scholarly journals Childhood neurodevelopmental markers and risk of premature mortality: Follow-up to age 60–65 years in the Aberdeen Children of the 1950s study

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255649
Author(s):  
Adele Warrilow ◽  
Geoff Der ◽  
Sally-Ann Cooper ◽  
Helen Minnis ◽  
Jill P. Pell
Keyword(s):  
General Population ◽  
Public Mental Health ◽  
Premature Mortality ◽  
Population Level ◽  
Population Cohort ◽  
Hazard Ratios ◽  
Wide Range ◽  
General Population Cohort ◽  
Cox Proportional Hazard Models

Background Individual neurodevelopmental disorders are associated with premature mortality. Little is known about the association between multiple neurodevelopmental markers and premature mortality at a population level. The ESSENCE (Early Symptomatic Syndromes Eliciting Neurodevelopmental Clinical Examinations) approach considers multiple neurodevelopmental parameters, assessing several markers in parallel that cluster, rather than considering individual diagnostic categories in isolation. Objectives To determine whether childhood neurodevelopmental markers, including reduced intellectual functioning, are associated with all-cause premature mortality. Methods and procedures In a general population cohort study (n = 12,150) with longitudinal follow up from childhood to middle age, Cox proportional hazard models were used to study the associations between childhood neurodevelopmental markers (Rutter B scale and IQ) and premature all-cause mortality. Outcomes and results The cognitive measures and 21 of the 26 Rutter B items were significantly associated with premature mortality in bivariate analyses with hazard ratios from 1.24 (95% CI 1.05–1.47) to 2.25 (95% CI 1.78–2.90). In the final adjusted model, neurodevelopmental markers suggestive of several domains including hyperactivity, conduct problems and intellectual impairment were positively associated with premature mortality and improved prediction of premature mortality. Conclusions A wide range of neurodevelopmental markers, including childhood IQ, were found to predict premature mortality in a large general population cohort with longitudinal follow up to 60–65 years of age. Implications These findings highlight the importance of a holistic assessment of children with neurodevelopmental markers that addresses a range of neurodevelopmental conditions. Our findings could open the door to a shift in child public mental health focus, where multiple and/or cumulative markers of neurodevelopmental conditions alert clinicians to the need for early intervention. This could lead to a reduction in the risk of broad health outcomes at a population level.

SAT0062 INCIDENCE OF STAPHYLOCOCCUS AUREUS BACTEREMIA IN PATIENTS WITH RHEUMATOID ARTHRITIS: A NATIONWIDE COHORT STUDY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 964.1-964
Author(s):  
S. Dieperink ◽  
B. Glintborg ◽  
L. B. Oestergaard ◽  
M. Nørgaard ◽  
T. Benfield ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Staphylococcus Aureus ◽  
General Population ◽  
Incidence Rate ◽  
Orthopaedic Implant ◽  
Research Support ◽  
Population Cohort ◽  
General Population Cohort ◽  
First Time

Background:Staphylococcus aureusis a frequent cause of bacteremia (SAB) associated with high mortality and morbidity. Patients with rheumatoid arthritis (RA) are at increased risk of septic arthritis and prosthetic joint infection withS. aureus.Objectives:To assess the incidence rate (IR) of first-time SAB in patients with RA and to estimate the incidence rate ratio (IRR) of SAB with a general population cohort without RA serving as the reference.Methods:Individuals with no prior history of SAB or RA were included consecutively from 31 December 1996, their 18th birthday or date of immigration, whichever came latest, and followed until first-time SAB, death, emigration or 31 December 2017, whichever came first. Information on RA diagnosis, vital status, age, sex, place of residence, comorbidities, medication and first-time SAB were achieved on an individual level through cross-linkage between five virtually complete Danish nationwide registries (Civil Registration System, National Patient Registry, Register of Medicinal Product Statistics, DANBIO rheumatology registry and the SAB database). We used Poisson regression to estimate adjusted IRRs overall and stratified by age and sex.Results:In total, 6,127,150 individuals were included of whom 34,627 individuals developed RA. In the RA cohort, 228 first-time SAB events occurred during 283,186 person years (PY) of follow-up (IR 80.5/100,000 PY) compared with 25,268 events during 87,521,120 PY of follow-up in the general population cohort (IR 28.9/100,000 PY). Median follow-up was 7.2 years (IQR 3.5-12.3) after RA diagnosis and 18.7 years (IQR 6.8-21) in the general population cohort. Individuals with RA who developed SAB were more often women, had an orthopaedic implant and had recent use of glucocorticoids compared with individuals with SAB without RA. (Table 1) IRs of SAB were higher among patients with RA compared with the general population in all age categories. The IRs increased with age and were higher in men, both in patients with RA and in the general population cohort. After adjustment, the IRR remained higher for individuals younger than 70 years with RA compared with the general population but was similar for older individuals. (Figure 1)Conclusion:In this nationwide cohort with more than 25,000 observed first-time SAB events, patients with RA younger than 70 years old had a 1.5-2 times higher incidence rate compared with the general population. The significance of anti-rheumatic treatments on risk and the prognosis of SAB in patients with RA remain to be explored.Acknowledgments:We wish to thank patient representative Pia Lüchau PedersenDisclosure of Interests:Sabine Dieperink: None declared, Bente Glintborg Grant/research support from: Grants from Pfizer, Biogen and Abbvie, Louise Bruun Oestergaard: None declared, Mette Nørgaard: None declared, Thomas Benfield Grant/research support from: Pfizer, Novo Nordisk and GSK, Frank Mehnert: None declared, Andreas Petersen: None declared, Merete L. Hetland Grant/research support from: BMS, MSD, AbbVie, Roche, Novartis, Biogen and Pfizer, Consultant of: Eli Lilly, Speakers bureau: Orion Pharma, Biogen, Pfizer, CellTrion, Merck and Samsung Bioepis

scholarly journals The association of urine metals and metal mixtures with cardiovascular incidence in an adult population from Spain: the Hortega Follow-Up Study

2019 ◽  
Vol 48 (6) ◽  
pp. 1839-1849 ◽  
Author(s):  
Arce Domingo-Relloso ◽  
Maria Grau-Perez ◽  
Laisa Briongos-Figuero ◽  
Jose L Gomez-Ariza ◽  
Tamara Garcia-Barrera ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
General Population ◽  
Adult Population ◽  
Metal Mixtures ◽  
Kernel Machine ◽  
Cox Proportional Hazard ◽  
Inclusion Probabilities ◽  
Hazard Ratios ◽  
Cox Proportional Hazard Models

Abstract Background The association of low-level exposure to metals and metal mixtures with cardiovascular incidence in the general population has rarely been studied. We flexibly evaluated the association of urinary metals and metal mixtures concentrations with cardiovascular diseases in a representative sample of a general population from Spain. Methods Urine antimony (Sb), barium (Ba), cadmium (Cd), chromium (Cr), cobalt (Co), copper (Cu), molybdenum (Mo), vanadium (V) and zinc (Zn) were measured in 1171 adults without clinical cardiovascular diseases, who participated in the Hortega Study. Cox proportional hazard models were used for evaluating the association between single metals and cardiovascular incidence. We used a Probit extension of Bayesian Kernel Machine Regression (BKMR-P) to handle metal mixtures in a survival setting. Results In single-metal models, the hazard ratios [confidence intervals (CIs)] of cardiovascular incidence, comparing the 80th to the 20th percentiles of metal distributions, were 1.35 (1.06, 1.72) for Cu, 1.43 (1.07, 1.90) for Zn, 1.51 (1.13, 2.03) for Sb, 1.46 (1.13, 1.88) for Cd, 1.64 (1.05, 2.58) for Cr and 1.31 (1.01, 1.71) for V. BKMR-P analysis was confirmatory of these findings, supporting that Cu, Zn, Sb, Cd, Cr and V are related to cardiovascular incidence in the presence of the other metals. Cd and Sb showed the highest posterior inclusion probabilities. Conclusions Urine Cu, Zn, Sb, Cd, Cr and V were independently associated with increased cardiovascular risk at levels relevant for the general population of Spain. Urine metals in the mixture were also jointly associated with cardiovascular incidence, with Cd and Sb being the most important components of the mixture.

Risk of developing diabetes and dyslipidemia among adolescents with bipolar disorder or schizophrenia

2013 ◽  
Vol 25 (1) ◽  
pp. 3-11 ◽  
Author(s):  
Cheryl Enger ◽  
Meghan E. Jones ◽  
Ludmila Kryzhanovskaya ◽  
Michael Doherty ◽  
Andrew T. McAfee
Keyword(s):  
Bipolar Disorder ◽  
Cohort Study ◽  
General Population ◽  
Incidence Rate ◽  
Retrospective Cohort ◽  
Claims Data ◽  
Comparison Study ◽  
Population Cohort ◽  
Hazard Ratios ◽  
General Population Cohort

Abstract The risks of developing diabetes and dyslipidemia among adolescents with schizophrenia and bipolar disorder have not been well-characterized. This study was designed to characterize these risks and compare them among adolescents in the general population. Methods: This retrospective cohort study used claims data from a large U.S. health insurer to identify adolescents (13–17 years) with claims for schizophrenia or bipolar disorder from 1997 to 2006. Adolescents without evidence of schizophrenia or bipolar disorder were randomly selected for comparison. Study outcomes were new diagnoses of diabetes and dyslipidemia. Results: We identified 17,884 adolescents with schizophrenia or bipolar disorder and 188,059 for the general population cohort. The incidence rate per 100,000 person-years of diabetes was higher in the schizophrenia or bipolar disorder cohort [424.3 (95% CI: 344.5–517.3)] than in the general population cohort (90.0 [95% CI: 79.6–101.3]). The incidence rate per 100,000 person-years of dyslipidemia was 346.4 (95% CI: 274.9–431.0) in the schizophrenia or bipolar disorder cohort and 86.6 (95% CI: 76.4–97.7) in the general population cohort. The adjusted hazard ratios of developing diabetes and dyslipidemia in the schizophrenia or bipolar disorder cohort relative to the general population cohort were 1.76 (95% CI: 1.15–2.72) and 1.66 (95% CI: 1.22–2.28), respectively. Adolescents with schizophrenia or bipolar disorder treated with antipsychotics had a higher risk of developing diabetes and dyslipidemia than those who were untreated. Conclusions: Adolescents with schizophrenia or bipolar disorder had significantly increased risks of developing diabetes and dyslipidemia compared to adolescents without these disorders.

scholarly journals Pharmacoepidemiology of Benzodiazepine and Sedative-Hypnotic Use in a Canadian General Population Cohort during 12 Years of Follow-up

2010 ◽  
Vol 55 (12) ◽  
pp. 792-799 ◽  
Author(s):  
Scott B Patten ◽  
Jeanne VA Williams ◽  
Dina H Lavorato ◽  
Aliya Kassam ◽  
C David Sabapathy
Keyword(s):  
General Population ◽  
Population Cohort ◽  
General Population Cohort

Long-Term Mortality of Patients with Primary Immune Thrombocytopenia

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 619-619
Author(s):  
Henrik Frederiksen ◽  
Merete Lund Maegbaek ◽  
Henrik Toft Sorensen
Keyword(s):  
Platelet Count ◽  
General Population ◽  
Index Date ◽  
Population Based ◽  
Ongoing Treatment ◽  
Remission Status ◽  
Population Cohort ◽  
Comparison Cohort ◽  
General Population Cohort

Abstract Abstract 619 Introduction Morbidity and mortality are higher among patients with primary immune thrombocytopenia (ITP) than in the general population. In 1999 we reported on a population-based cohort of patients with incident primary ITP, with long and complete follow-up1. Here we report on mortality within this cohort according to remission status. We also compare mortality in this cohort with that in the general population. Methods ITP cohort A population-based cohort of all incident ITP patients was identified, consisting of patients aged > 14 years, diagnosed in any Danish hospital or outpatient clinic during the 23-year period from 1973 through 19951. The date of last follow-up was the last date on which the patient was both present at the hospital and had his/her platelet count measured. The index date was defined as the last follow-up date. General population comparison cohort For each ITP patient, we randomly identified 10 comparison cohort members matched on age, sex, and calendar year. Members of the comparison cohort were assigned the index date according to the ITP patient of which they were matched. Remission Remission criteria for ITP patients at last follow-up were defined before data were collected. Criteria for Complete Remission (CR) were ITP treatment discontinued and platelet count > 149 × 109/l. Criteria for Partial Remission (PR) were ITP treatment discontinued, increased platelet count since diagnosis, and one of the following: 1) platelet count of 100–149 × 109/l; 2) platelet count increased by at least 50% to 50–99 × 109/l; 3) platelet count increased by at least 100% to 20–49 × 109/l; or 4) platelet count increased to at least 20 × 109/l, if initial platelet count was < 10 × 109/l. All other patients, including those who were still on ITP medical treatment at last follow-up, were in the No Remission (NR) group. For the survival analyses, patients in the NR category were stratified into the following three subgroups on the basis of treatment and platelet count at last follow-up: A. No remission due to ongoing treatment, with a platelet count > 149 × 109/l; B. No remission due to ongoing treatment, with a platelet count < 150 × 109/l; or C. No remission and no current treatment. Statistical analysis We assessed survival in the ITP cohort and compared it to the general population cohort. Participants in the two cohorts were followed from the index date until emigration, death, or 1 January 2012, whichever event came first. We used the Kaplan-Meier Method to compare survival between the ITP and the general population cohorts. We used Cox regression to compare rates of mortality among ITP patients and members of the general population cohort. We estimated mortality rate ratios (MRRs) and associated 95% confidence intervals (CIs). The MRRs were adjusted for age, sex, calendar year, comorbidity, and remission status at last follow-up. Results Since diagnosis, 116 (52%) of the ITP patients died. The mortality in the ITP cohort was consistently higher than the in the general population cohort (Figure 1), with an adjusted MRR of 1.4 (95% CI: 1.2–1.8). When remission status was taken into account, ITP patients who were in the NR category due to ongoing treatment and decreased platelet counts at last follow-up had the highest mortality (Figure 2). This subgroup had adjusted MRRs of 6.3 (95% CI: 3.7–10.7) after 5 years, 9.1 (95% CI: 5.1–16.4) after 10 years, and 9.9 (95% CI: 5.4–18.1) after 20 years, compared to the general population cohort. In contrast, patients who were in the CR category at last follow-up had 5-year,10-year, and 20-year MRRs comparable to those of the general population cohort. Conclusion Both short-term and long-term mortality among adult ITP patients are elevated compared to the general population. Mortality rates are highest among patients who are on ITP treatment and remain thrombocytopenic. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Establishing and characterising large COVID-19 cohorts after mapping the Information System for Research in Primary Care in Catalonia to the OMOP Common Data Model

2021 ◽  
Author(s):  
Edward Burn ◽  
Sergio Fernández-Bertolín ◽  
Erica A Voss ◽  
Clair Blacketer ◽  
Maria Aragón ◽  
...  
Keyword(s):  
Primary Care ◽  
General Population ◽  
Data Quality ◽  
Data Model ◽  
Common Data Model ◽  
Test Results ◽  
Patient Level ◽  
Population Cohort ◽  
General Population Cohort

Background Few datasets have been established that capture the full breadth of COVID-19 patient interactions with a health system. Our first objective was to create a COVID-19 dataset that linked primary care data to COVID-19 testing, hospitalisation, and mortality data at a patient level. Our second objective was to provide a descriptive analysis of COVID-19 outcomes among the general population and describe the characteristics of the affected individuals. Methods We mapped patient-level data from Catalonia, Spain, to the Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM). More than 3,000 data quality checks were performed to assess the readiness of the database for research. Subsequently, to summarise the COVID-19 population captured, we established a general population cohort as of the 1st March 2020 and identified outpatient COVID-19 diagnoses or positive test results for SARS-CoV-2, hospitalisations with COVID-19, and COVID-19 deaths during follow-up, which went up until 30th June 2021. Findings Mapping data to the OMOP CDM was performed and high data quality was observed. The mapped database was used to identify a total of 5,870,274 individuals, who were included in the general population cohort as of 1st March 2020. Over follow up, 604,472 had either an outpatient COVID-19 diagnosis or positive test result, 58,991 had a hospitalisation with COVID-19, 5,642 had an ICU admission with COVID-19, and 11,233 had a COVID-19 death. People who were hospitalised or died were more commonly older, male, and with more comorbidities. Those admitted to ICU with COVID-19 were generally younger and more often male than those hospitalised in general and those who died. Interpretation We have established a comprehensive dataset that captures COVID-19 diagnoses, test results, hospitalisations, and deaths in Catalonia, Spain. Extensive data checks have shown the data to be fit for use. From this dataset, a general population cohort of 5.9 million individuals was identified and their COVID-19 outcomes over time were described. Funding Generalitat de Catalunya and European Health Data and Evidence Network (EHDEN).

scholarly journals Endocannabinoid system mediates the association between gut-microbial diversity and anhedonia/amotivation in a general population cohort

2021 ◽  
Author(s):  
Amedeo Minichino ◽  
Matthew A. Jackson ◽  
Marta Francesconi ◽  
Claire J. Steves ◽  
Cristina Menni ◽  
...  
Keyword(s):  
General Population ◽  
Microbial Diversity ◽  
Gut Microbiome ◽  
Endocannabinoid System ◽  
Alpha Diversity ◽  
Serum Levels ◽  
Population Cohort ◽  
Random Intercept ◽  
General Population Cohort ◽  
Antidepressant Use

AbstractAnhedonia and amotivation are debilitating symptoms and represent unmet therapeutic needs in a range of clinical conditions. The gut-microbiome-endocannabinoid axis might represent a potential modifiable target for interventions. Based on results obtained from animal models, we tested the hypothesis that the endocannabinoid system mediates the association between gut-microbiome diversity and anhedonia/amotivation in a general population cohort. We used longitudinal data collected from 786 volunteer twins recruited as part the TwinsUK register. Our hypothesis was tested with a multilevel mediation model using family structure as random intercept. The model was set using alpha diversity (within-individual gut-microbial diversity) as predictor, serum and faecal levels of the endocannabinoid palmitoylethanolamide (PEA) as mediator, and anhedonia/amotivation as outcome. PEA is considered the endogenous equivalent of cannabidiol, with increased serum levels believed to have anti-depressive effects, while increased stool PEA levels, reflecting increased excretion, are believed to have opposite, detrimental, effects on mental health. We therefore expected that either reduced serum PEA or increased stool PEA would mediate the association between microbial diversity and anhedonia amotivation. Analyses were adjusted for obesity, diet, antidepressant use, sociodemographic and technical covariates. Data were imputed using multiple imputation by chained equations. Mean age was 65.2 ± 7.6; 93% of the sample were females. We found a direct, significant, association between alpha diversity and anhedonia/amotivation (β = −0.37; 95%CI: −0.71 to −0.03; P = 0.03). Faecal, but not serum, levels of the endocannabinoid palmitoylethanolamide (PEA) mediated this association: the indirect effect was significant (β = −0.13; 95%CI: −0.24 to −0.01; P = 0.03), as was the total effect (β = −0.38; 95%CI: −0.72 to −0.04; P = 0.03), whereas the direct effect of alpha diversity on anhedonia/amotivation was attenuated fully (β = −0.25; 95%CI: −0.60 to 0.09; P = 0.16). Our results suggest that gut-microbial diversity might contribute to anhedonia/amotivation via the endocannabinoid system. These findings shed light on the biological underpinnings of anhedonia/amotivation and suggest the gut microbiota-endocannabinoid axis as a promising therapeutic target in an area of unmet clinical need.

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