scholarly journals Psychiatric Medication Users by Age and Sex in the United States, 1999–2018

2021 ◽  
Vol 34 (4) ◽  
pp. 732-740
Author(s):  
Michael E. Johansen
2021 ◽  
pp. 003335492110267
Author(s):  
Kiersten J. Kugeler ◽  
Paul S. Mead ◽  
Amy M. Schwartz ◽  
Alison F. Hinckley

Lyme disease is the most common vector-borne disease in the United States and is characterized by a bimodal age distribution and male predominance. We examined trends in reported cases during a 25-year period to describe changes in the populations most affected by Lyme disease in the United States. We examined demographic characteristics of people with confirmed cases of Lyme disease reported to the Centers for Disease Control and Prevention during 1992-2016 through the National Notifiable Diseases Surveillance System. We grouped cases into 5-year periods (1992-1996, 1997-2001, 2002-2006, 2007-2011, 2012-2016). We calculated the average annual incidence by age and sex and used incidence rate ratios (IRRs) to describe changes in Lyme disease incidence by age and sex over time. We converted patient age at time of illness into patient birth year to ascertain disease patterns according to birth cohorts. The incidence of Lyme disease in the United States doubled from 1992-1996 to 2012-2016 (IRR = 1.74; 95% CI, 1.70-1.78) and increased disproportionately among males; IRRs were 39%-89% higher among males than among females for most age groups. During the study period, children aged 5-9 years were most frequently and consistently affected. In contrast, the average age of adults with Lyme disease increased over time; of all adults, people born during 1950-1964 were the most affected by Lyme disease. Our findings suggest that age-related behaviors and susceptibilities may drive infections among children, and the shifting peak among adults likely reflects a probability proportional to the relative size of the baby boom population. These findings can inform targeted and efficient public health education and intervention efforts.


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Fadar Otite ◽  
Smit Patel ◽  
Richa Sharma ◽  
Pushti Khandwala ◽  
Devashish Desai ◽  
...  

Background: The primary aim of this study is to describe current trends in racial-, age- and sex-specific incidence, clinical characteristics and burden of cerebral venous thrombosis (CVT) in the United States (US). Methods: Validated International Classification of Disease codes were used to identify all adult new cases of CVT (n=5,567) in the State Inpatients Database of New York and Florida (2006-2016) and all cases of CVT in the entire US from the National Inpatient Sample 2005-2016 (weighted n=57,315). Incident CVT counts were combined with annual US Census data to compute age and sex-specific incidence of CVT. Joinpoint regression was used to evaluate trends in incidence over time. Results: From 2005-2016, 0.47%-0.80% of all strokes in the US were CVTs but this proportion increased by 70.4% over time. Of all CVTs over this period, 66.7% were in females but this proportion declined over time (p<0.001). Pregnancy/puerperium (27.4%) and cancer (11.8%) were the most common risk factors in women, while cancer (19.5%) and central nervous trauma (11.3) were the most common in men. Whereas the prevalence of pregnancy/puerperium declined significantly over time in women, that of cancer, inflammatory conditions and trauma increased over time in both sexes. Annual age and sex-standardized incidence of CVT in cases/million population ranged from 13.9-20.2, but incidence varied significantly by sex (women: 20.3-26.9; men 6.8-16.8) and by age/sex (women 18-44yo: 24.0-32.6%; men: 18-44yo: 5.3-12.8). Age and sex-standardized incidence also differed by race (Blacks:18.6-27.2; whites: 14.3-18.5; Asians: 5.1-13.8). On joinpoint regression, incidence increased across 2006-2016 but most of this increase was driven by increase in all age groups of men (combined annualized percentage change (APC) 9.2%, p-value <0.001), women 45-64 yo (APC 7.8%, p-value <0.001) and women ≥65 yo (APC 7.4%, p-value <0.001). Incidence in women 18-44 yo remained unchanged over time . Conclusion: The epidemiological characteristics of CVT patients in the US is changing. Incidence increased significantly over the last decade. Further studies are needed to determine whether this increase represents a true increase from changing risk factors or artefactual increase from improved detection.


2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi87-vi87
Author(s):  
Gi-Ming Wang ◽  
Gino Cioffi ◽  
Nirav Patil ◽  
Kristin Waite ◽  
Robert Lanese ◽  
...  

Abstract BACKGROUND Gliomas are the most common type of malignant brain and other CNS tumors, accounting for 80.8% of malignant primary brain and CNS tumors. They cause significant morbidity and mortality. This study investigates the intersection between age and sex to better understand variation of incidence and survival for glioma in the United States. METHODS Incidence data from 2000-2017 were obtained from the Central Crain Tumor Registry of the United States, which obtains data from the CDC’s National Program of Cancer Registries and NCI’s Surveillance Epidemiology and End Results Program (SEER), and survival data from the CDC’s NPCR Registries. Age-adjusted incidence rates and rate ratios per 100,000 were generated to compare male-to-female incidence by age group. Cox proportional hazard models were performed by age group, generating hazard ratios to assess male-to-female survival differences. RESULTS Overall, glioma incidence was higher in males. Male-to-female incidence was lowest in ages 0-9 years (IRR: 1.04, 95% CI:1.01 - 1.07, p=0.003), increasing with age, peaking at 50-59 years (IRR:1.56, 95% CI: 1.53 - 1.59, p&lt; 0.001). Females had worse survival for ages 0-9 (HR:0.93, 95% CI:0.87-0.99), though male survival was worse for all other age groups, with the difference highest in those 20-29 years (HR:1.36, 95% CI:1.28-1.44). Incidence and survival differences by age and sex also varied by histological subtype of glioma. CONCLUSION To better understand the variation in glioma incidence and survival, investigating the intersection of age and sex is key. The current work shows that the combined impact of these variables is dependent on glioma subtype. These results contribute to the growing understanding of sex and age differences that impact cancer incidence and survival.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S684-S685
Author(s):  
Dae H Kim ◽  
Elisabetta Patorno ◽  
Ajinkya Pawar ◽  
Hemin Lee ◽  
Sebastian Schneeweiss ◽  
...  

Abstract Background: There has been increasing effort to measure frailty in the United States Medicare data. The performance of claims-based frailty measures has not been compared. Methods: This retrospective cohort study included 2,326 community-dwelling Medicare beneficiaries who participated in the 2008 assessment of the Health and Retirement Study. The claims-based frailty measures developed by Davidoff, Faurot, Segal, and Kim were compared against clinical measures of frailty (gait speed, grip strength) using correlation coefficients and health outcomes (e.g., mortality, hospitalization, activities-of-daily-living disabilities) over 2 years using C-statistics. Results: The Davidoff, Faurot, Segal, and Kim indices were negatively correlated with gait speed (-0.19, -0.33, -0.37, and -0.37, respectively), but age and sex adjustment variably attenuated the correlation to -0.17, -0.22, -0.18, and -0.33, respectively. The corresponding correlation coefficients with grip strength were -0.17, -0.27, -0.35, and -0.24, which attenuated to -0.09, -0.14, -0.05, and -0.23 after age and sex adjustment, respectively. The models that included age, sex, and each of Davidoff, Faurot, Segal, and Kim indices showed C-statistics of 0.67, 0.71, 0.71, 0.75 for mortality (versus C-statistic for age and sex: 0.66); 0.59, 0.64, 0.63, 0.70 for hospitalization (versus C-statistic for age and sex: 0.58); and 0.64, 0.63, 0.63, 0.70 for activities-of-daily-living disabilities (versus C-statistic for age and sex: 0.61), respectively. Conclusions: The choice of a claims-based frailty measure results in a meaningful variation in the identification of frail older adults at high risk for adverse health outcomes. Claims-based frailty measures that included demographic variables offer limited risk adjustment beyond age and sex.


Neurology ◽  
2020 ◽  
Vol 95 (16) ◽  
pp. e2200-e2213 ◽  
Author(s):  
Fadar Oliver Otite ◽  
Smit Patel ◽  
Richa Sharma ◽  
Pushti Khandwala ◽  
Devashish Desai ◽  
...  

ObjectiveTo test the hypothesis that race-, age-, and sex-specific incidence of cerebral venous thrombosis (CVT) has increased in the United States over the last decade.MethodsIn this retrospective cohort study, validated ICD codes were used to identify all new cases of CVT (n = 5,567) in the State Inpatients Databases (SIDs) of New York and Florida (2006–2016). A new CVT case was defined as first hospitalization for CVT in the SID without prior CVT hospitalization. CVT counts were combined with annual Census data to compute incidence. Joinpoint regression was used to evaluate trends in incidence over time.ResultsFrom 2006 to 2016, annual age- and sex-standardized incidence of CVT in cases per 1 million population ranged from 13.9 to 20.2, but incidence varied significantly by sex (women 20.3–26.9, men 6.8–16.8) and by age/sex (women 18–44 years of age 24.0–32.6, men 18–44 years of age 5.3–12.8). Incidence also differed by race (Blacks: 18.6–27.2; Whites: 14.3–18.5; Asians: 5.1–13.8). On joinpoint regression, incidence increased across 2006 to 2016, but most of this increase was driven by an increase in all age groups of men (combined annualized percentage change [APC] 9.2%, p < 0.001), women 45 to 64 years of age (APC 7.8%, p < 0.001), and women ≥65 years of age (APC 7.4%, p < 0.001). Incidence in women 18 to 44 years of age remained unchanged over time.ConclusionCVT incidence is disproportionately higher in Blacks compared to other races. New CVT hospitalizations increased significantly over the last decade mainly in men and older women. Further studies are needed to determine whether this increase represents a true increase from changing risk factors or an artifactual increase from improved detection.


PLoS ONE ◽  
2019 ◽  
Vol 14 (8) ◽  
pp. e0220864 ◽  
Author(s):  
Ovie Utuama ◽  
Fahad Mukhtar ◽  
Yen Thi-Hai Pham ◽  
Bashir Dabo ◽  
Priyashi Manani ◽  
...  

2020 ◽  
Vol 3 (06) ◽  
pp. 478-486
Author(s):  
Joanna Suomi ◽  
Gregory Hess ◽  
Christine Won ◽  
Morgan Bron ◽  
John Acquavella

Background: The prevalence of obstructive sleep apnea (OSA) has not been assessed within the United States (US) in over adecade. Objectives:From 2013 to 2016, we calculated annual 2-year limited duration prevalence of diagnosed OSA in a large (~66million), geographically diverse insured population. We evaluated trends by age and sex; and assessed positive airway pressure (PAP) use and excessive sleepiness (hypersomnia diagnosis, or prescriptions for stimulant or wake-promoting agent [WPA]). Methods:Overall and age/sex specific prevalence per 100 insured persons was calculated on an annual basis. The cohort was defined to include those with medical and pharmacy claims activity. To mitigate rule-out diagnoses,cases had to have ≥2 medical claims for OSA within a 6-month period. Overall annual prevalences were directly standardized to the US population using 2016 US age and sex Census weights. Results: Annualage/sex adjusted prevalence of OSA increased from 2.4% in 2013 to 3.4% in 2016. OSA patients had a mean age of 58 years and there was a ≈2:1 male:female prevalence ratio. OSA patients with PAP claims increased from 42.2% to 44.1% over the study period. Excessive sleepiness (hypersomnia or stimulant/WPA prescriptions) for patients with or without PAP use both declined by ≈ 4% -5%. Conclusions:Diagnosed OSA prevalence and PAP use among insured members with claims activity increased during 2013-2016 while clinical markers of excessive sleepiness declined.   Males had a much higher prevalence of OSA than females.


2020 ◽  
Vol 163 (6) ◽  
pp. 1070-1072
Author(s):  
Douglas J. Totten ◽  
John P. Marinelli ◽  
Samuel A. Spear ◽  
Sarah N. Bowe ◽  
Matthew L. Carlson

Stapedectomy remains a joint key-indicator case with ossiculoplasty for otolaryngology residents in the United States. Yet, residents consistently report feeling inadequately prepared to perform stapes surgery following graduation. Applying recently described age- and sex-standardized incidence rates of surgically confirmed cases of otosclerosis to the US populace, upper and lower estimates of residents’ case exposure to stapedectomy can be approximated. With this, uppermost projections estimate 6484 new cases of stapes surgery are performed annually nationwide. With approximately 1424 otolaryngology residents nationally, the average case exposure is 7.8 stapedectomies throughout their training, with upper and lower estimates of 17.1 and 4.2 cases, respectively. As such, proficiency in stapedectomy is no longer a realistic expectation for US graduating residents. This reality supports the removal of “stapedectomy” from the list of 14 key-indicator case requirements, leaving ossiculoplasty as its own key-indicator case, thereby reinforcing true competence in this fundamental procedure for the graduating otolaryngologist.


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