Prevalence of Disability Associated With Head Injury With Loss of Consciousness in Adults in the United States: A Population-Based Study

Objective:To provide nationally representative prevalence estimates of disability associated with prior head injury with loss of consciousness in the U.S. and to examine associations between prior head injury and disability.Methods:Cross-sectional analysis of 7,390 participants aged ≥40 years in the 2011-2014 National Health and Nutrition Examination Surveys (NHANES). Head injury with loss of consciousness was assessed by self-report. Domains of disability were assessed using a standardized structured questionnaire and measured grip strength. Logistic regression models adjusted for demographic, socioeconomic/behavioral, and medical comorbidity variables were used. Multiple imputation was used to account for missing covariate data.Results:Mean age of participants was 58 years, 53% were female, 71% were non-Hispanic white, and 16% had a history of head injury with loss of consciousness. Overall, participants with a history of head injury had higher prevalence of disability in at least one domain of functioning compared to individuals without head injury (47.4% versus 38.6%, p<0.001), with the highest prevalence of disability in the domains of mobility and work productivity. In fully adjusted models, head injury was significantly positively associated with disability in all domains assessed on the standardized questionnaire (all p<0.05), but not with upper extremity grip strength (all p>0.05).Conclusions:47.4% of individuals aged ≥40 years in the U.S with a history of head injury are living with disability in at least one domain of functioning, corresponding to 11.4 million affected individuals. This significant burden of disability suggests that efforts are needed to improve functioning among individuals with head injury.

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Misuse of Tramadol in the United States: An Analysis of the National Survey of Drug Use and Health 2002-2017

Substance Abuse Research and Treatment ◽

10.1177/1178221820930006 ◽

2020 ◽

Vol 14 ◽

pp. 117822182093000

Author(s):

Scott A Reines ◽

Bonnie Goldmann ◽

Mark Harnett ◽

Lucy Lu

Keyword(s):

Drug Use ◽

National Survey ◽

Household Survey ◽

The United States ◽

Population Based ◽

Cross Sectional ◽

Health Related ◽

Nationally Representative ◽

The U.S ◽

Intravenous Formulation

Objective: To analyze the rates of misuse - that is, use in any way not directed by a doctor - of products containing oral tramadol, a Schedule IV opioid, from the National Survey of Drug Use and Health (NSDUH), as compared to comparator Schedule II opioids (morphine, oxycodone, and hydrocodone) and alprazolam, a commonly prescribed Schedule IV controlled substance in the U.S. Methods: The NSDUH is a congressionally mandated household survey that collects information on tobacco, alcohol, and drug use, mental health and other health-related issues in the US. A cross-sectional surveillance study design was used to examine lifetime and past year misuse of oral tramadol and comparators of interest among NSHUH respondents aged 12 years or older. Based on when particular data were available, the past-year misuse analysis includes NSDUH data from 2015 to 2017, and the lifetime misuse analysis includes NSDUH data from 2002 to 2014. Results: In 2015 to 2017, past-year misuse of oral tramadol was approximately 4% of the total number of prescriptions, versus 7% to 8% for all of the comparators when adjusted for drug availability. In 2002 to 2014, lifetime misuse of oral tramadol remained at 1.5% or less over the 13-year period, and was lower than reported for hydrocodone (6%) and oxycodone (4%), respectively. Comparison of oral tramadol and alprazolam showed misuse of tramadol was also much lower than alprazolam. Too few reports of tramadol misuse by injection (n = 7) were reported, versus 570, 1096, and 32 reports of injection of morphine, oxycodone, and hydrocodone, respectively, during the 16-year analysis period to allow for any population-based estimation. Only morphine has an intravenous formulation available and tramadol was not available as an intravenous formulation in the U.S. during that time period. Conclusions: This analysis shows a low prevalence of oral tramadol misuse, relative to other commonly prescribed opioids, in a nationally representative sample of noninstitutionalized US residents. Estimates of reported oral tramadol misuse have remained relatively stable over time and are substantially lower than those reported for comparators when adjusted for prescription volume. Reports of oral tramadol misuse are also much less than alprazolam, another Schedule IV drug.

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Prevalence and determinants of erectile dysfunction in Santos, southeastern Brazil

Sao Paulo Medical Journal ◽

10.1590/s1516-31802002000200005 ◽

2002 ◽

Vol 120 (2) ◽

pp. 49-54 ◽

Cited By ~ 40

Author(s):

Edson Duarte Moreira Júnior ◽

Walter Jorge Bestane ◽

Elaine Bestane Bartolo ◽

João Antônio Saraiva Fittipaldi

Keyword(s):

Erectile Dysfunction ◽

Strong Predictor ◽

The United States ◽

Population Based ◽

Cross Sectional Study ◽

Southeastern Brazil ◽

Cross Sectional ◽

Heavy Smoking ◽

Potential Risk Factors ◽

History Of

CONTEXT: Recent population-based surveys suggest that the prevalence of erectile dysfunction is between 30% and 56% among men over the age of 40. Most of these studies, however, are from the United States or Europe. We need estimates of erectile dysfunction from samples of Brazilian populations, as societies that differ ethnically, culturally, and economically may also differ with respect to potential risk factors for erectile dysfunction. OBJECTIVE: To determine the prevalence of erectile dysfunction and its potential correlates. SETTING: Santos, State of São Paulo. DESIGN: Cross-sectional study. PARTICIPANTS: A population-based sample of men aged 40-70 years. Out of 718 men invited, 342 (47.6%) returned a completed questionnaire. MAIN MEASUREMENTS: Data on demographic variables, medical history, lifestyle habits and degree of erectile dysfunction. RESULTS: The prevalence of any degree of erectile dysfunction was 45.9% (minimal, 33.9%; moderate, 8.5%; complete, 3.5%) and increased with age. In bivariate age-adjusted analyses comparing men with no erectile dysfunction or minimal erectile dysfunction with those with moderate or complete erectile dysfunction, histories of diabetes or hypertension, depressive symptoms, heavy smoking and obesity were significantly associated with increased prevalence of erectile dysfunction, whereas moderate alcohol consumption was inversely associated with erectile dysfunction. In the multivariate model, age was a strong predictor of erectile dysfunction, while history of diabetes or hypertension and heavy smoking remained significantly associated with increased prevalence of erectile dysfunction. CONCLUSION: We found higher prevalence of erectile dysfunction (45.9%) among men older than 40 years old in Brazil. The variables associated with erectile dysfunction may alert physicians to patients who are at risk of erectile dysfunction as well as offer clues to the etiology of erectile dysfunction. Physicians should routinely ask their patients about sexual health and erectile dysfunction.

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BDNF SNP C270T Modifies the Association Between History of Head Injury and Cognitive Status in Older Adults

Innovation in Aging ◽

10.1093/geroni/igab046.2494 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 665-666

Author(s):

Mikaela Drewel ◽

Hector Gonzalez ◽

Gail Rattinger ◽

Joshua Matyi ◽

Alexandra Hammond ◽

...

Keyword(s):

Older Adults ◽

Head Injury ◽

Population Based ◽

Cognitive Status ◽

Cognitive Outcomes ◽

Self Report ◽

Nucleotide Polymorphisms ◽

Mixed Effect ◽

History Of ◽

Bdnf Signaling

Abstract Brain derived neurotrophic factor (BDNF), is a neurotrophin involved in neurogenesis and neuroplasticity. Several BDNF genes have been associated with cognitive function. Studies suggest head injury (HI) alters BDNF levels, and activities enhancing BDNF signaling promote better cognitive outcomes. We investigated the relationship between HI and BDNF single-nucleotide polymorphisms (SNPs) in predicting cognitive performance in a population-based sample of older adults. 4165 participants (56.7% female), dementia-free at baseline, were assessed triennially [follow-up years: mean (SD) = 5.85 (4.20), median = 7.33, maximum = 11.39]. Mean (SD) age was 75.36 (6.84). Cognition was assessed using the Modified Mini-Mental State Exam (3MS) and HI history from self-report. We examined interactions between BDNF SNPs [rs56164415 (BDNF C270T), rs6265 (Val66Met), rs2289656 (BDNF receptor trkB), and rs2072446 (NGF/BDNF receptor p75)] and history of HI (none, one, or multiple) in predicting cognitive decline. Covariates included age, education, sex, and apolipoprotein (APOE) E4 allele presence. Linear mixed-effect models indicated BDNF C270T significantly modified the association between HI and cognitive status (p < .006). Specifically, minor T allele carriers with single or multiple HI scored on average 2.08 and 3.21 points lower on the 3MS, respectively, than non-T carriers with no HI. Unexpectedly, there was a trend for APOE4*HI (p = .078) in that APOE E4 carriers with multiple HI scored higher than those lacking APOE E4 and HI. In this population-based sample, rs56164415 predicted cognitive outcomes that varied by history of HI. Factors influencing BDNF signaling may provide a potential avenue for intervention in recovery from HI.

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An American Language

10.1525/california/9780520297067.001.0001 ◽

2018 ◽

Cited By ~ 8

Author(s):

Rosina Lozano

Keyword(s):

United States ◽

National Policy ◽

The United States ◽

Spanish Language ◽

Spanish Speakers ◽

Language Recognition ◽

Political Language ◽

Political Issue ◽

History Of ◽

The U.S

An American Language is a political history of the Spanish language in the United States. The nation has always been multilingual and the Spanish language in particular has remained as an important political issue into the present. After the U.S.-Mexican War, the Spanish language became a language of politics as Spanish speakers in the U.S. Southwest used it to build territorial and state governments. In the twentieth century, Spanish became a political language where speakers and those opposed to its use clashed over what Spanish's presence in the United States meant. This book recovers this story by using evidence that includes Spanish language newspapers, letters, state and territorial session laws, and federal archives to profile the struggle and resilience of Spanish speakers who advocated for their language rights as U.S. citizens. Comparing Spanish as a language of politics and as a political language across the Southwest and noncontiguous territories provides an opportunity to measure shifts in allegiance to the nation and exposes differing forms of nationalism. Language concessions and continued use of Spanish is a measure of power. Official language recognition by federal or state officials validates Spanish speakers' claims to US citizenship. The long history of policies relating to language in the United States provides a way to measure how U.S. visions of itself have shifted due to continuous migration from Latin America. Spanish-speaking U.S. citizens are crucial arbiters of Spanish language politics and their successes have broader implications on national policy and our understanding of Americans.

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National Estimates of Genetic Testing in Women With a History of Breast or Ovarian Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2017.73.6314 ◽

2017 ◽

Vol 35 (34) ◽

pp. 3800-3806 ◽

Cited By ~ 112

Author(s):

Christopher P. Childers ◽

Kimberly K. Childers ◽

Melinda Maggard-Gibbons ◽

James Macinko

Keyword(s):

Ovarian Cancer ◽

Genetic Testing ◽

Unmet Need ◽

Cancer Control ◽

The United States ◽

Eligibility Criteria ◽

Cross Sectional ◽

Age Of Diagnosis ◽

History Of ◽

Interview Survey

Purpose In the United States, 3.8 million women have a history of breast (BC) or ovarian cancer (OC). Up to 15% of cases are attributable to heritable mutations, which, if identified, provide critical knowledge for treatment and preventive care. It is unknown how many patients who are at high risk for these mutations have not been tested and how rates vary by risk criteria. Methods We used pooled cross-sectional data from three Cancer Control Modules (2005, 2010, 2015) of the National Health Interview Survey, a national in-person household interview survey. Eligible patients were adult females with a history of BC and/or OC meeting select 2017 National Comprehensive Cancer Network eligibility criteria on the basis of age of diagnosis and family history. Outcomes included the proportion of individuals reporting a history of discussing genetic testing with a health professional, being advised to undergo genetic testing, or undergoing genetic testing for BC or OC. Results Of 47,218 women, 2.7% had a BC history and 0.4% had an OC history. For BC, 35.6% met one or more select eligibility criteria; of those, 29.0% discussed, 20.2% were advised to undergo, and 15.3% underwent genetic testing. Testing rates for individual eligibility criteria ranged from 6.2% (relative with OC) to 18.2% (diagnosis ≤ 45 years of age). For OC, 15.1% discussed, 13.1% were advised to undergo, and 10.5% underwent testing. Using only four BC eligibility criteria and all patients with OC, an estimated 1.2 to 1.3 million individuals failed to receive testing. Conclusion Fewer than one in five individuals with a history of BC or OC meeting select National Cancer Comprehensive Network criteria have undergone genetic testing. Most have never discussed testing with a health care provider. Large national efforts are warranted to address this unmet need.

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Prevalence of disabilities and non-communicable diseases in an elderly population in the Telangana state, India: a population-based cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-041755 ◽

2021 ◽

Vol 11 (2) ◽

pp. e041755

Author(s):

Srinivas Marmamula ◽

Satya Brahmanandam Modepalli ◽

Thirupathi Reddy Kumbham ◽

Rajesh Challa ◽

Jill E Keeffe

Keyword(s):

Elderly Population ◽

Self Care ◽

The Elderly ◽

Population Based ◽

Cross Sectional Study ◽

Communicable Diseases ◽

Self Report ◽

Sectional Study ◽

Cross Sectional ◽

Non Communicable Diseases

ObjectivesTo assess the prevalence of disabilities (vision, hearing, mobility, cognitive, self-care and communication) and non-communicable diseases (NCDs) among the elderly population in two districts in Telangana, India.DesignPopulation-based cross-sectional study using a cluster random sampling method to select the study clusters.SettingElderly population in Khammam and Warangal districts were recruited. Detailed interviews were conducted by trained community health workers. Personal and demographic information such as age, gender, level of education and a self-report of NCDs was collected. The Washington Disability Questionnaire was administered to assess the presence of disabilities.Participants1821 participants aged ≥60 years, 54.5% were women, and 73.3% had no education.Primary outcome measurePrevalence of disabilities and NCDs.ResultsOverall, the prevalence of at least disability was 20.3% (95% CI 16.3 to 24.9). The prevalence of self- reported disabilities were: seeing (5.9%; 95% CI 4.4 to 7.8), mobility (12.8%; 95% CI 9.7 to 16.8), hearing (3.6%; 95% CI 2.7 to 4.8), cognition (4.8%; 95% CI 3.5 to 6.7), self-care (3.3%; 95% CI 2.3 to 4.7) and communication (1.8%; 95% CI 1.2 to 2.6). Overall, the prevalence of at least one NCD was 34.2% (95% CI 30.9 to 37.7). Hypertension was the most common systemic condition (25.4%; 95% CI 22.4 to 28.7), followed by diabetes (9.0%; 95% CI 7.3 to 11.0), and body pains (muscle-skeletal) (9.9%; 95% CI 8.1 to 12.2).ConclusionEvery fifth elderly person in the districts of Khammam and Warangal in Telangana had at least one self-reported disability. Besides, a third of the elderly had at least one NCD. There is a definite need to develop comprehensive public health strategies to address disabilities and NCDs in Telangana.

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Association of Edentulism with Various Chronic Diseases in Mexican Elders 60+ Years: Results of a Population-Based Survey

Healthcare ◽

10.3390/healthcare9040404 ◽

2021 ◽

Vol 9 (4) ◽

pp. 404

Author(s):

Alejandro José Casanova-Rosado ◽

Juan Fernando Casanova-Rosado ◽

Mirna Minaya-Sánchez ◽

José Luís Robles-Minaya ◽

Juan Alejandro Casanova-Sarmiento ◽

...

Keyword(s):

Angina Pectoris ◽

Mental Disorders ◽

Chronic Diseases ◽

Population Based ◽

Self Report ◽

World Health ◽

Complex Nature ◽

Cluster Sampling ◽

World Health Survey ◽

Cross Sectional

Objective: To determine the association of edentulism with different chronic diseases and mental disorders in Mexicans aged 60 years and over. Material and Methods: A cross-sectional study was carried out using data from the World Health Survey for Mexico, in a probabilistic, multi-stage cluster sampling framework. Data for self-report of chronic diseases (diabetes, arthritis, angina pectoris and asthma), mental disorders (depression and schizophrenia) and edentulism were analyzed. Edentulism data were available for 20 of the 32 States of Mexico. Statistical analysis was performed in Stata 14.0 using the svy module for complex sampling (Complex nature under which individuals are sampled). Results: In total 4213 subjects were included, representing a population of 7,576,057 individuals. Mean age was 70.13 ± 7.82 years (range 60 to 98); 56.2% were women. Chronic diseases’ prevalence and mental disorders prevalence were as follows: diabetes 15.0% (N = 1,132,693); arthritis 13.2% (N = 1,001,667); depression 5.5% (N = 414,912); angina pectoris 4.5% (344,315); asthma 3.6% (N = 269,287); and schizophrenia 2.2% (N = 16,988). The prevalence of edentulism was 26.3%, which pertained to 1,993,463 people aged 60 years and over. Angina in women aged 60 to 69 years (p < 0.05) and depression in men aged 70 years and over (p < 0.0001) were associated with higher prevalence of edentulism. Conclusions: There was generally sparse association between edentulism on chronic diseases and mental disorders included in the study, except for women aged 60 to 69 years for angina, and in men aged 70 and over, for depression. Although our findings are misaligned with previous reports, longitudinal studies are required to test causal and temporal relationships between edentulism with chronic diseases and mental disorders.

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The association between subclinical hypothyroidism and TPOAb positivity with infertility in a population-based study: Tehran thyroid study (TTS)

BMC Endocrine Disorders ◽

10.1186/s12902-021-00773-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Batul Birjandi ◽

Fahimeh Ramezani Tehrani ◽

Atieh Amouzegar ◽

Maryam Tohidi ◽

Razieh Bidhendi Yarandi ◽

...

Keyword(s):

Thyroid Autoimmunity ◽

Population Based ◽

Cross Sectional Study ◽

Cross Sectional ◽

Population Based Study ◽

History Of ◽

Autoimmune Condition ◽

Biochemical Measurements ◽

Adverse Pregnancy ◽

Adjusted Logistic Regression

Abstract Background Thyroid autoimmunity(TAI) is the most prevalent autoimmune condition in women of fertile age. There are increasing data regarding the association of thyroid dysfunction and thyroid autoimmunity with adverse pregnancy outcomes but there is no consensus regarding infertility and TPOAb positivity; thus we aimed to evaluate the association between thyroid TPOAb positivity and infertility in females and males in a population-based study (TTS). Methods Cross-sectional study of 3197 female and male participants in Tehran Thyroid Study (TTS) at the framework of the Tehran Lipid and Glucose Study (TLGS). Data included biochemical measurements and a self-administered questionnaire. Results A total of 12,823 cases in phase 4, 3719 cases (2108 female and 1611 male) were analyzed. The mean TSH of the infertile female and male was 2.52 ± 2.68 μIU/ml and 3.24 ± 10.26 μIU/ml respectively. The TPO median(IQR) of women with and without a history of infertility were 6.05 (3.30–13.96)and 6.04 (3.17–11.15);(P = 0.613), they were 5.08 (3.20–125.68) and 5.31 (3.93–125.68);(P = 0.490) in male participants, respectively. Results of crude and adjusted logistic regression analysis of the development of infertility by thyroid function and TPOAb, except for fT4 in male subjects, depicted no association between infertility and other variables in both crude and adjusted models. Conclusion Based on the result, thyroid autoimmunity was not associated with infertility in both females and males.

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Subjective cognitive complaints at age 70: associations with amyloid and mental health

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2020-325620 ◽

2021 ◽

pp. jnnp-2020-325620

Author(s):

Ivanna M. Pavisic ◽

Kirsty Lu ◽

Sarah E. Keuss ◽

Sarah-Naomi James ◽

Christopher A. Lane ◽

...

Keyword(s):

Family History ◽

Trait Anxiety ◽

Population Based ◽

Cross Sectional Study ◽

Subjective Cognitive Decline ◽

Cross Sectional ◽

Amyloid Pathology ◽

History Of ◽

Β Amyloid ◽

Anxiety Depression

ObjectiveTo investigate subjective cognitive decline (SCD) in relation to β-amyloid pathology and to test for associations with anxiety, depression, objective cognition and family history of dementia in the Insight 46 study.MethodsCognitively unimpaired ~70-year-old participants, all born in the same week in 1946 (n=460, 49% female, 18% amyloid-positive), underwent assessments including the SCD-Questionnaire (MyCog). MyCog scores were evaluated with respect to 18F-Florbetapir-PET amyloid status (positive/negative). Associations with anxiety, depression, objective cognition (measured by the Preclinical Alzheimer Cognitive Composite, PACC) and family history of dementia were also investigated. The informant’s perspective on SCD was evaluated in relation to MyCog score.ResultsAnxiety (mean (SD) trait anxiety score: 4.4 (3.9)) was associated with higher MyCog scores, especially in women. MyCog scores were higher in amyloid-positive compared with amyloid-negative individuals (adjusted means (95% CIs): 5.3 (4.4 to 6.1) vs 4.3 (3.9 to 4.7), p=0.044), after accounting for differences in anxiety. PACC (mean (SD) −0.05 (0.68)) and family history of dementia (prevalence: 23.9%) were not independently associated with MyCog scores. The informant’s perception of SCD was generally in accordance with that of the participant.ConclusionsThis cross-sectional study demonstrates that symptoms of SCD are associated with both β-amyloid pathology, and more consistently, trait anxiety in a population-based cohort of older adults, at an age when those who are destined to develop dementia are still likely to be some years away from symptoms. This highlights the necessity of considering anxiety symptoms when assessing Alzheimer’s disease pathology and SCD.

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