scholarly journals Life course traumas, phenotypic aging, and cardiovascular disease: retrospective analysis of 104,939 UKB participants

Author(s):  
Xingqi Cao ◽  
Jingyun Zhang ◽  
Chao Ma ◽  
Xueqin Li ◽  
Chia-Ling Kuo ◽  
...  

Background: While childhood and adulthood traumatic experiences have been linked to subsequent cardiovascular disease (CVD), the relationship between life course traumas and CVD and the underpinning pathways are poorly understood. This study aimed to: (1) examine the associations of childhood, adulthood, and lifetime traumas with CVD; (2) examine the associations between diverse life course traumatic profiles and CVD; and (3) examine the extent to which Phenotypic Age (PhenoAge), a well-developed phenotypic aging measure, mediates these associations. Methods: We included 104,939 participants from the UK Biobank who completed the 2016 online mental health questionnaire. CVD outcomes including ischemic heart disease, myocardial infarction, and stroke were ascertained. Childhood, adulthood, and lifetime traumas were categorized into three subgroups (mild, moderate, and severe), respectively. Four life course traumatic profiles were defined as non-severe traumas across life course, non-severe childhood and severe adulthood traumas, severe childhood and non-severe adulthood traumas, and severe traumas across life course based on both childhood and adulthood traumas. PhenoAge was measured using an equation previously developed. Multivariable logistic models and formal mediation analyses were performed. Results: Of 104,939 participants, 7,398 (7.0%) were diagnosed with CVD. Subgroups of childhood, adulthood, and lifetime traumas were associated with CVD, respectively. Furthermore, life course traumatic profiles were significantly associated with CVD. For instance, compared with subgroups experiencing non-severe traumas across life course, those who experienced non-severe childhood and severe adulthood traumas, severe childhood and non-severe adulthood traumas, and severe traumas across life course had higher odd of CVD, with odds ratios of 1.07 (95% confidence interval [CI]: 1.00, 1.15), 1.17 (95% CI: 1.09, 1.25), and 1.33 (95% CI: 1.24, 1.43), respectively. Formal mediation analyses suggested that PhenoAge partially mediated the above associations. For instance, PhenoAge mediated 5.8% of increased CVD events in subgroups who experienced severe childhood traumas, relative to those experiencing mild childhood traumas. Conclusions: Childhood, adulthood, and lifetime traumas, as well as diverse life course traumatic profiles, were associated with CVD. Furthermore, phenotypic aging partially mediated these associations. These findings suggest a potential pathway from life course traumas to CVD through phenotypic aging, and underscore the importance of policy programs targeting traumatic events over the life course in ameliorating inequalities in cardiovascular health.

2012 ◽  
pp. 138-154
Author(s):  
Richard Ennals

At a time of change and disorder, this article argues that the whole range of government policies need to be reviewed, and reconceptualised in terms of generations and relations between generations. This article concentrates on the UK, from a European perspective, and with particular reference to the Scandinavian Model. In the context of crisis, new initiatives are required, taking account of transitions during the life course, relations between generations, and sustainability. The perspective of the Ageing Workforce casts light across the spectrum of policy areas. It is a moving picture, not a snapshot.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Nilay S Shah ◽  
Hongyan Ning ◽  
Amanda Perak ◽  
Norrina B Allen ◽  
John T Wilkins ◽  
...  

Introduction: Premature fatal cardiovascular disease rates have plateaued in the US. Identifying population distributions of short- and long-term predicted risk for atherosclerotic cardiovascular disease (ASCVD) can inform interventions and policy to improve cardiovascular health over the life course. Methods: Among nonpregnant participants age 30-59 years without prevalent CVD from the National Health and Nutrition Examination Surveys 2015-18, continuous 10 year (10Y) and 30 year (30Y) predicted ASCVD risk were assigned using the Pooled Cohort Equations and a 30-year competing risk model, respectively. Intermediate/high 10Y risk was defined as ≥7.5%, and high 30Y risk was chosen a priori as ≥20%, based on 2019 guideline levels for risk stratification. Participants were combined into low 10Y/low 30Y, low 10Y/high 30Y, and intermediate/high 10Y categories. We calculated and compared risk distributions overall and across race-sex, age, body mass index (BMI), and education using chi-square tests. Results: In 1495 NHANES participants age 30-59 years (representing 53,022,413 Americans), median 10Y risk was 2.3% and 30Y risk was 15.5%. Approximately 12% of individuals were already estimated to have intermediate/high 10Y risk. Of those at low 10Y risk, 30% had high 30Y predicted risk. Distributions differed significantly by sex, race, age, BMI, and education (P<0.01, Figure ). Black males more frequently had high 10Y risk compared with other race-sex groups. Older individuals, those with BMI ≥30 kg/m 2 , and with ≤high school education had a higher frequency of low 10Y/high 30Y risk. Conclusions: More than one-third of middle-aged U.S. adults have elevated short- or long-term predicted risk for ASCVD. While the majority of middle-aged US adults are at low 10Y risk, a large proportion among this subgroup are at high 30Y ASCVD risk, indicating a substantial need for enhanced clinical and population level prevention earlier in the life course.


2015 ◽  
Vol 30 (6) ◽  
pp. 468-470
Author(s):  
Laura L. Hayman ◽  
Jane Nelson Worel

2020 ◽  
Vol 61 (2) ◽  
pp. 190-207
Author(s):  
Eun Ha Namkung ◽  
Deborah Carr

We examine whether perceived interpersonal discrimination mediates the association between disability and psychological well-being (depression, negative and positive affect) and how these processes differ across the life course. Data are from two waves (2004–2006; 2013–2014) of the Midlife in the United States (MIDUS; N = 2,503). Perceived discrimination accounts for 5% to 8% of the association between disability and the three mental health outcomes. Moderated mediation analyses reveal significant age differences; perceived discrimination is a stronger explanatory mechanism among midlife (ages 40–64) relative to older (age 65+) adults. Disability stigma takes a heightened psychological toll at midlife, a life stage when adults are expected to be able-bodied and interact with a diverse social network, which may be a source of interpersonal mistreatment. Among older adults, for whom impairment is expected and common, the psychological impact of disability may operate through other pathways. We discuss implications for research and practice.


Author(s):  
Tina Haux

The inclusion of research impact in the 2014 Research Excellence Framework in the UK (REF2014) was greeted with scepticism by the academic community, not least due to the challenges of defining and measuring the nature and significance of impact. A new analytical framework of the nature of impact is developed in this chapter and it distinguishes between policy creation, direction, discourse and practice. This framework is then applied to the top-ranked impact case studies in the REF2014 from the Social Work and Social Policy sub-panel and the ESRC Early Career Impact Prize Winners in order to assess impact across the life-course of academics.  


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
M Edelstein

Abstract Since the introduction of the expanded programme on immunization in the 1970s, vaccination has evolved from being an intervention of early infancy to being a programme targeting individuals at all stages of life including birth, infancy, childhood, teenage years, pregnancy and adulthood. The UK has been at the forefront of this lifelong approach to vaccination and has introduced vaccines at all stages of life in its national schedule, including vaccination against hepatitis B at birth, Meningococcal disease group B in infancy, influenza in primary school years, Meningococcal disease groups A, C, W and Y in teenage years, pertussis in pregnancy and shingles in older adults. Based on a range of studies conducted by Public Health England, This session will reflect on some of the challenges brought on by the life course approach in the UK including issues of access in different age groups, choosing the right age and settings for vaccinations, age-specific attitudes to vaccination and subsequent communication strategies, and challenges with monitoring a life-course programme.


2007 ◽  
Vol 37 (11) ◽  
pp. 1575-1583 ◽  
Author(s):  
MONIQUE SÉGUIN ◽  
ALAIN LESAGE ◽  
GUSTAVO TURECKI ◽  
MÉLANIE BOUCHARD ◽  
NADIA CHAWKY ◽  
...  

ABSTRACTBackgroundLittle is known about differential suicide profiles across the life trajectory. This study introduces the life-course method in suicide research with the aim of refining the longitudinal and cumulative assessment of psychosocial factors by quantifying accumulation of burden over time in order to delineate distinctive pathways of completed suicide.MethodThe psychological autopsy method was used to obtain third-party information on consecutive suicides. Life-history calendar analysis served to arrive at an adversity score per 5-year segment that was then cluster-analysed and correlated to define victim profiles.ResultsTwo distinct life trajectories emerged: (1) individuals who experienced childhood traumas, developmental adversity and little protection were more likely to present concurrent psychiatric and Axis II disorders; and (2) individuals who experienced less adversity but seemed more reactive to later major difficulties.ConclusionsThe life calendar approach presented here in suicide research adds to the identification of life events, distal and recent, previously associated with suicide. It also quantifies the burden of adversity over the life course, defining two distinct profiles that could benefit from distinct targeted preventive intervention.


2011 ◽  
Vol 16 (2) ◽  
pp. 108-120 ◽  
Author(s):  
Angela Meah ◽  
Matt Watson

Amidst growing concern about both nutrition and food safety, anxiety about a loss of everyday cooking skills is a common part of public discourse. Within both the media and academia, it is widely perceived that there has been an erosion of the skills held by previous generations with the development of convenience foods and kitchen technologies cited as culpable in ‘deskilling’ current and future generations. These discourses are paralleled in policy concerns, where the incidence of indigenous food-borne disease in the UK has led to the emergence of an understanding of consumer behaviour, within the food industry and among food scientists, based on assumptions about consumer ‘ignorance’ and poor food hygiene knowledge and cooking skills. These assumptions are accompanied by perceptions of a loss of ‘common-sense’ understandings about the spoilage and storage characteristics of food, supposedly characteristic of earlier generations. The complexity of cooking skills immediately invites closer attention to discourses of their assumed decline. This paper draws upon early findings from a current qualitative research project which focuses on patterns of continuity and change in families’ domestic kitchen practices across three generations. Drawing mainly upon two family case studies, the data presented problematise assumptions that earlier generations were paragons of virtue in the context of both food hygiene and cooking. In taking a broader, life-course perspective, we highlight the absence of linearity in participants’ engagement with cooking as they move between different transitional points throughout the life-course.


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