Abstract W P126: Allostatic Load Predicts Stroke Mortality Risk in Older Danes: Findings From the 1914 Glostrup Aging Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Christian R Salazar ◽  
Kirsten Avlund ◽  
Douglas E Morse
Keyword(s):  
Cardiovascular Disease ◽  
Birth Cohort ◽  
Mortality Risk ◽  
Allostatic Load ◽  
Cox Regression ◽  
Oldest Old ◽  
Stroke Mortality ◽  
Risk Of Death ◽  
Aging Study ◽  
Physiological Markers

Allostatic load (AL) is a composite measure of cumulative biological damage derived from physiological markers across multiple systems. While previous reports have shown that AL predicts cardiovascular events at early old age, the prognostic value of AL on stroke mortality among the oldest old remains largely unexplored. The objective of this study was to evaluate the association between AL and stroke mortality risk in a birth cohort of older Danish adults from the 1914 Glostrup Aging Study. In total, 330 Danish participants completed a structured questionnaire at baseline (age 80) and were assessed for 10 physiological markers that spanned the cardiovascular (systolic and diastolic blood pressure, heart rate), metabolic (HDL, ratio of total cholesterol/HDL, BMI, triglycerides, serum albumin, blood glucose), and inflammatory (IL6, TNF-alpha) systems. Composite summary scores of AL ranging from 0-10 were computed for each participant using a count-based approach, with high and low cut-points of AL defined at the median. Using the Danish National Civil Death Registry, we ascertained deaths from cardiovascular disease and stroke for all participants and examined survival probability over a 15-year period with Cox regression. Overall, there were 106 cardiovascular disease-related deaths, of which 25 were due to stroke. Older adults with high AL had a 2-fold higher hazard risk of death from stroke than those with low AL (hazard ratio [HR]=1.96, 95% confidence interval [CI]: 0.89 - 4.35), after adjustment for conventional risk factors of stroke. When stratified by sex, men with high AL had about a 6-fold higher risk of death from stroke than those with low AL (adjusted HR= 5.67, 95% CI= 1.66 - 19.4). No association between AL and stroke mortality risk was observed in women (adjusted HR=0.78, 95% CI: 0.23 - 2.63) among whom there were only 6 stroke deaths. In a birth cohort of older Danish adults, AL showed promise as a prognostic tool for stroke mortality risk. Larger studies in more diverse populations are necessary to confirm our findings.

scholarly journals Raised cardiovascular disease mortality after central nervous system tumour diagnosis: analysis of 171 926 patients from UK and USA

2021 ◽  
Author(s):  
KAI JIN ◽  
Michael TC Poon ◽  
Paul M Brennan ◽  
Catherine LM Sudlow ◽  
Jonine D Figueroa
Keyword(s):  
Cardiovascular Disease ◽  
Central Nervous System ◽  
Nervous System ◽  
General Population ◽  
Mortality Risk ◽  
Cox Regression ◽  
Malignant Tumours ◽  
Targeted Interventions ◽  
Cns Tumours ◽  
Cvd Mortality

Background Patients with central nervous system (CNS) tumours have significant morbidity and mortality. Some studies showed CNS tumours patients may be at risk for cardiovascular disease (CVD) mortality. The magnitude of CVD risk among CNS tumours patients has not been comprehensively assessed. If CVD mortality is elevated in this population, there may be a potential for risk reduction to improve outcomes. We examined CVD mortality risk in patients with malignant and non-malignant CNS tumours. Methods We conducted analyses using UK (Wales)-based Secure Anonymised Information Linkage (SAIL) for 8743 CNS tumour patients diagnosed in 2000-2015 (54.9% of whom died) and US-based National Cancer Institutes Surveillance, Epidemiology, and End Results (SEER) for 163183 patients in 2005-2015 (39.6% of whom died). We calculated age-, sex-, and calendar-year- adjusted standardised mortality ratios (SMRs) for CVD death in CNS tumour patients compared to Welsh and US residents. We used multivariable cause-specific Cox regression models to examine factors associated with CVD mortality among CNS tumour patients. We stratified all analyses by malignancy and main histological types. Results CVD was the second commonest cause of death for CNS tumour patients in SAIL (UK) and SEER (US) (9.5% & 11.7%, respectively). Patients with CNS tumours had higher CVD mortality than the general population (SAIL SMR=2.64, 95% CI=2.39-2.90; SEER SMR=1.38, 95% CI=1.35-1.42). Malignant CNS tumour patients had over 2-fold higher CVD mortality risk in both US and UK cohorts. SMRs for non-malignant tumours were almost 2-fold higher in SAIL than in SEER (SAIL SMR=2.73, 95% CI=2.46-3.02; SEER SMR=1.30, 95% CI=1.26-1.33). The greatest magnitude of excess CVD mortality risk, particularly from cerebrovascular disease, was substantially greater in patients diagnosed at age younger than 50 years and within the first year after their cancer diagnosis (SAIL SMR=2.98, 95% CI=2.39-3.66; SEER SMR=2.14, 95% CI=2.03-2.25). Age, sex, race/ethnicity in USA, deprivation in UK and no surgery were associated with CVD mortality. Discussion CVD mortality is high among patients diagnosed with both malignant and non-malignant CNS tumours compared to the general population. Targeted interventions and risk stratification tools might improve survival.

Mortality after proximal hip fracture in the Singapore population

2005 ◽  
Vol 15 (3) ◽  
pp. 166-170 ◽  
Author(s):  
K.H. Lin ◽  
Y.W. Lim ◽  
Y.J. Wu ◽  
K.S. Lam
Keyword(s):  
Hip Fracture ◽  
Mortality Risk ◽  
Cox Regression ◽  
Regional Hospital ◽  
Age Group ◽  
Risk Of Death ◽  
The Past ◽  
The Mean ◽  
One Year

The aims were to prospectively assess the mortality risk following proximal hip fractures, identify factors predictive of increased mortality and to investigate the time trends in mortality with comparison to previous studies. Prospectively collected data from 68 consecutive patients who had been admitted to a regional hospital from May 2001 to September 2001 were reviewed. The mean age of the patients was 79.3 years old (range, 55–98) and 72.1% females. Patients were followed prospectively to determine the mortality risk associated with hip fracture over a two-year follow-up period. The acute in-hospital mortality rate at six months, one year and two years was 5.9% (4/68), 14.7% (10/68), 20.6% (14/68) and 25% (17/68) respectively. One-year and two-year mortality for those patients who were 80 or older was significantly higher than for other patients and the number of co-morbid illnesses also had significant effect. Cox regression was performed to determine the significant predictors for survival time. It was noted that patients 80 years or older were at higher risk of death compared with those less than 80 years as well as those with higher number of co-morbid illnesses. Our mortality rates have not declined in the past 10 years when compared with previous local studies. We conclude that for this group of patients studied, their mortality at one year and two years could be predicted by their age group and their number of co-morbid illnesses.

scholarly journals Religious affiliation and the risk of COVID 19 related mortality; a retrospective analysis of variation in pre and post lockdown risk by religious group in England and Wales

2020 ◽  
Author(s):  
Charlotte Hannah Gaughan ◽  
Daniel Ayoubkhani ◽  
Vahe Nafilyan ◽  
Peter Goldblatt ◽  
Chris White ◽  
...  
Keyword(s):  
Mortality Risk ◽  
Cox Regression ◽  
Religious Affiliation ◽  
Religious Groups ◽  
England And Wales ◽  
Risk Of Death ◽  
Before And After ◽  
The Difference ◽  
Behavioural Factors ◽  
The Uk

AbstractBackgroundCOVID 19 mortality risk is associated with demographic and behavioural factors; furthermore religious gatherings have been linked with the spread of COVID. We sought to understand the variation in the risk of COVID 19 related death across religious groups in the UK both before and after lockdown.MethodsWe conducted a retrospective cohort study of usual residents in England and Wales enumerated at the 2011 Census (n = 48,422,583), for risk of death involving COVID-19 using linked death certificates. Cox regression models were estimated to compare risks between religious groups. Time dependent religion coefficients were added to the model allowing hazard ratios (HRs) pre and post lockdown period to be estimated separately.ResultsCompared to Christians all religious groups had an elevated risk of death involving COVID-19; the largest age adjusted HRs were for Muslim and Jewish males at 2.5 (95% confidence interval 2.3-2.7) and 2.1 (1.9-2.5), respectively. The corresponding HRs for Muslim and Jewish females were 1.9 (1.7-2.1) and 1.5 (1.7-2.1). The difference in risk between groups contracted after lockdown. Those who affiliated with no religion had the lowest risk of COVID 19 related death before and after lockdown.ConclusionThe majority of the variation in COVID 19 mortality risk was explained by controlling for socio demographic and geographic determinants; however, Jews remained at a higher risk of death compared to all other groups. Lockdown measures were associated with reduced differences in COVID 19 mortality rates between religious groups, further research is required to understand the causal mechanisms.

scholarly journals Growth monitoring and mortality risk in low birthweight infants: a birth cohort study in Burkina Faso

2021 ◽  
Vol 5 ◽  
pp. 82
Author(s):  
Martha Mwangome ◽  
Moses Ngari ◽  
Paluku Bahwere ◽  
Patrick Kabore ◽  
Marie McGrath ◽  
...  
Keyword(s):  
Weight Gain ◽  
Birth Weight ◽  
Burkina Faso ◽  
Birth Cohort ◽  
Mortality Risk ◽  
Low Birthweight ◽  
Growth Monitoring ◽  
Operating Characteristics ◽  
Risk Of Death ◽  
Increased Risk

Background: Wasting and underweight in infancy is an increasingly recognised problem but consensus on optimum assessment is lacking.  In particular, there is uncertainty on how to interpret anthropometry among low birth weight (LBW) infants who may be growing normally. This research aimed to determine growth of infants from birth to two months (around age of vaccination) and the mortality risk of underweight LBW infants compared to normal birth weight (NBW) infants at two and six months age. Methods: A secondary analysis of a birth cohort of 1103 infants in Burkina Faso was conducted. Anthropometry was performed monthly from 0 to 12 months. We assessed associations with mortality using Cox proportional hazards models and assessed discriminatory values using area under receiver operating characteristics curves. Results: Eighty-six (7.8%) children died by age one year, 26/86 (30%) and 51/86 (59%) within two and six months, respectively. At age two months, weight gain since birth did not better discriminate mortality risk than current weight-for-age (P=0.72) or mid-upper arm circumference (P=0.21). In total, 227 (21%) LBW infants had increased risk of mortality: adjusted hazards ratio (aHR) 3.30 (95%CI 2.09 to 4.90).  Among infants who were underweight at two and six months, LBW infants (64% and 49%, respectively) were not at reduced risk of death compared to NBW infants (aHR 2.63 (95%CI 0.76 to 9.15) and 2.43 (95%CI 0.74 to 7.98), respectively). Conclusion: Assessing weight gain since birth does not offer advantages over immediate anthropometry for discriminating mortality risk. LBW infants who are later identified as underweight require care to help prevent mortality.

Association of obesity indices with physiological markers for cardiovascular disease among middle age and elderly in Chuncheon : Hallym Aging Study.

2008 ◽  
Vol 30 (1) ◽  
pp. 89-99 ◽  
Author(s):  
Jin Young Jeong ◽  
Jeong Hun Kim ◽  
Young Ho Choi ◽  
Soong Nang Jang ◽  
Yong Jun Choi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Middle Age ◽  
Aging Study ◽  
Obesity Indices ◽  
Physiological Markers

scholarly journals Association of age at first drink and first alcohol intoxication as predictors of mortality: a birth cohort study

2020 ◽  
Vol 30 (6) ◽  
pp. 1189-1193
Author(s):  
Jonna Levola ◽  
Richard J Rose ◽  
Antti Mustonen ◽  
Marian Sarala ◽  
Jouko Miettunen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Birth Cohort ◽  
Cox Regression ◽  
Alcohol Intoxication ◽  
Age At Onset ◽  
Birth Cohort Study ◽  
Adolescent Drinking ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Health Related

Abstract Background More information on the health-related repercussions of age at onset of adolescent drinking is needed. The aim of this study was to examine the associations between self-reported age at first drink and age at first alcohol intoxication with the risk of death by age 30. Methods The sample (n = 6564; 49.1% males) included all participants of the Northern Finland Birth Cohort Study 1986 (NFBC1986) for whom the two measures of adolescent drinking were available. Self-reported age at onset of first drink and first alcohol intoxication were analyzed along with background variables and data regarding subsequent psychiatric diagnoses. Adolescents were dichotomized into those reporting age at first drink and age at first intoxication before or after age 14. Cox regression was used to calculate hazard ratios (HRs) with 95% confidence interval (95% CI) for death by age 30. Results By the age of 30, 0.7% (n = 47) of all 6564 participants were deceased. In the multivariable models, male gender and a history of illicit substance use in adolescence were associated with both all-cause mortality and mortality due to accidents or suicide. After controlling for confounding variables, age at first alcohol intoxication was associated with all-cause mortality (HR 2.33; 95% CI 1.04–5.20) as well as death due to accidents or suicide (HR 2.99; 95% CI 1.11–8.05). Conclusions Earlier age at first intoxication carries long-term repercussions with respect to premature loss of life. Efforts should be made targeting the prolongation of initiating binge drinking in adolescence to diminish this mortality risk.

scholarly journals Algorithm for assessing the total 10 years risk of death from cardiovascular diseases in women 25-64 years old in Tyumen (Tyumen risk scale)

2021 ◽  
pp. 14-21
Author(s):  
G. S. Pushkarev ◽  
S. T. Matskeplishvili ◽  
V. A. Kuznetsov ◽  
E. V. Akimova
Keyword(s):  
Cardiovascular Risk ◽  
Mortality Rate ◽  
Marital Status ◽  
Mortality Risk ◽  
Cardiovascular Mortality ◽  
Cox Regression ◽  
High Density Lipoproteins ◽  
Female Population ◽  
Risk Of Death ◽  
Cardiovascular Mortality Risk

Purpose: To define total 10-year cardiovascular mortality risk in Russian females in dependence on traditional and psychosocial risk factors (RF) and to design the algorithm of its estimation.Methods. The study included non-organized population of Central Administrative district of Tyumen city. Epidemiological study, based on the representative selection of 1000 females aged 25-64 years. Screening respond was 81.3%. Cardiovascular mortality rate within 10 years was studied. Totally, 31 cases of cardiovascular death were registered in female cohort within 10year follow-up. We used a multivariate Cox regression model to estimate hazard ratio (HR) and confidence interval (CI). Relations between mortality rate and factors such as age, smoking, education, occupation, marital status, systolic and diastolic blood pressure (SBP and DBP), body mass index, total cholesterol, cholesterol of low and high density lipoproteins were analyzed.Results. To build a model of total cardiovascular risk, six statistically significant indicators were selected: age (HR – 1.099, 95% CI 1.032-1.1.69), SBP (1.026, 95% CI 1.011-1.041), primary education (4.315, 95% CI 1.878-9.910), work associated with heavy physical labor (4.073, 95% CI 1.324-12.528), executives (3.822, 95% CI 1.386-10.537) and marital status (2.978, 95% CI 1.197-7.409). Based on these data, model for total cardiovascular mortality risk in females was designed with good predictive accuracy (AUC was 0.882, 95% CI – 0.833 – 0.930).Conclusion. Thus, created mathematical model, built based on statistically significant traditional and psychosocial RF, makes it possible to effectively predict the total cardiovascular risk at the individual level in the female population.

scholarly journals Nocturia as a Risk Factor for All-Cause and Cardiovascular Disease Mortality

2021 ◽  
Author(s):  
Shinje Moon ◽  
Yoon Jung Kim ◽  
Hye Soo Chung ◽  
Jae Myung Yu ◽  
Il In Park ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Mortality Risk ◽  
Cox Regression ◽  
Baseline Survey ◽  
Mortality Data ◽  
Cox Regression Analysis ◽  
Health And Nutrition ◽  
Disease Mortality ◽  
Confounding Variables ◽  
Cox Proportional Hazard Regression

Abstract This study aimed to evaluate the relationship between nocturia and mortality risk using the National Health and Nutrition Examination Survey database 2005–2010, given that only few studies have investigated nocturia or its association with mortality using this database. Data were obtained from the database, and nocturia was defined based on the symptom questionnaire. We categorized patients into two groups: mild nocturia (2–3 voids/night) and moderate-to severe nocturia (≥4 voids/night). Mortality data were obtained by linking the primary database to death certificate data found in the National Death Index with mortality follow-up up to December 31, 2015. Multiple Cox proportional hazard regression analyses were performed with adjustment for confounding variables at the baseline survey. We included 9,892 adults (4,758 men, 5,134 women) in this study. Nocturia occurred in 3,314 individuals (33.5%). In the multiple Cox regression analysis (results presented as hazard ratio, 95% confidence interval), nocturia was significantly associated with all-cause (1.21, 1.08–1.35, p=0.001) and cardiovascular disease (1.45, 1.13–1.85, p=0.003) mortality. Both mild and moderate-to-severe nocturia were significantly associated with all-cause (1.14, 1.02–1.28, p=0.021 and 1.62, 1.34–1.98, p<0.001, respectively) and cardiovascular disease (1.43, 1.11–1.84, p=0.006 and 1.58, 1.01–2.45, p=0.043, respectively) mortality. Nocturia was significantly associated with mortality in men and women after adjustments for major confounding factors. Moreover, the mortality risk increased with increasing nocturia severity.

scholarly journals Low serum klotho associated with all-cause mortality among a nationally representative sample of American adults

2021 ◽  
Author(s):  
Jacob K Kresovich ◽  
Catherine M Bulka
Keyword(s):  
Physical Activity ◽  
Mortality Risk ◽  
Representative Sample ◽  
Cox Regression ◽  
The United States ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Nationally Representative ◽  
Low Serum

Abstract α-Klotho (klotho) is a protein involved in suppressing oxidative stress and inflammation. In animal models, it is reported to underlie numerous aging phenotypes and longevity. Among a nationally representative sample of adults aged 40 to 79 in the United States, we investigated whether circulating concentrations of klotho is a marker of mortality risk. Serum klotho was measured by ELISA on 10,069 individuals enrolled in the National Health and Nutrition Examination Survey between 2007-2014. Mortality follow-up data based on the National Death Index were available through December 31, 2015. After a mean follow-up of 58 months (range: 1-108), 616 incident deaths occurred. Using survey-weighted Cox regression models adjusted for age, sex and survey cycle, low serum klotho concentration (&lt; 666 pg/mL) was associated with a 31% higher risk of death (compared to klotho concentration &gt; 985 pg/mL, HR: 1.31, 95% CI: 1.00, 1.71, P= 0.05). Associations were consistent for mortality caused by heart disease or cancer. Associations of klotho with all-cause mortality did not appear to differ by most participant characteristics. However, we observed effect modification by physical activity, such that low levels of serum klotho were more strongly associated with mortality among individuals who did not meet recommendation-based physical activity guidelines. Our findings suggest that, among the general population of American adults, circulating levels of klotho may serve as a marker of mortality risk.

scholarly journals Prospective Association of the Portfolio Diet with All-Cause and Cause-Specific Mortality Risk in the Mr. OS and Ms. OS Study

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4360
Author(s):  
Kenneth Lo ◽  
Andrea J. Glenn ◽  
Suey Yeung ◽  
Cyril W. C. Kendall ◽  
John L. Sievenpiper ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Mortality Risk ◽  
Cancer Mortality ◽  
Lower Risk ◽  
Cox Regression ◽  
Statistical Significance ◽  
Food Sources ◽  
Inverse Association ◽  
Diet Adherence ◽  
Specific Mortality

The Portfolio Diet has demonstrated its cardiovascular benefit from interventions, but the association between Portfolio Diet adherence and the risk of all-cause and cause-specific mortality has not been examined in Chinese population. The present study has collected Portfolio Diet adherence (assessed by food frequency questionnaire), lifestyle factors and mortality status of 3991 participants in the Mr. Osteoporosis (OS) and Ms. OS Study. Cox regression models were used to examine the association between the Portfolio Diet adherence and mortality risk (all-cause, cardiovascular disease or cancer). The highest quartile of the Portfolio Diet score was associated with a 28% lower risk of all-cause (hazard ratio, HR: 0.72) and cancer (HR: 0.72) mortality, respectively. The association between Portfolio Diet adherence and cardiovascular disease mortality did not reach statistical significance (HR: 0.90, 95% CI = 0.64, 1.26). Among male participants, the highest adherence to the Portfolio Diet was also associated with a lower risk of all-cause (HR: 0.63) and cancer mortality (HR: 0.59), and there was an inverse association between food sources of plant protein and the risk of cardiovascular mortality (HR: 0.50). However, most associations between the Portfolio Diet and mortality were not significant among females. The protection for cancer mortality risk might reach the plateau at the highest adherence to the Portfolio Diet for females. To conclude, greater adherence to the Portfolio Diet was significantly associated with a lower risk of mortality in Hong Kong older adults, and the associations appeared stronger among males.

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