scholarly journals Childhood bereavement and adult mortality: A 65-year follow-up of the Stockholm birth cohort

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Hiyoshi ◽  
L Berg ◽  
A Grotta ◽  
Y Almquist ◽  
M Rostila
Keyword(s):  
Life Course ◽  
Birth Cohort ◽  
Mortality Risk ◽  
Excess Mortality ◽  
Parental Loss ◽  
Health Consequences ◽  
Childhood Bereavement ◽  
Bereaved Children ◽  
Death Of A Parent ◽  
The Life Course

Abstract About 3% of children in Sweden, 4-5% in the UK, and 5% in the US experience the death of a parent during childhood. The event is highly unexpected and stressful and could have long-term social and health consequences across the life course. To alleviate grief, bereaved children may engage in health-damaging behaviours such as smoking, alcohol or drug abuse, violence, delinquency and risky sexual behaviour. Few studies have been able to study health consequences by childhood parental loss and mechanisms explaining associations across the life course. Using the Stockholm Birth Cohort Study (SBC), including all children born in 1953 in the metropolitan Stockholm area, we examined whether childhood bereavement is associated with all-cause mortality until age 63 and whether various pathways (e.g. economic, behavioral and social circumstances) account for the association. 15,117 individuals were followed between 1953 and 2018 using survey data and national registry data. We used Cox proportional hazard regression and mediation analysis for survival analysis to decompose direct and indirect effects. The death of a parent was associated with 40 to 50% elevated risk of mortality in offspring, and the association was mediated through delinquent behaviour in adolescence and income in adulthood especially for male offspring. Our findings suggest that parental loss has a life long impact on the mortality risk of bereaved children and that interventions targeting delinquency and socio-economic circumstances in bereaved children could be successful in reducing their excess mortality risk. Key messages Bereavement in childhood has a life-long impact on health. Interventions targeting delinquency and socio-economic circumstances could be successful in reducing the excess mortality risk.

scholarly journals Parental death in childhood and pathways to increased mortality across the life course in Stockholm, Sweden: A cohort study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (3) ◽  
pp. e1003549
Author(s):  
Ayako Hiyoshi ◽  
Lisa Berg ◽  
Alessandra Grotta ◽  
Ylva Almquist ◽  
Mikael Rostila
Keyword(s):  
Cohort Study ◽  
Life Course ◽  
Mortality Risk ◽  
Early Adulthood ◽  
Parental Death ◽  
Delinquent Behaviour ◽  
Bereaved Children ◽  
All Cause Mortality ◽  
Behavioural Factors ◽  
The Life Course

Background Previous studies have shown that the experience of parental death during childhood is associated with increased mortality risk. However, few studies have examined potential pathways that may explain these findings. The aim of this study is to examine whether familial and behavioural factors during adolescence and socioeconomic disadvantages in early adulthood mediate the association between loss of a parent at age 0 to 12 and all-cause mortality by the age of 63. Methods and findings A cohort study was conducted using data from the Stockholm Birth Cohort Multigenerational Study for 12,615 children born in 1953, with information covering 1953 to 2016. Familial and behavioural factors at age 13 to 19 included psychiatric and alcohol problems in the surviving parent, receipt of social assistance, and delinquent behaviour in the offspring. Socioeconomic disadvantage in early adulthood included educational attainment, occupational social class, and income at age 27 to 37. We used Cox proportional hazard regression models, combined with a multimediator analysis, to separate direct and indirect effects of parental death on all-cause mortality. Among the 12,582 offspring in the study (men 51%; women 49%), about 3% experienced the death of a parent in childhood. During follow-up from the age of 38 to 63, there were 935 deaths among offspring. Parental death was associated with an elevated risk of mortality after adjusting for demographic and household socioeconomic characteristics at birth (hazard ratio [HR]: 1.52 [95% confidence interval: 1.10 to 2.08, p-value = 0.010]). Delinquent behaviour in adolescence and income during early adulthood were the most influential mediators, and the indirect associations through these variables were HR 1.03 (1.00 to 1.06, 0.029) and HR 1.04 (1.01 to 1.07, 0.029), respectively. After accounting for these indirect paths, the direct path was attenuated to HR 1.35 (0.98 to 1.85, 0.066). The limitations of the study include that the associations may be partly due to genetic, social, and behavioural residual confounding, that statistical power was low in some of the subgroup analyses, and that there might be other relevant paths that were not investigated in the present study. Conclusions Our findings from this cohort study suggest that childhood parental death is associated with increased mortality and that the association was mediated through a chain of disadvantages over the life course including delinquency in adolescence and lower income during early adulthood. Professionals working with bereaved children should take the higher mortality risk in bereaved offspring into account and consider its lifelong consequences. When planning and providing support to bereaved children, it may be particularly important to be aware of their increased susceptibility to delinquency and socioeconomic vulnerability that eventually lead to higher mortality.

scholarly journals Recomposing persons: Scavenging and storytelling in a birth cohort archive

2021 ◽  
pp. 095269512199539
Author(s):  
Penny Tinkler ◽  
Resto Cruz ◽  
Laura Fenton
Keyword(s):  
Life Course ◽  
Cohort Studies ◽  
Birth Cohort ◽  
Quantitative Data ◽  
Population Level ◽  
Relational Embeddedness ◽  
The Life Course ◽  
Over Time

Birth cohort studies can be used not only to generate population-level quantitative data, but also to recompose persons. The crux is how we understand data and persons. Recomposition entails scavenging for various (including unrecognised) data. It foregrounds the perspective and subjectivity of survey participants, but without forgetting the partiality and incompleteness of the accounts that it may generate. Although interested in the singularity of individuals, it attends to the historical and relational embeddedness of personhood. It examines the multiple and complex temporalities that suffuse people’s lives, hence departing from linear notions of the life course. It implies involvement, as well as reflexivity, on the part of researchers. It embraces the heterogeneity and transformations over time of scientific archives and the interpretive possibilities, as well as incompleteness, of birth cohort studies data. Interested in the unfolding of lives over time, it also shines light on meaningful biographical moments.

Associations between life-course frailty and later-life heart size and function in the 1946 NSHD British birth cohort-an epidemiological study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.C Topriceanu ◽  
J.C Moon ◽  
R Hardy ◽  
A.D Hughes ◽  
N Chaturvedi ◽  
...  
Keyword(s):  
Life Course ◽  
Birth Cohort ◽  
Frailty Index ◽  
Later Life ◽  
Left Ventricular ◽  
Step Change ◽  
Deficit Accumulation ◽  
Heart Size ◽  
And Function ◽  
The Life Course

Abstract Background Cardiovascular diseases are an important component of the multi-morbidity syndrome which is associated with negative health outcomes resulting in a major societal economic burden. An objective way to assess multi-morbidity is to calculate a frailty index based on medical deficit accumulation. Late-life frailty has been validated to predict mortality, but little is known about the association between life-course frailty and cardiovascular health in later-life. Purpose To study the association between life-course frailty and later-life heart size and function using data from the world's longest running birth cohort with continuous follow-up. Methods A 45-deficit frailty index (FI) was calculated at 4 age-intervals across the life-course (0 to 16 years old, 19 to 44 years old, 45 to 54 years old and 60 to 64 years old) in participants from the UK 1946 Medical Research Council (MRC) National Survey of Heath and Development (NSHD) birth cohort. The life-course frailty indices (FI0_16, FI19_44, FI45_54 and FI60_64) reflect the cumulative medical deficits at the corresponding age-intervals. They were used to derive FImean and FIsum reflecting overall-life frailty. The step change in deficit accumulation between age-intervals was also calculated (FI2-1, FI3-1, FI4-1, FI3-2, FI4-2, FI4-3). Echocardiographic data at 60–64 years provided: E/e' ratio, ejection fraction (EF), myocardial contraction fraction index (MCFi) and left ventricular mass index (LVmassi). Generalized linear mixed models with gamma distribution and log link assessed the association between FIs and echo parameters after adjustment for sex, socio-economic position and body mass index. Results 1.805 NSHD participants were included (834 male). Accumulation of a single deficit had a significant impact (p<0.0001 to p<0.049) on LVmassi and MCFi in all the life-course FIs and overall FIs. LVmassi increased by 0.89% to 1.42% for the life-course FIs and by 0.36%/1.82% for FIsum and FImean respectively. MCFi decreased by 0.62% to 1.02% for the life-course FIs and by 0.33%/ 1.04%. for FIsum and FImean respectively. One accumulated deficit translated into higher multiplicative odds (13.2 for FI60-64, 2.1 for FI4-1, 75.4 for FI4-2 and 78.5 for FI4-3) of elevated filling pressure (defined as E/e' ratio >13, p<0.0.005 to p<0.02).A unit increase in frailty decreased LV EF (%) by 11%/12% for FI45-54 and FI60-64 respectively, by 10% to 12% for FI2-1, FI3-1, FI4-1 and FI4-2, and 4%/15% for FIsum and FImean respectively (p<0.0014 to p<0.044). Conclusion Frailty during the life-course, overall life-frailty and the step change in deficit accumulation is associated with later-life cardiac dysfunction. Frailty strain appears to have its greatest impact on pathological myocardial hypertrophy (high LVmassi and low MCFi) potentially paving the way to later-life systolic or diastolic dysfunction in susceptible individuals. Funding Acknowledgement Type of funding source: None

scholarly journals Longitudinal birth cohort study finds that life-course frailty associates with later-life heart size and function

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Constantin-Cristian Topriceanu ◽  
James C. Moon ◽  
Rebecca Hardy ◽  
Nishi Chaturvedi ◽  
Alun D. Hughes ◽  
...  
Keyword(s):  
Life Course ◽  
Birth Cohort ◽  
Left Ventricular ◽  
Step Change ◽  
Deficit Accumulation ◽  
Cardiac Phenotype ◽  
Time Period ◽  
Time Periods ◽  
The Life Course ◽  
Health Deficit

AbstractA frailty index (FI) counts health deficit accumulation. Besides traditional risk factors, it is unknown whether the health deficit burden is related to the appearance of cardiovascular disease. In order to answer this question, the same multidimensional FI looking at 45-health deficits was serially calculated per participant at 4 time periods (0–16, 19–44, 45–54 and 60–64 years) using data from the 1946 Medical Research Council (MRC) British National Survey of Health and Development (NSHD)—the world’s longest running longitudinal birth cohort with continuous follow-up. From these the mean and total FI for the life-course, and the step change in deficit accumulation from one time period to another was derived. Echocardiographic data at 60–64 years provided: ejection fraction (EF), left ventricular mass indexed to body surface area (LVmassi, BSA), myocardial contraction fraction indexed to BSA (MCFi) and E/e′. Generalized linear models assessed the association between FIs and echocardiographic parameters after adjustment for relevant covariates. 1375 participants were included. For each single new deficit accumulated at any one of the 4 time periods, LVmassi increased by 0.91–1.44% (p < 0.013), while MCFi decreased by 0.6–1.02% (p < 0.05). A unit increase in FI at age 45–54 and 60–64, decreased EF by 11–12% (p < 0.013). A single health deficit step change occurring between 60 and 64 years and one of the earlier time periods, translated into higher odds (2.1–78.5, p < 0.020) of elevated LV filling pressure. Thus, the accumulation of health deficits at any time period of the life-course associates with a maladaptive cardiac phenotype in older age, dominated by myocardial hypertrophy and poorer function.

scholarly journals Life-course burden of health deficits associates with later-life heart size and function in the 1946 British birth cohort

2020 ◽  
Author(s):  
Constantin-Cristian Topriceanu ◽  
James C Moon ◽  
Rebecca Hardy ◽  
Nishi Chaturvedi ◽  
Alun Hughes ◽  
...  
Keyword(s):  
Life Course ◽  
Birth Cohort ◽  
Later Life ◽  
Myocardial Contraction ◽  
Left Ventricular ◽  
Heart Size ◽  
Time Periods ◽  
And Function ◽  
The Life Course ◽  
Myocardial Contraction Fraction

Aim: To study the association between the life course accumulation of health deficits and later life heart size and function using data from the 1946 National Survey of Heath and Development (NSHD) British birth cohort, the longest running birth cohort with continuous follow up in the world. Methods and Results: A multidimensional health deficit index (DI) looking at 45 health deficits was serially calculated at 4 time periods of the life course in NSHD participants (0 to 16, 19 to 44, 45 to 54 and 60 to 64 years), and from these the mean and total DI for the life course was derived (DImean, DIsum). The step change in deficit accumulation from one time period to another was also calculated. Echocardiographic data at 60-64 years provided: ejection fraction (EF), left ventricular mass indexed to body surface area (LVmassi, BSA), myocardial contraction fraction indexed to BSA (MCFi) and E/e. Generalized linear models assessed the association between DIs and echocardiographic parameters after adjustment for sex, socioeconomic position and body mass index. 1,375 NSHD participants were included (46.47% male). For each single new deficit accumulated at any one of the 4 time periods of the life course, LVmassi increased by 0.91 to 1.44% (p<0.013), while MCFi decreased by 0.6 to 1.02% (p<0.05 except at 45 to 54 years). One unit increase in DI at age 45 to 54 and 60 to 64 decreased LV EF by 11 to 12% (p<0.013). A single deficit step change occurring between 60-64 years and one of the earlier time periods, translated into significantly higher odds (2.1 to 78.5, p<0.020) of elevated LV filling pressure defined as E/e>13. Conclusion: The accumulation of health deficits at any time period of the life course associates with a maladaptive cardiac phenotype in older age, dominated by myocardial hypertrophy and poorer function. The burden of health deficits appears to strain the myocardium potentially leading to future cardiac dysfunction. Keywords: frailty; cardiovascular disease; ejection fraction; left ventricular mass index; myocardial contraction fraction; E/e.

scholarly journals Socio-economic position at four time points across the life course and all-cause mortality: updated results from the Uppsala Birth Cohort Multigenerational Study

2020 ◽  
Vol 11 (1) ◽  
pp. 27-54
Author(s):  
Amy Heshmati ◽  
Gita D Mishra ◽  
Anna Goodman ◽  
Ilona Koupil
Keyword(s):  
Life Course ◽  
Birth Cohort ◽  
Later Life ◽  
University Hospital ◽  
Sensitive Period ◽  
Saturated Model ◽  
All Cause Mortality ◽  
Economic Position ◽  
The Life Course ◽  
Multigenerational Study

Socio-economic position (SEP) is associated with all-cause mortality across all stages of the life course; however, it is valuable to distinguish at what time periods SEP has the most influence on mortality. Our aim was to investigate whether the effect of SEP on all-cause mortality accumulates over the life course or if some periods of the life course are more important. Our study population were from the Uppsala Birth Cohort Multigenerational Study, born 1915–29 at Uppsala University Hospital, Sweden. We followed 3,951 men and 3,601 women who had SEP at birth available, during childhood (at age ten), in adulthood (ages 30–45) and in later life (ages 50–65) from 15 September 1980 until emigration, death or until 31 December 2010. We compared a set of nested Cox proportional regression models, each corresponding to a specific life course model (critical, sensitive and accumulation models), to a fully saturated model, to ascertain which model best describes the relationship between SEP and mortality. Analyses were stratified by gender. For both men and women the effect of SEP across the life course on all-cause mortality is best described by the sensitive period model, whereby being advantaged in later life (ages 50–65 years) provides the largest protective effect. However, the linear accumulation model also provided a good fit of the data for women suggesting that improvements in SEP at any stage of the life course corresponds to a decrease in all-cause mortality.

scholarly journals Adherence to a Dietary Approaches to Stop Hypertension (DASH)-type diet over the life course and associated vascular function: a study based on the MRC 1946 British birth cohort

2018 ◽  
Vol 119 (5) ◽  
pp. 581-589 ◽  
Author(s):  
Jane Maddock ◽  
Nida Ziauddeen ◽  
Gina L. Ambrosini ◽  
Andrew Wong ◽  
Rebecca Hardy ◽  
...  
Keyword(s):  
Risk Factors ◽  
Life Course ◽  
Birth Cohort ◽  
Vascular Function ◽  
Hdl Cholesterol ◽  
Intima Media Thickness ◽  
Dash Diet ◽  
The Life Course ◽  
Diet Score

AbstractLittle is known about long-term associations between the Dietary Approaches to Stop Hypertension (DASH) diet and conventional cardiovascular (CV)-risk factors as well as novel measures of vascular function. This study aimed to examine whether long-term adherence to a DASH-type diet in a British birth cohort is associated with conventional CV-risk factors and two vascular function markers, carotid intima–media thickness (cIMT) and pulse wave velocity (PWV). Data came from 1409 participants of the Medical Research Council (MRC) National Survey of Health and Development. Dietary intake was assessed at 36, 43, 53 and 60–64 years using 5-d estimated food diaries. The DASH-type diet score was calculated using the Fung index. Conventional CV-risk factors (blood pressure (BP) and lipids), cIMT in the right and/or left common carotid artery and PWV was measured when participants were 60–64 years. Associations between the DASH-type diet score and outcomes were assessed using multiple regression models adjusted for socioeconomic position, BMI, smoking and physical activity. Participants in higher sex-specific quintiles (Q) of the long-term DASH-type diet had lower BP (P≤0·08), higher HDL-cholesterol (P<0·001) and lower TAG (P<0·001) compared with people in Q1. Participants in Q5 of the long-term DASH-type diet had lower PWV (−0·28sd; 95 % CI −0·50, −0·07,Ptrend=0·01) and cIMT (−0·24sd; 95 % CI −0·44, −0·04,Ptrend=0·02) compared with participants in the Q1. This association was independent of the conventional CV-risk factors. Greater adherence to a DASH diet over the life course is associated with conventional CV-risk factors and independently associated with cIMT and PWV.

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