Loneliness Predicts Development of Pain, Fatigue, and Depression in Older Adults

Abstract Pain, fatigue, and depression form a well-recognized symptom cluster that is posited to have a shared mechanism. It is possible that chronic psychosocial stressors such as loneliness may impact the central nervous system and immune system, potentially leading to symptom cluster development. Loneliness is an increasingly recognized type of psychosocial stress, especially among older American adults. Thus, we investigated whether loneliness increased risk of developing the symptom cluster of pain, fatigue, and depression over time. Using Health and Retirement Study data from 2006 – 2016, we examined self-respondents ≥50 years-old for the presence of co-occurring pain, fatigue, and depressive symptoms surpassing threshold levels (ie., the symptom cluster). Loneliness (measured by the 3-item UCLA Loneliness Scale) at baseline was used as the predictor of interest. Of the total sample (n=11,766), n=5,956 (50.6%) had up to two complete sets of follow-up symptom cluster measurements. Logistic regression models for longitudinal data were fitted using a generalized estimating equation (GEE). After adjusting for demographic and clinical variables, loneliness strongly predicted the development of the symptom cluster (adjusted OR=3.16 (95% CI 2.77, 3.61)) as well as each component symptom (pain adjusted OR=1.54 (95% CI 1.42, 1.67); fatigue adjusted OR=1.88 (95% CI 1.74, 2.03); depression adjusted OR = 3.87 (95% CI 3.55, 4.21). Further research should investigate whether interventions targeting loneliness or other psychosocial stressors may have a role in prevention of this symptom cluster.

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Unwelcome Companions: Loneliness Associates with the Cluster of Pain, Fatigue, and Depression in Older Adults

Gerontology and Geriatric Medicine ◽

10.1177/2333721421997620 ◽

2021 ◽

Vol 7 ◽

pp. 233372142199762

Author(s):

Victoria D. Powell ◽

Nauzley C. Abedini ◽

Andrzej T. Galecki ◽

Mohammed Kabeto ◽

Navasuja Kumar ◽

...

Keyword(s):

Older Adults ◽

Total Sample ◽

Study Data ◽

Demographic Variables ◽

Symptom Cluster ◽

Psychosocial Stressors ◽

Cross Sectional ◽

Logistic Regression Models ◽

Severe Fatigue ◽

Retirement Study

Objective: Pain, fatigue, and depression commonly co-occur as a symptom cluster in pathological inflammatory states. Psychosocial stressors such as loneliness may lead to similar states through shared mechanisms. We investigated the association of loneliness with pain, fatigue, and depression in older adults. Methods: Using Health and Retirement Study data ( N = 11,766), we measured cross-sectional prevalence of frequent, moderate to severe pain; severe fatigue; depressive symptoms; and co-occurrence of symptoms surpassing threshold levels (i.e., symptom cluster). Logistic regression models evaluated associations with loneliness. Results: Pain, fatigue, and depression were reported in 19.2%, 20.0%, and 15.3% of the total sample, respectively. The symptom cluster was seen in 4.9% overall; prevalence in lonely individuals was significantly increased (11.6% vs. 2.3%, p < .0001). After adjusting for demographic variables, loneliness associated with the symptom cluster (adjusted OR = 3.39, 95% CI = 2.91, 3.95) and each symptom (pain adjusted OR = 1.61, 95% CI = 1.48, 1.76; fatigue adjusted OR = 2.02, 95% CI = 1.85, 2.20; depression adjusted OR = 4.34, 95% CI = 3.93, 4.79). Discussion: Loneliness strongly associates with the symptom cluster of pain, fatigue, and depression. Further research should examine causal relationships and investigate whether interventions targeting loneliness mitigate pain, fatigue, and depression.

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Low HbA1c levels and all-cause or cardiovascular mortality among people without diabetes: the US National Health and Nutrition Examination Survey 1999–2015

International Journal of Epidemiology ◽

10.1093/ije/dyaa263 ◽

2020 ◽

Author(s):

Kosuke Inoue ◽

Roch Nianogo ◽

Donatello Telesca ◽

Atsushi Goto ◽

Vahe Khachadourian ◽

...

Keyword(s):

Cardiovascular Mortality ◽

Regression Models ◽

Machine Learning Algorithms ◽

Logistic Regression Models ◽

Health And Nutrition ◽

Increased Risk ◽

The Us ◽

All Cause Mortality ◽

Hba1c Levels

Abstract Objective It is unclear whether relatively low glycated haemoglobin (HbA1c) levels are beneficial or harmful for the long-term health outcomes among people without diabetes. We aimed to investigate the association between low HbA1c levels and mortality among the US general population. Methods This study includes a nationally representative sample of 39 453 US adults from the National Health and Nutrition Examination Surveys 1999–2014, linked to mortality data through 2015. We employed the parametric g-formula with pooled logistic regression models and the ensemble machine learning algorithms to estimate the time-varying risk of all-cause and cardiovascular mortality by HbA1c categories (low, 4.0 to <5.0%; mid-level, 5.0 to <5.7%; prediabetes, 5.7 to <6.5%; and diabetes, ≥6.5% or taking antidiabetic medication), adjusting for 72 potential confounders including demographic characteristics, lifestyle, biomarkers, comorbidities and medications. Results Over a median follow-up of 7.5 years, 5118 (13%) all-cause deaths, and 1116 (3%) cardiovascular deaths were observed. Logistic regression models and machine learning algorithms showed nearly identical predictive performance of death and risk estimates. Compared with mid-level HbA1c, low HbA1c was associated with a 30% (95% CI, 16 to 48) and a 12% (95% CI, 3 to 22) increased risk of all-cause mortality at 5 years and 10 years of follow-up, respectively. We found no evidence that low HbA1c levels were associated with cardiovascular mortality risk. The diabetes group, but not the prediabetes group, also showed an increased risk of all-cause mortality. Conclusions Using the US national database and adjusting for an extensive set of potential confounders with flexible modelling, we found that adults with low HbA1c were at increased risk of all-cause mortality. Further evaluation and careful monitoring of low HbA1c levels need to be considered.

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Dietary and lifestyle inflammatory scores are associated with increased risk of metabolic syndrome in Iranian adults

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00648-1 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Hossein Farhadnejad ◽

Karim Parastouei ◽

Hosein Rostami ◽

Parvin Mirmiran ◽

Fereidoun Azizi

Keyword(s):

Metabolic Syndrome ◽

Positive Association ◽

Population Based ◽

Population Based Study ◽

Logistic Regression Models ◽

Increased Risk ◽

Confounding Variables ◽

Adjusted Model ◽

Diet And Lifestyle

Abstract Background In the current study, we aimed to investigate the association of dietary inflammation scores (DIS) and lifestyle inflammation scores (LIS) with the risk of metabolic syndrome (MetS) in a prospective population-based study. Methods A total of 1625 participants without MetS were recruited from among participants of the Tehran Lipid and Glucose Study(2006–2008) and followed a mean of 6.1 years. Dietary data of subjects were collected using a food frequency questionnaire at baseline to determine LIS and DIS. Multivariable logistic regression models, were used to calculate the odds ratio (ORs) and 95 % confidence interval (CI) of MetS across tertiles of DIS and LIS. Results Mean ± SD age of individuals (45.8 % men) was 37.5 ± 13.4 years. Median (25–75 interquartile range) DIS and LIS for all participants was 0.80 (− 2.94, 3.64) and 0.48 (− 0.18, − 0.89), respectively. During the study follow-up, 291 (17.9 %) new cases of MetS were identified. Based on the age and sex-adjusted model, a positive association was found between LIS (OR = 7.56; 95% CI 5.10–11.22, P for trend < 0.001) and risk of MetS, however, the association of DIS and risk of MetS development was not statistically significant (OR = 1.30;95% CI 0.93–1.80, P for trend = 0.127). In the multivariable model, after adjustment for confounding variables, including age, sex, body mass index, physical activity, smoking, and energy intake, the risk of MetS is increased across tertiles of DIS (OR = 1.59; 95% CI 1.09–2.33, P for trend = 0.015) and LIS(OR = 8.38; 95% CI 5.51–12.7, P for trend < 0.001). Conclusions The findings of the current study showed that greater adherence to LIS and DIS, determined to indicate the inflammatory potential of diet and lifestyle, are associated with increased the risk of MetS.

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Is Childhood Socioeconomic Status Related to Coronary Heart Disease? Evidence From the Health and Retirement Study (1992-2012)

Gerontology and Geriatric Medicine ◽

10.1177/2333721417696673 ◽

2017 ◽

Vol 3 ◽

pp. 233372141769667 ◽

Cited By ~ 3

Author(s):

Minjee Lee ◽

M. Mahmud Khan ◽

Brad Wright

Keyword(s):

Socioeconomic Status ◽

Coronary Heart Disease ◽

Heart Disease ◽

Later Life ◽

Study Data ◽

Health And Retirement Study ◽

Increased Risk ◽

Childhood Socioeconomic Status ◽

Nationally Representative ◽

Retirement Study

Objective: We investigated the association between childhood socioeconomic status (SES) and coronary heart disease (CHD) in older Americans. Method: We used Health and Retirement Study data from 1992 to 2012 to examine a nationally representative sample of Americans aged ≥50 years ( N = 30,623). We modeled CHD as a function of childhood and adult SES using maternal and paternal educational level as a proxy for childhood SES. Results: Respondents reporting low childhood SES were significantly more likely to have CHD than respondents reporting high childhood SES. Respondents reporting both low childhood and adult SES were 2.34 times more likely to have CHD than respondents reporting both high childhood and adult SES. People with low childhood SES and high adult SES were 1.60 times more likely than people with high childhood SES and high adult SES to report CHD in the fully adjusted model. High childhood SES and low adult SES increased the likelihood of CHD by 13%, compared with high SES both as a child and adult. Conclusion: Childhood SES is significantly associated with increased risk of CHD in later life among older adult Americans.

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Relationship between alcohol consumption and cancer in rural Chinese adults: 1 5- year follow-up cohort study

10.21203/rs.3.rs-48959/v1 ◽

2020 ◽

Author(s):

Yue Zhang ◽

Jingyi Li ◽

Nannan Cheng ◽

Jie Yang ◽

Lijing Ye ◽

...

Keyword(s):

Cohort Study ◽

Alcohol Consumption ◽

Cancer Incidence ◽

Rural China ◽

Density Lipoprotein ◽

Estimating Equation ◽

Chinese Adults ◽

Increased Risk ◽

Risk Of Cancer

Abstract Background：We aimed to evaluate the association between alcohol consumption and risk of cancer incidence among rural Chinese adults. Methods: We utilized data from a community-based cohort study in rural China enrolled in 2003 and followed up prospectively up to 2018. Generalized estimating equation models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) to analyze the relationship between alcohol consumption and cancer incidence. Results: After an average of 15 years of follow-up, a total of 9870 adult participants were included in this study. The results of the regression analysis for males showed that former drinkers had a significantly increased risk of cancer compared to never drinkers ([OR]2.46,95%[CI](1.43-4.23)). The cancer risk for current drinkers with heavy alcohol consumption(>400g/week) significantly increased ([OR]1.66,95% [CI] (1.18-2.34))compared to never drinkers. Among current drinkers, for every 100g of alcohol consumed per week, the risk of cancer increased by 15%. Among current drinkers, those aged 53.5 years or older , had a significant increase in the risk of cancer ([OR]1.26,95% [CI](1.12-1.42), for those with triglycerides ≥150 mg/dL, the risk of cancer was even higher ([OR]1.50,95%[CI](1.20-1.88), P for interaction 0.018), and for those with high density lipoprotein cholesterol (HDLC)<40 mg/dL, the risk of cancer increased the greatest ([OR]2.03,95%[CI](1.36-3.04), P for interaction 0.005). Conclusions: Among middle-aged and elderly males in rural China, the risk of cancer significantly increased among former and heavy current drinkers compared with never drinkers. Age, triglycerides, and HDLC may increase the risk of cancer along with alcohol consumption.

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Does Flipping the Tubercle for Improved Cartilage Repair Exposure Increase the Risk for Arthrofibrosis?

Cartilage ◽

10.1177/1947603520968209 ◽

2020 ◽

pp. 194760352096820

Author(s):

Gergo Merkely ◽

Jakob Ackermann ◽

Emily Sheehy ◽

Andreas H. Gomoll

Keyword(s):

Logistic Regression ◽

Cartilage Repair ◽

Regression Models ◽

Case Control Study ◽

Level Of Evidence ◽

Logistic Regression Models ◽

Increased Risk ◽

Repair Procedure ◽

Control Study

Objective We sought to determine whether rates of postoperative arthrofibrosis following tibial tuberosity osteotomy (TTO) with complete mobilization of the fragment (TTO-HD) are comparable to TTOs where the hinge remained intact (TTO-HI). Design Patients who underwent TTO with concomitant cartilage repair procedure between January 2007 and May 2017, with at least 2 years of follow-up were included in this study. Postoperative reinterventions following TTO-HD and TTO-HI were assessed and multivariant logistic regression models were used to identify whether postoperative reinterventions can be attributed to either technique when controlled for defect size or defect number. Results A total of 127 patients (TTO-HD, n = 80; TTO-HI, n = 47) were included in this study. Significantly more patients in the TTO-HD group (31.2%) developed postoperative arthrofibrosis compared with TTO-HI (6.4%; P < 0.05). Multivariant logistic regression revealed that TTO-HD is an independent risk factor for predicting postoperative arthrofibrosis (OR 6.5, CI = 1.7-24.2, P < 0.05). Conclusion Patients who underwent TTO with distal hinge detachment and a proximally flipped tubercle for better exposure during concomitant cartilage repair were at a significantly higher risk of postoperative arthrofibrosis than patients with similar size and number of defects treated without mobilization of the tubercle. While certain procedures can benefit from larger exposure, surgeons should be aware of the increased risk of postoperative arthrofibrosis. Level of Evidence Level III, case-control study.

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Serum IGFBP-2 and Risk of Atypical Hyperplasia of the Breast

Journal of Cancer Epidemiology ◽

10.1155/2015/203284 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Chelsea Catsburg ◽

Marc J. Gunter ◽

Lesley Tinker ◽

Rowan T. Chlebowski ◽

Michael Pollak ◽

...

Keyword(s):

Conditional Logistic Regression ◽

Atypical Hyperplasia ◽

Mammary Tissue ◽

Inverse Association ◽

Logistic Regression Models ◽

Increased Risk ◽

Nested Case Control ◽

Nonsignificant Decrease ◽

Control Study

Atypical hyperplasia of the breast (AH) is associated with increased risk of subsequent invasive breast cancer, yet little is known about the etiology of AH. Insulin-like growth factor binding protein 2 (IGFBP-2) may contribute to the development of AH due to its proliferative effects on mammary tissue. We conducted a nested case-control study of postmenopausal women enrolled in Women’s Health Initiative-Clinical Trial. Cases were 275 women who developed incident AH during follow-up, individually (1 : 1) matched to controls. Levels of IGFBP-2 were determined from fasting serum collected at baseline. Multivariable conditional logistic regression models were used to estimate odds ratios for the association of IGFBP-2 with risk of AH. Serum IGFBP-2 was associated with a nonsignificant decrease in risk for AH, when comparing the highest quartile to lowest quartile (OR = 0.65; 95% CI = 0.32–1.31). This decrease in risk was most evident when analyses were restricted to nondiabetic, nonusers of hormone therapy (OR = 0.33, 95% CI = 0.13–0.86,ptrend= 0.06) and nondiabetic women who were overweight or obese (OR = 0.43, 95% CI = 0.18–1.03,ptrend= 0.05). Results from this study provide some support for an inverse association between serum IGFBP2 levels and risk of AH, particularly in nondiabetic women who are overweight or obese. Further studies are required to confirm these results.

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Early Electronic Screen Exposure and Autistic-Like Behaviors among Preschoolers: The Mediating Role of Caregiver-Child Interaction, Sleep Duration and Outdoor Activities

Children ◽

10.3390/children7110200 ◽

2020 ◽

Vol 7 (11) ◽

pp. 200

Author(s):

Jing-Yi Chen ◽

Esben Strodl ◽

Li-Hua Huang ◽

Ying-Jie Chen ◽

Gui-You Yang ◽

...

Keyword(s):

Sleep Duration ◽

Well Being ◽

Study Data ◽

Preschool Age ◽

Outdoor Activities ◽

Logistic Regression Models ◽

Mediating Role ◽

Child Interaction ◽

Increased Risk

Research into early screen exposure has raised growing concerns about its impact upon children’s neuropsychological well-being. However, possible pathways remain unclear. This study therefore aimed not only to evaluate the association between screen exposure during the ages of 0–3 years and preschoolers’ autistic-like behaviors, but also the mediating roles of the frequency of caregiver-child interaction, sleep duration and level of participation in outdoor activities. Based on the 2017 survey of the Longhua Child Cohort Study, data of 29,595 child-caregiver dyads were obtained via a caregiver-reported questionnaire, with the data from 29,461 dyads included in the data analysis. Multiple linear and logistic regression models were employed to estimate the associations between screen exposure, caregiver-child interaction, sleep duration, outdoor activities, and children’s autistic-like behaviors. The results indicated that screen exposure during 0–3 years of age was associated with the presence of autistic-like behaviors at preschool age, and the strength of the association was enhanced with the increase of average daily screen time (Odds Ratios (ORs) ranging from 1.358 to 4.026). The frequency of caregiver-child interaction and sleep duration mediated 5.32% and 1.19% of the variance of the association respectively, but outdoor activities did not mediate the association. Our findings indicate that preschoolers who are exposed to screens at aged 0–3 years might have an increased risk of autistic-like behaviors, and that, the frequency of caregiver-child interaction and sleep duration might function as potential mediators of this association.

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Risk factors for immune-related adverse events associated with anti-PD-1 pembrolizumab

Scientific Reports ◽

10.1038/s41598-019-50574-6 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 13

Author(s):

Yeonghee Eun ◽

In Young Kim ◽

Jong-Mu Sun ◽

Jeeyun Lee ◽

Hoon-Suk Cha ◽

...

Keyword(s):

Risk Factors ◽

Adverse Events ◽

Medical Center ◽

Multivariate Regression Analysis ◽

Study Data ◽

Endocrine Disorders ◽

Logistic Regression Models ◽

Neutrophil Lymphocyte Ratio ◽

Increased Risk ◽

Clinically Significant

Abstract We investigated risk factors for immune-related adverse events (irAEs) in patients treated with anti-programmed cell death protein1 antibody pembrolizumab. A retrospective medical record review was performed to identify all patients who received at least one dose of pembrolizumab at Samsung Medical Center, Seoul, Korea between June 2015 and December 2017. Three hundred and ninety-one patients were included in the study. Data were collected on baseline characteristics, treatment details, and adverse events. Univariate and multivariate logistic regression models were used to identify risk factors for irAEs. Sixty-seven (17.1%) patients experienced clinically significant irAEs; most commonly dermatologic disorders, followed by pneumonitis, musculoskeletal disorders, and endocrine disorders. Fourteen patients (3.6%) experienced serious irAEs (grade ≥ 3). Most common serious irAEs were pneumonitis (2.3%). Four deaths were associated with irAEs, all of which were due to pneumonitis. In multivariate regression analysis, a higher body mass index (BMI) and multiple cycles of pembrolizumab were associated with higher risk of irAEs (BMI: odds ratio [OR] 1.08, 95% confidence interval [CI] 1.01–1.16; pembrolizumab cycle: OR 1.15, 95% CI 1.08–1.22). A derived neutrophil-lymphocyte ratio (dNLR) greater than 3 at baseline was correlated with low risk of irAEs (OR 0.37, 95% CI 0.17–0.81). Our study demonstrated that an elevated BMI and higher number of cycles of pembrolizumab were associated with an increased risk of irAEs in patients treated with pembrolizumab. Additionally, increased dNLR at baseline was negatively correlated with the risk of developing irAEs.

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Changes in vitamin D levels and depressive symptoms in later life in England

Scientific Reports ◽

10.1038/s41598-021-87432-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Giorgio Di Gessa ◽

Jane P. Biddulph ◽

Paola Zaninotto ◽

Cesar de Oliveira

Keyword(s):

Vitamin D ◽

Depressive Symptoms ◽

Later Life ◽

Vitamin D Supplementation ◽

Cross Sectional ◽

Logistic Regression Models ◽

Representative Study ◽

Increased Risk ◽

Vitamin D Levels

AbstractInadequate vitamin D levels have been associated with increased risk of depression. However, most of these studies are cross-sectional and failed to investigate the effect of changes in vitamin D levels. This study aimed to investigate the longitudinal association of changes in serum 25-hydroxyvitamin D levels with depressive symptoms in 3365 participants of the English Longitudinal Study of Ageing, a large nationally-representative study of older adults. Based on their vitamin D levels at baseline and follow-up (sufficient ≥ 50 nmol/L; insufficient < 50 nmol/L), participants were classified as follows: with sufficient levels at both waves; with sufficient levels at baseline but not at follow-up; with insufficient levels at baseline but ≥ 50 nmol/L at follow-up; and with levels < 50 nmol/L at each time point. Depressive symptoms were measured using the 8-point CES-D scale. Data were analysed using logistic regression models. Compared with those with sufficient levels of vitamin D at both waves, only those with insufficient levels throughout were more likely to report elevated depressive symptoms (OR = 1.39, 95% CI = 1.00–1.93). Becoming or no longer being vitamin D deficient was, in the short term, not associated with elevated depressive symptoms. Further evidence is required on whether vitamin D supplementation might contribute to the prevention or treatment of depression as well as on the duration of time for changes in vitamin D levels to lead to detectable changes in depressive symptoms.

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