transmitting signals. This study mainly explored the association of the LAMB1 expression with clinicopathological characteristics and prognosis in gastric cancer. Methods: The expression data and clinical information of gastric cancer patients were downloaded from The Cancer Genome Atlas (TCGA) and Asian Cancer Research Group (ACRG). And we analyzed the relationship between LAMB1 expression and clinical characteristics through R. CIBERSORTx was used to calculate the absolute score of immune cells in gastric tumor tissues. Then COX proportional hazard models and Kaplan-Meier curves were performed to evaluate the role of LAMB1 and its influence on prognosis in gastric cancer patients. Finally, GO and KEGG analysis were applied for LAMB1-related genes in gastric cancer, and PPI network was constructed in Cytoscape software. Results: In the TCGA cohort, patients with gastric cancer frequently generated LAMB1 gene copy number variation, but had little effect on mRNA expression. Both in the TCGA and ACRG cohorts, the mRNA expression of LAMB1 in gastric cancer tissues was higher than it in normal tissues. All patients were divided into high expression group and low expression group according to the median expression level of LAMB1. The elevated expression group obviously had more advanced cases and higher infiltration levels of M2 macrophages. COX proportional hazard models and Kaplan-Meier curves revealed that patients with enhanced expression of LAMB1 have a worse prognosis. GO/KEGG analysis showed that LAMB1-related genes were enriched in PI3K-Akt signaling pathway, focal adhesion, ECM-receptor interaction, etc. Conclusions: The high expression of LAMB1 in gastric cancer is related to the poor prognosis of patients, and it may be related to microenvironmental changes in tumors.


2020 ◽  
Author(s):  
Daniel C McFarland ◽  
Rebecca M. Saracino ◽  
Andrew H. Miller ◽  
William Breitbart ◽  
Barry Rosenfeld ◽  
...  

Background: Lung cancer-related inflammation is associated with depression. Both elevated inflammation and depression are associated with worse survival. However, outcomes of patients with concomitant depression and elevated inflammation are not known. Materials & methods: Patients with metastatic lung cancer (n = 123) were evaluated for depression and inflammation. Kaplan–Meier plots and Cox proportional hazard models provided survival estimations. Results: Estimated survival was 515 days for the cohort and 323 days for patients with depression (hazard ratio: 1.12; 95% CI: 1.05–1.179), 356 days for patients with elevated inflammation (hazard ratio: 2.85, 95% CI: 1.856–4.388), and 307 days with both (χ2 = 12.546; p < 0.001]). Conclusion: Depression and inflammation are independently associated with inferior survival. Survival worsened by inflammation is mediated by depression-a treatable risk factor.


2019 ◽  
Vol 47 (1) ◽  
pp. 148-176 ◽  
Author(s):  
Kevin Koehler ◽  
Holger Albrecht

This article presents a systematic analysis of military coups following popular mass uprisings in nondemocratic regimes, conceptualized as endgame coups. Drawing on our original, medium- n data set of revolutionary situations, we find that such endgame coups form a distinct type of military intervention in politics. Compared to regular coups, episodes of popular mass contestation prompt conservative interventions in politics of the military’s leadership aimed at preserving the regime’s authoritarian infrastructure. A systematic test of factors characterizing postcoup political trajectories is based on Cox proportional hazard models and provides empirical evidence in contrast to the widely held notion of “democratic coups.” Our findings reveal that endgame coups are conservative rollback coups, executed by military leaderships, that result in continued political instability and illiberal politics.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hirokazu Honda ◽  
Miho Kimachi ◽  
Noriaki Kurita ◽  
Nobuhiko Joki ◽  
Masaomi Nangaku

Abstract Recent studies have reported that high mean corpuscular volume (MCV) might be associated with mortality in patients with advanced chronic kidney disease (CKD). However, the question of whether a high MCV confers a risk for mortality in Japanese patients remains unclear. We conducted a longitudinal analysis of a cohort of 8571 patients using data derived from the Japan Dialysis Outcomes and Practice Patterns Study (J-DOPPS) phases 1 to 5. Associations of all-cause mortality, vascular events, and hospitalization due to infection with baseline MCV were examined via Cox proportional hazard models. Non-linear relationships between MCV and these outcomes were examined using restricted cubic spline analyses. Associations between time-varying MCV and these outcomes were also examined as sensitivity analyses. Cox proportional hazard models showed a significant association of low MCV (< 90 fL), but not for high MCV (102 < fL), with a higher incidence of all-cause mortality and hospitalization due to infection compared with 94 ≤ MCV < 98 fL (reference). Cubic spline analysis indicated a graphically U-shaped association between baseline MCV and all-cause mortality (p for non-linearity p < 0.001). In conclusion, a low rather than high MCV might be associated with increased risk for all-cause mortality and hospitalization due to infection among Japanese patients on hemodialysis.


2017 ◽  
Vol 23 (2) ◽  
pp. 281-294 ◽  
Author(s):  
Juan Gabriel Brida ◽  
Chiara Dalle Nogare ◽  
Raffaele Scuderi

Museum attendance is often seen as a chance for visitors to learn and thus increase their cultural capital. However, a share of the visitors may decide to attend museums for reasons other than cultural capital accumulation. This article investigates whether learning process takes place also in the case of tourists whose main motivation for the visit is recreational. Different attitudes towards cultural consumption may have a role in explaining visit length, seen as a proxy for learning. We present an empirical analysis of the determinants of both willingness to stay and actual length of stay at a museum. Evidence is based on a survey of tourists visiting the Italian museum of Vittoriale. Generalized ordered logit under partial proportional odds assumption and Cox proportional hazard models are used to assess the role of the covariates. A set of economic, socio-demographic, trip-related and psychographic controls is tested, with particular emphasis on motivation.


2020 ◽  
Author(s):  
Meg E Fluharty ◽  
Rebecca Hardy ◽  
George B. Ploubidis ◽  
Benedetta Pongiglione ◽  
David Bann

AbstractIntroductionDisadvantaged socioeconomic position (SEP) in early and adult life has been repeatedly associated with premature mortality. However, it is unclear whether these inequalities differ across time, nor if they are consistent across different SEP indicators.MethodsBritish birth cohorts born in 1946, 1958 and 1970 were used, and multiple SEP indicators in early and adult life were examined. Deaths were identified via national statistics or notifications. Cox proportional hazard models were used to estimate associations between SEP indicators and mortality risk—from 26-43 (n=40,784), 26-58 (n=35,431), and 26-70 years (n=5,353).ResultsMore disadvantaged SEP was associated with higher mortality risk—magnitudes of association were similar across cohort and each SEP indicator. For example, hazards ratios (95% CI) between 26-43 years comparing lowest to highest father’s social class were 2.74 (1.02—7.32) in 1946c, 1.66 (1.03—2.69) in 1958c, and 1.94 (1.20—3.15) in 1970c. Childhood social class, adult social class, and housing tenure were each independently associated with mortality risk.ConclusionsSocioeconomic circumstances in early and adult life appear to have had persisting associations with premature mortality from 1971—2016. This reaffirms the need to address socioeconomic factors across life to reduce inequalities in survival to older age.


2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Junwon Lee ◽  
Hyun Goo Kang ◽  
Hae Rang Kim ◽  
Christopher Seungkyu Lee ◽  
Min Kim ◽  
...  

AbstractWe investigated the incidence and risk factors of late age-related macular degeneration (AMD) in the fellow eye (FE) without significant drusen of patients with unilateral exudative macular neovascularization (MNV). In this retrospective study, 241 eligible patients who were followed-up for more than 3 years were enrolled. We analyzed the incidence and hazard ratios (HRs) of late AMD in the FE according to demographic and ophthalmologic variables. Hypopigmentation on color fundus photography (CFP) corresponds to shallow irregular RPE elevation (SIRE), so-called “double-layer sign” and/or “attenuation or disruption of RPE and/or ellipsoid zone” on OCT. The 5-year incidence of FE exudative MNV conversion was 8.6%. The 5-year incidence of FE exudative MNV of large hypopigmentation (≥ 0.5 disc area; DA) and small hypopigmentation (< 0.5 DA) on CFP, and SIRE (≥ 1000 µm) and small RPE elevation (< 1000 µm) on OCT were 36.2%, 14.2%, 55.0%, and 15.6%, respectively. The multivariate Cox proportional hazard model revealed that large hypopigmentation, small hypopigmentation, SIRE, and small RPE elevation showed HRs of 23.230, 8.037, 132.589, and 41.823 for FE exudative MNV occurrence, respectively. Hypopigmentation on CFP and SIRE on OCT could represent the same lesion. Even small hypopigmentation and small RPE elevation were significant risk factors for progression to exudative MNV.


2019 ◽  
Vol 8 (9) ◽  
pp. 1273-1281 ◽  
Author(s):  
Dong Cen ◽  
Hui Liu ◽  
Zhe Wan ◽  
Zhongjie Lin ◽  
Yanting Wang ◽  
...  

Purpose Gallbladder neuroendocrine neoplasm (GB-NEN) is a relatively rare neoplasm, accounting for 0.5% of all neuroendocrine neoplasm cases and 2.1% of gallbladder cancers. Because of the limited understanding of GB-NEN, the aim of this study was to explore the clinicopathology and survival of GB-NEN patients selected from the Surveillance, Epidemiology, and End Results (SEER) database. Methods A total of 248 GB-NEN patients from the SEER database diagnosed between 2004 and 2015 were included. Kaplan–Meier curves were used to examine the survival time. Multivariate Cox proportional hazard models were used to estimate hazard ratios with 95% confidence intervals to analyze the impact of factors on overall survival and cancer-specific survival. Results The majority of the GB-NEN patients were women (67.3%), white (77%), and married (61.7%). Most tumors were <2 cm in size (31.0%), G3 stage (25.8%), and distant SEER stage (41.1%). 62.9% and 64.5% of cases showed an absence of lymph node metastasis and tumor metastasis, respectively. Patients who received gallbladder surgery had significantly better survival outcomes (P < 0.001). However, patients who received both gallbladder surgery and lymph node resection did not have better survival outcome compared with patients who received only gallbladder surgery. Multivariate Cox proportional hazard models indicated that older age, unmarried status, large tumor size (>5 cm), and distant SEER stage were significant independent predictors for decreased overall survival time and cancer-specific survival time (P < 0.05). Conclusion Age, marital status, tumor size, and SEER stage were predictors for the survival of GB-NEN patients. Gallbladder surgery was associated with better survival, but the combination of gallbladder surgery and lymphadenectomy had no effect on survival outcomes.


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