scholarly journals Middle-age dementia risk scores and old-age cognition: a quasi-experimental population-based twin study with over 20-year follow-up

2020 ◽  
pp. jnnp-2020-324009
Author(s):  
Paula Iso-Markku ◽  
Jaakko Kaprio ◽  
Noora Lindgren ◽  
Juha O Rinne ◽  
Eero Vuoksimaa
Keyword(s):  
Old Age ◽  
Middle Age ◽  
Twin Pair ◽  
Population Based ◽  
Self Report ◽  
Risk Scores ◽  
Experimental Population ◽  
Dementia Risk ◽  
Quasi Experimental ◽  
Intervention Trials

BackgroundMiddle-age risk scores predict cognitive impairment, but it is not known if these associations are evident when controlling for shared genetic and environmental factors. Using two risk scores, self-report educational-occupational score and Cardiovascular Risk Factors, Aging and Dementia (CAIDE), we investigated if twins with higher middle-age dementia risk have poorer old-age cognition compared with their co-twins with lower risk.MethodsWe used a population-based older Finnish Twin Cohort study with middle-age questionnaire data (n=15 169, mean age=52.0 years, SD=11.8) and old-age cognition measured via telephone interview (mean age=74.1, SD=4.1, n=4302). Between-family and within-family linear regression analyses were performed.ResultsIn between-family analyses (N=2359), higher educational-occupational score was related to better cognition (B=0.76, 95% CI 0.69 to 0.83) and higher CAIDE score was associated with poorer cognition (B=−0.73, 95% CI −0.82 to -0.65). Within twin-pair differences in educational-occupational score were significantly related to within twin-pair differences in cognition in dizygotic (DZ) pairs (B=0.78, 95% CI 0.25 to 1.31; N=338) but not in monozygotic (MZ) pairs (B=0.12, 95% CI −0.44 to 0.68; N=221). Within twin-pair differences in CAIDE score were not related to within twin-pair differences in cognition: DZ B=−0.38 (95% CI −0.90 to 0.14, N=343) and MZ B=−0.05 (95% CI −0.59 to 0.49; N=226).ConclusionMiddle-age dementia risk scores predicted old-age cognition, but within twin-pair analyses gave little support for associations independent of shared environmental and genetic factors. Understanding genetic underpinnings of risk score−cognition associations is important for early detection of dementia and designing intervention trials.

DT-02-06: Middle age protective score based on self-reported measures predicts dementia status in old age: A population-based study with 28-year follow-up

2015 ◽  
Vol 11 (7S_Part_7) ◽  
pp. P335-P335
Author(s):  
Eero Vuoksimaa ◽  
Kauko Heikkilä ◽  
Markku Koskenvuo ◽  
Juha O. Rinne ◽  
Jaakko Kaprio
Keyword(s):  
Old Age ◽  
Middle Age ◽  
Population Based ◽  
Population Based Study

scholarly journals Later onset of hypertension increased the risk of dementia in Mild Cognitive Impairment in community

2019 ◽  
Author(s):  
hongyun qin ◽  
chengping Hu ◽  
xudong Zhao ◽  
binggen Zhu ◽  
Zhicheng Cao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Old Age ◽  
Pulse Pressure ◽  
Middle Age ◽  
Multivariate Logistic Regression Analysis ◽  
Population Based ◽  
Age Group ◽  
Onset Age

Abstract Objective To investigate the effect of later onset of hypertension on the progression of MCI in community. Methods Participants are from The Study (NO.PKJ2010-Y26, 2011), a population-based longitudinal cognition survey of people aged 55+, sampled by probability proportional to size cluster. Hypertension onset age was estimated by self-reported information and medical insurance card records, then classified into two groups: the middle-age group (onset age < 65 years) and the old-age group (onset age ≥ 65 years). In order to study the effect of later onset of hypertension on dementia, the incidence of dementia was compared between the two groups. Results A total of 277 hypertensive mild cognitive impairment (MCI) participants without dementia were followed for 6 years. 56 MCI participants (20.22%) progressed to dementia (MCIp). The proportion of MCIp participants in the old-age onset hypertension group (≥ 65 years) was higher than that of middle-age onset one (27.0% vs 15.4%; X2 = 5.538, P = 0.019). And in the old-age onset hypertension group, the proportion of MCIp without diabetes mellitus was higher than those with diabetes mellitus (24.7% vs 12.6%; X2 = 5.321, P = 0.021), and the proportion of MCIp with increased pulse pressure was higher than those without increased pulse pressure (33.3% vs 15.4%; X2 = 3.902, P = 0.048). However, the multivariate logistic regression analysis showed that older age was the only risk for MCIp (OR=0.732, p=0.029). Conclusions These results suggest that, later onset hypertension was harmful to cognition even in cases where the level of blood pressure maintained at 130/80mmHg with antihypertensive management. It is necessary to expand the research sample and improve the experimental methods for further confirmation.

scholarly journals Alcohol drinking in middle age and subsequent risk of mild cognitive impairment and dementia in old age: a prospective population based study

BMJ ◽  
2004 ◽  
Vol 329 (7465) ◽  
pp. 539 ◽  
Author(s):  
Tiia Anttila ◽  
Eeva-Liisa Helkala ◽  
Matti Viitanen ◽  
Ingemar Kåreholt ◽  
Laura Fratiglioni ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Old Age ◽  
Alcohol Drinking ◽  
Middle Age ◽  
Population Based ◽  
Population Based Study ◽  
Subsequent Risk

scholarly journals Impact of a Population-based Systems Approach on Evidence-based Care for Medicaid-insured Pregnant and Postpartum Women: A Quasi-Experimental Study

2021 ◽  
Author(s):  
Lee Anne Roman ◽  
Jennifer E. Raffo ◽  
Kelly L. Strutz ◽  
Zhehui Luo ◽  
Melinda Johnson ◽  
...  
Keyword(s):  
Black Women ◽  
Systems Approach ◽  
First Trimester ◽  
Population Based ◽  
Postpartum Care ◽  
Care Utilization ◽  
Evidence Based ◽  
Experimental Population ◽  
Positive Effects ◽  
Quasi Experimental

AbstractIntroductionEvidence-based enhanced prenatal/postnatal care (EPC) programs for Medicaid-insured women have significant positive effects on care and health outcomes. However, EPC enrollment rates are typically low, enrolling less than 30% of eligible women. This study investigated the effects of a population-based systems approach on timely EPC participation and other health care utilization.MethodsThis quasi-experimental, population-based, difference-in-difference study used linked birth certificates, Medicaid claims, and EPC data from complete statewide Medicaid birth cohorts retrieved from 2009-2017 and analyzed in 2019-20. System strategies included cross-agency leadership, clinical-community linked practices, Community Health Worker care, mental health coordination, and patient empowerment. Outcomes included EPC participation and early enrollment, prenatal care adequacy, emergency department contact, and postpartum care.ResultsPrenatal EPC (7.4 absolute percentage points; 95% CI: 6.3—8.5) and first trimester EPC, (12.4; 95% CI: 10.2—14.5) increased among women served by practices that co-located EPC resources, relative to the comparator group. First trimester EPC improved in the county (17.9; 95% CI: 15.7—20.0); ED decreased in the practices (−11.1; 95% CI: -12.3— -9.9) and postpartum care improved (7.1; 95% CI: 6— 8.2) in the county. EPC participation for Black women served by the practices improved (4.4; 95% CI: 2.2—6.6), as well as early EPC (12.3; 95% CI: 9.0—15.6) and postpartum visits (10.4; 95% CI: 8.3—12.4).ConclusionsA population systems approach improved EPC participation and service utilization for Medicaid-insured women in a county population, for those in practices that co-located EPC resources, and for Black women.

scholarly journals Prediction of Frailty and Dementia Using Oral Health Impact Profile from a Population-Based Survey

2020 ◽  
Vol 17 (6) ◽  
pp. 1997
Author(s):  
Chi-Jung Tai ◽  
Jen-Hao Chen ◽  
Tzyy-Guey Tseng ◽  
Yi-Ting Lin ◽  
Yu-Han Hsiao ◽  
...  
Keyword(s):  
Oral Health ◽  
Prediction Models ◽  
Health Impact ◽  
Population Based ◽  
Community Dwelling ◽  
Self Report ◽  
Risk Scores ◽  
Stepwise Logistic Regression ◽  
Oral Health Impact Profile ◽  
Composite Risk

Oral health and dentition have been associated with cognitive ability and frailty, but an applicable screening tool has not yet been developed. This study aimed to establish risk prediction models for dementia and frailty. A sample of 2905 community-dwelling older adults aged ≥58 years using the Taiwan Longitudinal Study on Aging (TLSA) survey was adapted and analyzed for this study. Risk scores were estimated by stepwise logistic regression. In models adjusted for covariates, increased age, female sex, no dental prosthesis (adjusted Odds ratio [adjOR], 1.61; 95% confidence interval [CI], 1.11–2.35), diabetes mellitus, chronic kidney disease, and an increased Oral Health Impact Profile (OHIP)-7T Q3 score (adjOR, 1.33; 95% CI, 1.19–1.49) were all significantly associated with frailty. In addition to these factors, an inability to self-report height or weight (adjOR, 4.52; 95% CI, 3.52–5.81) and an increased OHIP-7T Q7 score (adjOR, 1.21; 95% CI, 1.06–1.37) were significantly associated with dementia. The cut-off points of the risk scores for frailty and dementia were 80 (sensitivity, 80.0%; specificity, 81.2%) and 77 (sensitivity, 83.4%; specificity, 71.5%), respectively. The findings highlighted a number of composite risk factors of frailty and dementia. Importantly, the developed prediction models were easily applicable to screen for frailty and dementia in communities or dental clinics.

Epidemiology for Monitoring and Evaluation

2021 ◽  
pp. 199-212
Author(s):  
J Patrick Vaughan ◽  
Cesar Victora ◽  
A Mushtaque R Chowdhury
Keyword(s):  
Systems Approach ◽  
Health Planning ◽  
Monitoring And Evaluation ◽  
Health Status Indicators ◽  
Population Based ◽  
Experimental Population ◽  
Quasi Experimental ◽  
Efficacy Measures ◽  
Study Designs ◽  
The Impact

Monitoring involves continuous observation to see if plans are on track and evaluation determines the effectiveness of planned health interventions delivered by the health services and programmes. The systems approach uses indicators to measure delivery, access, quality, and coverage of services and programmes and their impact on health status indicators. Efficacy measures the impact of interventions in individual people. Measuring effectiveness in whole communities utilizes quasi-experimental population-based study designs with community controls. The importance of ethical principles and monitoring equity in health planning is presented and emphasised.

scholarly journals Childhood socioeconomic circumstances and disability trajectories in older men and women: a European cohort study

2018 ◽  
Vol 29 (1) ◽  
pp. 50-58 ◽  
Author(s):  
Aljoscha Landös ◽  
Martina von Arx ◽  
Boris Cheval ◽  
Stefan Sieber ◽  
Matthias Kliegel ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Old Age ◽  
Daily Living ◽  
Longitudinal Research ◽  
Middle Age ◽  
Population Based ◽  
Older Age ◽  
Socioeconomic Indicators ◽  
Logistic Regression Models ◽  
And Control

Abstract Background We observed a lack of population-based longitudinal research examining the association of disadvantaged childhood socioeconomic circumstances (CSC) and disability [activities of daily living (ADL) and instrumental activities of daily living (IADL)] in older age, and whether socioeconomic attainments in adulthood can compensate for a poor socioeconomic start in life. Methods Data on 24 440 persons aged 50–96 in 14 European countries (Survey of Health, Ageing and Retirement in Europe) were used to measure the associations between CSC and limitations with ADL and with IADL, using mixed-effects logistic regression models. Models stratified by gender were adjusted for education during young adulthood, main occupation during middle age, ability to make ends meet during old age and potential confounding and control variables. Results Risks of ADL and IADL limitations increased with age and were different between women and men. For women, a gradient across CSC strata was observed, showing that the more disadvantaged the CSC, the higher the risk of ADL and IADL limitations in old age, even after adjustment for adult socioeconomic indicators. For men, the association between CSC and disability was mediated by the main occupation in middle age and the ability to make ends meet at older age. Conclusion Women who grew up in socioeconomically disadvantaged households were at higher risk of disability in older age and this disadvantage was not attenuated by favourable adult socioeconomic conditions. Men were more likely to make up for a disadvantaged start in adulthood.

Use of a Mild-Gain Hearing Aid by Middle-Age Normal-Hearing Adults Who Do and Do Not Self-Report Trouble Hearing in Background Noise

2020 ◽  
Vol 29 (3) ◽  
pp. 419-428
Author(s):  
Jasleen Singh ◽  
Karen A. Doherty
Keyword(s):  
Hearing Aids ◽  
Background Noise ◽  
Middle Age ◽  
Hearing Aid ◽  
Normal Hearing ◽  
Self Report ◽  
Hearing Aid Use ◽  
Hearing Handicap ◽  
Before And After ◽  
Hearing Problems

Purpose The aim of the study was to assess how the use of a mild-gain hearing aid can affect hearing handicap, motivation, and attitudes toward hearing aids for middle-age, normal-hearing adults who do and do not self-report trouble hearing in background noise. Method A total of 20 participants (45–60 years of age) with clinically normal-hearing thresholds (< 25 dB HL) were enrolled in this study. Ten self-reported difficulty hearing in background noise, and 10 did not self-report difficulty hearing in background noise. All participants were fit with mild-gain hearing aids, bilaterally, and were asked to wear them for 2 weeks. Hearing handicap, attitudes toward hearing aids and hearing loss, and motivation to address hearing problems were evaluated before and after participants wore the hearing aids. Participants were also asked if they would consider purchasing a hearing aid before and after 2 weeks of hearing aid use. Results After wearing the hearing aids for 2 weeks, hearing handicap scores decreased for the participants who self-reported difficulty hearing in background noise. No changes in hearing handicap scores were observed for the participants who did not self-report trouble hearing in background noise. The participants who self-reported difficulty hearing in background noise also reported greater personal distress from their hearing problems, were more motivated to address their hearing problems, and had higher levels of hearing handicap compared to the participants who did not self-report trouble hearing in background noise. Only 20% (2/10) of the participants who self-reported trouble hearing in background noise reported that they would consider purchasing a hearing aid after 2 weeks of hearing aid use. Conclusions The use of mild-gain hearing aids has the potential to reduce hearing handicap for normal-hearing, middle-age adults who self-report difficulty hearing in background noise. However, this may not be the most appropriate treatment option for their current hearing problems given that only 20% of these participants would consider purchasing a hearing aid after wearing hearing aids for 2 weeks.

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