scholarly journals Birth Cohort Differences in Multimorbidity Burden Among Aging U.S. Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 257-257
Author(s):  
Nicholas Bishop ◽  
Steven Haas ◽  
Ana Quiñones
Keyword(s):  
Cognitive Impairment ◽  
Birth Cohort ◽  
Repeated Measures ◽  
Chronic Conditions ◽  
Linear Models ◽  
Birth Cohorts ◽  
Older Americans ◽  
Cohort Differences ◽  
Increased Risk ◽  
The Us

Abstract Multimorbidity is the co-occurrence of two or more chronic health conditions and affects more than half of the US population aged 65 and older. Recent trends suggest increased risk of poor self-reported health, physical disability, cognitive impairment, and mortality among later born birth cohorts, yet we are unaware of work examining cohort trends in multimorbidity among aging US adults. Observations were drawn from the Health and Retirement Study (2000–2018) and included adults aged 51 and older across 7 birth cohorts (1923 and earlier, 1924–1930, 1931–1941, 1942–1947, 1948–1953, 1954–1959, and 1960–1965). Multimorbidity was measured as a count of 9 chronic conditions including heart disease, hypertension, stroke, diabetes, arthritis, lung disease, cancer (excluding skin cancer), depression, and cognitive impairment. General linear models adjusting for repeated measures and covariates including age, sex, race/ethnicity, and education were used to identify whether trends in multimorbidity varied across birth cohort. 31,923 adults contributed 153,940 total observations, grand mean age was 68.0 (SD=10.09), and mean multimorbidity was 2.19 (SD=1.49). In analyses adjusted for age and other covariates, adults born 1948–1953 reported .34 more chronic conditions (SE=.03, p<.001), adults born 1954–1959 reported .42 more chronic conditions (SE=.03, p<.001), and adults born 1960–1965 reported .55 more chronic conditions (SE=.03, p<.001), than those born 1931–1941, respectively. Our preliminary results confirm increasing multimorbidity among later birth cohorts of older Americans and should help guide policy to manage impending health declines among older Americans.

Secular trends in the prevalence of dementia and depression in Swedish septuagenarians 1976–2006

2013 ◽  
Vol 43 (12) ◽  
pp. 2627-2634 ◽  
Author(s):  
P. Wiberg ◽  
M. Waern ◽  
E. Billstedt ◽  
S. Östling ◽  
I. Skoog
Keyword(s):  
Major Depression ◽  
Birth Cohort ◽  
Linear Models ◽  
Response Rate ◽  
The Elderly ◽  
Population Based ◽  
Minor Depression ◽  
Birth Cohorts ◽  
Cohort Differences ◽  
Prevalence Of Dementia

BackgroundIt is not clear whether the prevalence of dementia and depression among the elderly has changed during the past 30 years.MethodPopulation-based samples from Gothenburg, Sweden were examined with identical psychiatric and neuropsychiatric examinations at age 70 years in 1976–1977 (n = 404, response rate 78.8%) and 2000–2001 (n = 579, response rate 66.4%), and at age 75 in 1976–1977 (n = 303, response rate 78%) and 2005–2006 (n = 753, response rate 63.4%). Depression was diagnosed according to DSM-IV and dementia according to Kay's criteria. General linear models (GLMs) were used to test for differences between groups.ResultsDementia was related to age but not to birth cohort or sex. Major depression was related to sex (higher in women) but not to birth cohort or age. Minor depression was related to birth cohort, sex (higher in women), age (higher at age 75) and the interaction effect of birth cohort × age; that is, the prevalence of minor depression increased with age in the 2000s but not in the 1970s. Thus, the prevalence of minor depression was higher in 2005–2006 than in 1976–1977 among 75-year-olds for both men (12.4% v. 3.7%) and women (19.1% v. 5.6%) whereas there were no birth cohort differences at age 70.ConclusionsSecular changes were observed only for minor depression, which is considered to be related more to psychosocial factors than major depression. The high prevalence of minor depression in later-born birth cohorts emphasizes the importance of detecting minor depression in the elderly.

Trends for influenza and pneumonia hospitalization in the older population: age, period, and cohort effects

2010 ◽  
Vol 138 (8) ◽  
pp. 1135-1145 ◽  
Author(s):  
S. A. COHEN ◽  
A. C. KLASSEN ◽  
S. AHMED ◽  
E. M. AGREE ◽  
T. A. LOUIS ◽  
...  
Keyword(s):  
Birth Cohort ◽  
Disease Burden ◽  
Linear Models ◽  
Census Bureau ◽  
Birth Cohorts ◽  
Disease Rates ◽  
The Us ◽  
Risk Of Disease ◽  
Cohort Groups ◽  
Us Census

SUMMARYBirth cohort has been shown to be related to morbidity and mortality from other diseases and conditions, yet little is known about the potential for birth cohort in its relation to pneumonia and influenza (P&I) outcomes. This issue is particularly important in older adults, who experience the highest disease burden and most severe complications from these largely preventable diseases. The objective of this analysis is to assess P&I patterns in US seniors with respect to age, time, and birth cohort. All Medicare hospitalizations due to P&I (ICD-9CM codes 480-487) were abstracted and categorized by single-year of age and influenza year. These counts were then divided by intercensal estimates of age-specific population levels extracted from the US Census Bureau to obtain age- and season-specific rates. Rates were log-transformed and linear models were used to assess the relationships in P&I rates and age, influenza year, and cohort. The increase in disease rates with age accounted for most of the variability by age and influenza season. Consistent relationships between disease rates and birth cohorts remained, even after controlling for age. Seasonal associations were stronger for influenza than for pneumonia. These findings suggest that there may be a set of unmeasured characteristics or events people of certain ages experienced contemporaneously that may account for the observed differences in P&I rates in birth cohorts. Further understanding of these circumstances and those resulting age and cohort groups most vulnerable to P&I may help to target health services towards those most at risk of disease.

scholarly journals HETEROGENEITY IN PROGRESSION OF COGNITIVE IMPAIRMENT AND VARIATIONS IN HEALTH EXPENDITURES AND HEALTH SERVICES USE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S126-S126
Author(s):  
Wassim Tarraf ◽  
Hector M González
Keyword(s):  
Nursing Home ◽  
Cognitive Impairment ◽  
Cognitive Aging ◽  
Linear Models ◽  
Health Issues ◽  
Health Services Use ◽  
The Us ◽  
Inpatient Hospitalizations ◽  
Baseline Probability ◽  
Using Data

Abstract Cognitive aging and disease (e.g. dementia) are leading public health issues as longevity increases and the US population ages. We fit generalized linear models using data from the longitudinal Health and Retirement Study (2008-2014) on (Unweighted N=1,884) participants 70-years and older who met criteria for cognitive impairment not dementia (CIND), based on Aging, Demographics, and Memory Study specification, at baseline (2008) to test how impairment reversion, stability, and transition to dementia over 8-years affect change in biennial hospitalizations, nursing-home use, and out-of-pocket expenditures (OOP). Over 8-years, 13% reverted to normal cognition, 20% remained as CIND, 21% transitioned to dementia, and 46% died. In these groups, average OOP spending at baseline was $2311 (SE=$225), $2722 (SE=$278), $2180 (SE=$228), and $3653 (SE=$322), respectively. Average OOP spending increased to $3,095, $4,720, and $11,548 by the 8th year for those that reverted, stayed stable, and transitioned, respectively. Average OOP spending at the wave preceding death was $11,600. We observed substantial increases in nursing home use that were particularly pronounced among those that transitioned to dementia (Baseline Probability=0.04 increasing to 0.37 over 8-years) or died (0.09 increasing to 0.35 over 6-years), and similar but less pronounced differences in patterns of inpatient hospitalizations. Estimates were only slightly modified through adjustments to sociodemographic characteristics and comorbid conditions. We discuss how healthcare policy and clinical interventions focusing on early identification of impairment can potentially lead to improved and more efficient healthcare if better understanding of heterogeneities in impairment and cognitive disease progression is achieved.

scholarly journals Topiramate use early in pregnancy and the risk of oral clefts

Neurology ◽  
2017 ◽  
Vol 90 (4) ◽  
pp. e342-e351 ◽  
Author(s):  
Sonia Hernandez-Diaz ◽  
Krista F. Huybrechts ◽  
Rishi J. Desai ◽  
Jacqueline M. Cohen ◽  
Helen Mogun ◽  
...  
Keyword(s):  
Linear Models ◽  
Reference Group ◽  
First Trimester ◽  
Population Based ◽  
Oral Clefts ◽  
Born Infant ◽  
Increased Risk ◽  
The Us ◽  
Median Daily Dose ◽  
In Pregnancy

ObjectiveTo assess the relative risk of oral clefts associated with maternal use of high and low doses of topiramate during the first trimester for epilepsy and nonepilepsy indications.MethodsThis population-based study nested in the US 2000–2010 Medicaid Analytic eXtract included a cohort of 1,360,101 pregnant women with a live-born infant enrolled in Medicaid from 3 months before conception through 1 month after delivery. Oral clefts were defined as the presence of a recorded diagnosis in claims during the first 90 days after birth. Women with a topiramate dispensing during the first trimester were compared with those without any dispensing and with an active reference group of women with a lamotrigine dispensing during the first trimester. Risk ratios (RRs) were estimated with generalized linear models with fine stratification on the propensity score of treatment to control for potential confounders. Stratified analyses by indication of use and dose were conducted.ResultsThe risk of oral clefts at birth was 4.1 per 1,000 in the 2,425 infants born to women exposed to topiramate compared with 1.1 per 1,000 in the unexposed group (RR 2.90, 95% confidence interval [CI] 1.56–5.40). The RR among women with epilepsy was 8.30 (95% CI 2.65–26.07); among women with other indications such as bipolar disorder, it was 1.45 (95% CI 0.54–3.86). The median daily dose for the first prescription filled during the first trimester was 200 mg for women with epilepsy and 100 mg for women without epilepsy. For topiramate monotherapy, the RR for oral clefts associated with doses ≤100 mg was 1.64 (95% CI 0.53–5.07) and for doses >100 mg it was 5.16 (95% CI 1.94–13.73). Results were similar when lamotrigine was used as a reference group.ConclusionThe increased risk of oral clefts associated with use of topiramate early in pregnancy was more pronounced in women with epilepsy, who used higher doses.

scholarly journals Improved Cognitive Function in the Tromsø Study in Norway From 2001 to 2016

2021 ◽  
pp. 10.1212/CPJ.0000000000001115
Author(s):  
Bente Johnsen ◽  
Bjørn Heine Strand ◽  
Ieva Martinaityte ◽  
Ellisiv B. Mathiesen ◽  
Henrik Schirmer
Keyword(s):  
Physical Activity ◽  
Birth Cohort ◽  
Age Groups ◽  
Cohort Effect ◽  
Cognitive Test ◽  
Birth Cohorts ◽  
Cohort Differences ◽  
Level Increase ◽  
Drinking Frequency ◽  
Birth Cohort Effect

AbstractObjective:Physical capacity and cardiovascular risk profiles seem to be improving in the population. Cognition have been improving due to a birth cohort effect, but evidence is conflicting on whether this improvement remains in the latest decades, and what is causing the changes in our population over 60 years old. We aimed to investigate birth cohort differences in cognition.Method:The study comprised 9514 participants from the Tromsø study, an ongoing longitudinal cohort study. Participants were in the ages 60–87 years, born between 1914 and 1956. They did four cognitive tests in three waves during 2001-2016. Linear regression was applied, and adjusted for age, education, blood pressure, smoking, hypercholesterolemia, stroke, heart attack, depression, diabetes, physical activity, alcohol use, BMI and height.Results:Cognitive test scores were better in later-born birth cohorts for all age groups, and in both sexes, compared with earlier born cohorts. Increased education, physical activity, alcohol intake, decreasing smoking prevalence and increasing height was associated with one third of this improvement across birth cohorts in women and one half of the improvement in men.Conclusion:Cognitive results were better in more recent born birth cohorts compared with earlier born, assessed at the same age. The improvement was present in all cognitive domains, suggesting an overall improvement in cognitive performance. The 80-year-olds assessed in 2015-16 performed like 60-year-olds assessed in 2001. The improved scores were associated with increased education level, increase in modest drinking frequency, increased physical activity and for men, smoking cessation and increased height.

Comparing cohort incidence of schizophrenia with that of bipolar disorder and affective psychosis in individuals born in Stockholm County 1955–1967

2015 ◽  
Vol 45 (16) ◽  
pp. 3433-3439 ◽  
Author(s):  
J. Söderlund ◽  
S. Wicks ◽  
L. Jörgensen ◽  
C. Dalman
Keyword(s):  
Risk Factors ◽  
Bipolar Disorder ◽  
Birth Cohort ◽  
Socioeconomic Development ◽  
Incidence Rates ◽  
Birth Cohorts ◽  
Affective Psychoses ◽  
Increased Risk ◽  
National Patient ◽  
Incident Cases

Background.Perinatal factors are associated with increased risk for both schizophrenia and bipolar disorder. Improvements in obstetric and maternal healthcare and positive socioeconomic development in Sweden from the 1950s onwards could be expected to affect incidence estimates. However, commonly incidence rates are calculated during a specific year, i.e. time of diagnosis, which mirrors proximal precipitating risk factors. To examine whether incidence estimates are compatible with the hypothesis of an impact of perinatal exposures on the risk of the different disorders we here instead calculate incidence rates for consecutive birth cohorts born between 1955 and 1967. We hypothesized that schizophrenia incidence would be more affected compared to bipolar disorder and other affective psychoses since most perinatal risk factors are more pronounced in schizophrenia aetiology.Method.Birth cohorts of individuals born in Sweden and resident in Stockholm (N = 2 16 322), were followed in The National Patient Register regarding incident inpatient episodes Incident cases/10 000 person-years and birth cohort were calculated. Linear regression was used to estimate change in incidence rate.Results.We found stable birth cohort-based incidence estimates for bipolar disorder and other affective psychoses, but a continuous reduction in incidence estimates for schizophrenia as well as other non-affective psychoses in subsequent birth cohorts from 1955 to 1967.Conclusions.The consecutive birth cohort-based incidence estimates unveiled patterns that are compatible with the hypothesis of an impact of early life exposures decreasing over time, in the aetiology of schizophrenia, whereas this pattern is less apparent in affective psychoses..

scholarly journals Global patterns and trends in ovarian cancer incidence: age, period and birth cohort analysis

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yanting Zhang ◽  
Ganfeng Luo ◽  
Mengjie Li ◽  
Pi Guo ◽  
Yuejiao Xiao ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
South America ◽  
Eastern Europe ◽  
Birth Cohort ◽  
Cancer Incidence ◽  
Central And Eastern Europe ◽  
Cohort Analysis ◽  
The Philippines ◽  
Birth Cohorts ◽  
Increased Risk

Abstract Background Ovarian cancer (OC) is the seventh most common malignancy worldwide and the most lethal gynaecological malignancy. We aimed to explore global geographical patterns and temporal trends from 1973 to 2015 for 41 countries in OC incidence and especially to analyse the birth cohort effect to gain further insight into the underlying causal factors of OC and identify countries with increasing risk of OC. Methods OC data were drawn from the Cancer Incidence in Five Continents databases and online databases published by governments. The joinpoint regression model was applied to detect changes in OC trends. The age–period–cohort model was applied to explore age and birth cohort effects. Results The age-standardized rate of OC incidence ranged from 3.0 to 11.4 per 100,000 women worldwide in 2012. The highest age-standardized rate was observed in Central and Eastern Europe, with 11.4 per 100,000 women in 2012. For the most recent 10-year period, the increasing trends were mainly observed in Central and South America, Asia and Central and Eastern Europe. The largest significant increase was observed in Brazil, with an average annual percentage change of 4.4%. For recent birth cohorts, cohort-specific increases in risk were pronounced in Estonia, Finland, Iceland, Lithuania, the United Kingdom, Germany, the Netherlands, Italy, Malta, Slovenia, Bulgaria, Russia, Australia, New Zealand, Brazil, Costa Rica, Ecuador, India, Japan, the Philippines and Thailand. Conclusions Disparities in the incidence and risk of OC persist worldwide. The increased risk of birth cohort in OC incidence was observed for most countries in Asia, Central and Eastern Europe, and Central and South America. The reason for the increasing OC risk for recent birth cohorts in these countries should be investigated with further epidemiology studies.

scholarly journals Birth cohort differences in the use of medications in a Brazilian population of older elderly: the Bambuí cohort study of aging (1997 and 2008)

2011 ◽  
Vol 27 (suppl 3) ◽  
pp. s435-s443 ◽  
Author(s):  
Antônio Ignácio de Loyola Filho ◽  
Josélia O. A. Firmo ◽  
Elizabeth Uchôa ◽  
Maria Fernanda Lima-Costa
Keyword(s):  
Cohort Study ◽  
Chronic Conditions ◽  
Population Based ◽  
Baseline Survey ◽  
Birth Cohorts ◽  
Antithrombotic Agents ◽  
Medical Visits ◽  
Cohort Differences ◽  
Minas Gerais State ◽  
Recent Cohort

This study examined differences in the use of medications in two birth cohorts (born from 1916 to 1926 and from 1927 to 1937) among older elderly in the population-based cohort study in Bambuí, Minas Gerais State, Brazil. The study used data on participants who were 71-81 years of age in the baseline survey in 1997 (n = 492) and in the 11th wave, in 2008 (n = 620). The number of medications currently consumed (mean = 4.6 and 3.4, respectively) and prevalence of polypharmacy (46.6% and 29.1%, respectively) were higher in the more recent cohort as compared to the earlier one. These differences were independent of gender, age, schooling, number of medical visits in the previous 12 months, and number of chronic conditions. The more recent cohort showed significant differences in the use of psychoactive drugs, lipid modifying agents, drugs for diabetes, and antithrombotic agents, as well as changes in drugs used for arterial hypertension. In general, these changes are consistent with those observed in elderly populations in high-income countries.

scholarly journals MULTIPLE CHRONIC CONDITIONS AND RISK OF DEMENTIA AND COGNITIVE IMPAIRMENT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S316-S316 ◽  
Author(s):  
Yura Lee ◽  
Youngjoo Cho ◽  
Hyunkyoung Oh
Keyword(s):  
Cognitive Impairment ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Longitudinal Design ◽  
Multinomial Logistic Regression ◽  
Cognitive Activity ◽  
Multiple Chronic Conditions ◽  
Multiple Chronic Condition ◽  
Increased Risk ◽  
The Relationship

Abstract This study explores the relationship between the presence of multiple chronic condition and risk of dementia and cognitive impairment with no dementia (CIND) among older Americans. The study sample included 617 participants aged 70 years and older from the Aging, Demographics, and Memory Study (ADAMS). An expert consensus panel of the ADAMS data provided each participant a cognitive diagnosis into 1) no cognitive impairment, 2) CIND, or 3) dementia. The presence of multiple chronic condition was defined as having three or more chronic conditions in this study (e.g., heart attack, stroke, respiratory problems, cancer, hypertension, diabetes). Functional limitation, depression, cognitive activity engagement, apolipoprotein E (ApoE), and sociodemographic characteristics were included as covariates. A multinomial logistic regression analysis showed that individuals who have multiple chronic conditions have increased odds of being diagnosed with CIND versus no cognitive impairment controlling for other covariates. However, multiple chronic condition was not associated with increased risk of being diagnosed with dementia versus no cognitive impairment. Conclusion: The finding suggests that the presence of multiple chronic conditions may be a risk factor for cognitive impairment in later life. However, further investigation using a longitudinal design is needed to better understand the relationship between cognition and multiple chronic conditions.

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