scholarly journals Clinically Important Improvement in Function Is Common in People with or at High Risk of Knee OA: The MOST Study

2010 ◽  
Vol 37 (6) ◽  
pp. 1244-1251 ◽  
Author(s):  
DANIEL K. WHITE ◽  
JULIE J. KEYSOR ◽  
MICHAEL P. LAVALLEY ◽  
CORA E. LEWIS ◽  
JAMES C. TORNER ◽  
...  
Keyword(s):  
Risk Factors ◽  
Depressive Symptoms ◽  
High Risk ◽  
Knee Pain ◽  
Walking Speed ◽  
Knee Extensor ◽  
Baseline Risk ◽  
Knee Oa ◽  
Important Improvement ◽  
Knee Extensor Strength

Objective.To calculate the frequency of clinically important improvement in function over 30 months and identify risk factors in people who have or are at risk of knee osteoarthritis (OA).Methods.Subjects were from the Multicenter Osteoarthritis (MOST), a longitudinal study of persons with or at high risk of knee OA. We defined minimal clinically important improvement (MCII) with the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) physical function using 3 different methods. Baseline risk factors tested for improvement included age, sex, educational attainment, presence of radiographic knee OA (ROA), the number of comorbidities, body mass index (BMI), knee pain, walking speed, isokinetic knee extensor strength, depressive symptoms, physical activity, and medication usage. We used logistic regression to evaluate the association of baseline risk factors with MCII.Results.Of the 1801 subjects (mean age 63 yrs, BMI = 31, 63% women), most had mild limitations in baseline function (WOMAC = 19 ± 11). Regardless of how defined, a substantial percentage of subjects (24%–39%) reached MCII at 30 months. Compared to their counterparts, people with MCII were less likely to have ROA and to use medications, and were more likely to have a lower BMI, less knee pain, a faster walking speed, more knee strength, and fewer depressive symptoms. After adjustment, MCII was 40% to 50% less likely in those with ROA, and 1.9 to 2.0 times more likely in those walking 1.0 meters/second faster than counterparts.Conclusion.Clinically important improvement is frequent in people with or at high risk of knee OA. The absence of ROA and a faster walking speed appear to be associated with clinically important improvements.

Abstract 18634: Favorable Cardiovascular Health and the Compression of Morbidity: Findings From the Chicago Heart Detection Project in Industry Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Norrina B Allen ◽  
Lihui Zhao ◽  
Lei Liu ◽  
Martha Daviglus ◽  
Kiang Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Healthcare Costs ◽  
Cardiovascular Health ◽  
Heart Association ◽  
Baseline Risk ◽  
Compression Of Morbidity ◽  
High Risk Factors ◽  
Morbidity Score

Introduction: We sought to determine the association of CV health at younger ages with the proportion of life lived free of morbidity, the cumulative burden of morbidity, and average healthcare costs at older ages. Methods: The Chicago Heart Association (CHA) study is a longitudinal cohort of employed men and women aged 18-59 years at baseline exam in 1967-1973. Baseline risk factor levels included blood pressure, cholesterol, diabetes, BMI and smoking. Individuals were classified into one of four strata: favorable levels of all factors, 0 factors high but 1+ elevated, 1 high, and ≥2 high risk factors. Linked CMS/NDI data from 1984-2010 were used to determine morbidity in older age providing up to 40 years of follow-up. We included participants who were age 65+ between 1984 and 2010 and enrolled in Medicare FFS. All-cause morbidity was defined using the Gagne score. A CV morbidity score was defined as the sum of 4 CVDs including CHD (includes MI), PVD, cerebrovascular disease and CHF. Results: We included 25,390 participants (43% female, 90% White, mean age 44 at baseline); 6% had favorable levels, 19% had 1+ risk factors at elevated levels, 40% had 1 high risk factor and 35% had 2+ high risk factors. As compared to those with 2+ high risk factors, favorable CV health had lower levels of all-cause and CV morbidity from age 65-90 years, and a lower cumulative morbidity burden (p<0.001) translating to lower average annual healthcare costs ($15,905 vs $20,791 per year, p<0.001). Favorable CV health postponed the onset of all-cause morbidity by 4.5 years, the onset of CV morbidity by almost 7 years and extended life by almost 4 years resulting in a compression of morbidity on both the absolute and relative scale (see figure). Conclusion: Individuals in favorable CV health live a longer, healthier life and a greater proportion of life free of morbidity. These findings provide support for prevention efforts aimed at preserving cardiovascular health and reducing the burden of disease in older ages.

Abstract 78: Risk Factors Associated with Failure of Aggressive Medical Therapy in the SAMMPRIS Trial

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Michael F Waters ◽  
Brian L Hoh ◽  
Michael J Lynn ◽  
Tanya N Turan ◽  
Colin P Derdeyn ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Medical Therapy ◽  
Primary Endpoint ◽  
Univariate Analysis ◽  
Baseline Risk ◽  
Medical Group ◽  
High Risk Patients ◽  
Increased Risk ◽  
Risk Patients

Background: The SAMMPRIS trial showed that aggressive medical therapy was more effective than stenting for preventing stroke in high-risk patients with symptomatic intracranial stenosis. However, 15% of patients in the medical group still had a primary endpoint (any stroke or death within 30 days of enrollment or stroke in the territory beyond 30 days) during a median follow-up of 32.7 months. We sought to determine baseline risk factors that were associated with a primary endpoint in the medical arm of SAMMPRIS. Methods: Data on 227 patients randomized to the medical group in SAMMPRIS were analyzed. Baseline demographic features, vascular risk factors, qualifying event, brain imaging and angiographic features were analyzed. The hazard ratio and p-value from a Cox proportional hazard regression model relating time until a primary endpoint to each factor were calculated. Results: Female gender, diabetes, stroke as the qualifying event (especially non-penetrator stroke), old infarct in the territory of the stenotic artery, and > 80% stenosis were associated (p < 0.10) with a higher risk of the primary endpoint on univariate analysis (see accompanying table) (multivariate analysis will be available by the time of ISC). Variables not associated with a higher risk of a primary endpoint in the medical arm included: age, race, antithrombotic therapy at the time of a qualifying event, time from qualifying event to enrollment (< 7 days vs. > 7 days), and location of stenosis. Conclusions: Several features were associated with an increased risk of the primary endpoint in the medical group in SAMMPRIS. On univariate analysis, the most important risk factors were an old infarct in the territory of the stenotic artery and stroke (especially non-penetrator stroke) as the qualifying event. These features will be useful for identifying particularly high-risk patients who should be targeted for future clinical trials testing alternative therapies to aggressive medical management.

Assessment of Cardiovascular Events in Chronic Myeloid Leukemia Patients Treated with Tyrosine Kinase Inhibitors

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4031-4031
Author(s):  
Katia B.B. Pagnano ◽  
Paola Morelato Assunção ◽  
Roberto Zullli ◽  
Marcia T Delamain ◽  
Gislaine OLIVEIRA Duarte ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Cardiovascular Events ◽  
Kinase Inhibitors ◽  
Risk Groups ◽  
Arterial Disease ◽  
Baseline Risk ◽  
Advisory Committees ◽  
Coronary Arterial Disease ◽  
Very High

Abstract Introduction : Treatment with tyrosine kinase inhibitors (TKIs) has dramatically increased the overall survival of patients with chronic myeloid leukemia (CML) but second generation TKI has been associated with an increased risk of cardiovascular events. Objectives: The aim of this study was to evaluate the incidence of cardiovascular adverse events (CVE) in CML patients treated with TKIs and to correlate with the cardiovascular (CV) risk of the patients. Methods: this is a retrospective analysis of consecutive CML patients treated with TKIs between 2005 and 2013at our Institution. Baseline risk factors for CV diseases were collected at baseline and included age, arterial hypertension (AH), dyslipidemia, obesity, hypothireoidism, smoking, diabetes mellitus (DM), coronary artery disease and chronic renal failure. Cardiovascular events during TKI treatment were collected and included: myocardial infarction, unstable angina, peripheral arterial disease, stroke, arrythmia,hypertension and cardiac failure. Cardiovascular risk was calculated using the SCORE chart of the European Society of Cardiology and patients were classified in low, moderate, high and very high risk. Results: We analyzed CML patients treated with imatinib (n=117), dasatinib (n=91) and nilotinib (n=60). The median time of follow-up was 748, 519 and 851 days, respectively. Baseline risk factors: 90 patients (38,5%) had hypertension, 34 (14,5%) DM, 67 (28,6%) dyslipidemia, 51 (21,8%) obesity, 22 (9,4%) hypothyroidism, 14 (6%) coronary arterial disease, 21 (9%) systolic cardiac dysfunction, 4 (1,7%) stroke, 20 (8,5%) chronic kidney failure and 36 (15,4%) were smokers. SCORE chart classification: 106 patients (39,5%) were in the low-risk category, 70 (26%) in the moderate risk, 46 (17,2%) in the high risk, 46 (17,2%) in the very high risk group. Overall, the cumulative incidence of CVE was 4.1%. Five (5.5%) events occurred during dasatinib treatment (P=0.015), 6 (10%) events during nilotinib and no events during imatinib treatment (P=0.001). The incidence of CVE was 10.8% in the high and very high-risk groups and 0.52% in moderate and low risk group (P≤0.001). The incidence of arterial ischemic events (AIE) was 10% (n=6) in patients treated with nilotinib, 2.2% (n=2) with dasatinib and 0% with imatinib (P≤0.001). Arterial events were exclusively observed in high and very high-risk groups (8 events, 8.7%) (P≤0.001). The risk factors associated with a higher risk of CVE were hypertension (P≤0.001), dyslipidemia (P≤0.001), coronary arterial disease (P=0.003), congestive heart failure (P=0.002) and chronic renal failure (P=0.011). Disease progression was the main cause of death in all groups. Conclusions: CVE were more frequent in patients treated with second generation TKIs. AIE were more frequent in patients treated with nilotinib, in those having a high or very high risk SCORE. The CV risk stratification of CML patients before and during TKI therapy can help in TKI selection and to identify patients at high risk, in order to reduce the morbidity and mortality associated with CVE. Disclosures Pagnano: Novartis: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Bristol Miers-Squibb: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau.

scholarly journals The Association of Diabetes With Knee Pain Locations, Pain While Walking, and Walking Speed: Data From the Osteoarthritis Initiative

2020 ◽  
Vol 100 (11) ◽  
pp. 1977-1986
Author(s):  
Aqeel M Alenazi ◽  
Mohammed M Alshehri ◽  
Shaima Alothman ◽  
Bader A Alqahtani ◽  
Jason Rucker ◽  
...  
Keyword(s):  
Knee Pain ◽  
Odds Ratio ◽  
Walking Speed ◽  
Walk Test ◽  
Regression Analyses ◽  
Cross Sectional ◽  
Knee Oa ◽  
Osteoarthritis Initiative ◽  
Sectional Analysis ◽  
The Impact

Abstract Objective Osteoarthritis (OA) and diabetes mellitus (DM) often coexist and can result in negative outcomes. DM can affect pain and walking speed in people with knee OA; however, the impact of DM on OA is understudied. The purpose of this study was to investigate the association between diabetes and knee pain locations, pain severity while walking, and walking speed in people with knee OA. Methods A cross-sectional analysis was used. Data from 1790 individuals from the Osteoarthritis Initiative (mean [SD] age = 69 [8.7] years) with knee pain were included and grouped into knee OA and diabetes (n = 236) or knee OA only (n = 1554). Knee pain locations were categorized as no pain, localized pain, regional pain, or diffuse pain. Knee pain during a 20-m walk test was categorized as no pain, mild, moderate, or severe knee pain. Walking speed was measured using the 20-m walk test. Multinomial and linear regression analyses were performed. Results Diabetes was associated with regional knee pain (odds ratio [OR] = 1.77; 95% CI = 1.01–3.11). Diabetes was associated only with moderate (OR = 1.78; 95% CI = 1.02–3.10) or severe (OR = 2.52; 95% CI = 1.01–6.28) pain while walking. Diabetes was associated with decreased walking speed (B = −0.064; 95% CI = −0.09 to −0.03). Conclusions Diabetes was associated with regional knee pain but not with localized or diffuse knee pain and was associated with moderate to severe knee pain while walking and slower walking speed in people with knee OA. Impact Clinicians can use a knee pain map for examining knee pain locations for people with diabetes and knee OA. Knee pain during walking and walking speed should be screened for people with knee OA and diabetes because of the influence of diabetes on these parameters in this population. Lay Summary Diabetes might be associated with specific knee pain locations, pain during activities such as walking, and reduced walking speed in people with knee OA.

Risk factors for severe anemia requiring red blood cell transfusions in lymphoma patients receiving chemotherapy

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19537-19537
Author(s):  
X. Zhou ◽  
S. R. Teegala ◽  
A. Huen ◽  
Y. Ji ◽  
L. E. Fayad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
High Risk ◽  
Significant Risk ◽  
Baseline Risk ◽  
Severe Anemia ◽  
Nodal Involvement ◽  
Initial Regimen ◽  
Number Of Cycles

19537 Background: Anemia is a frequent complication in lymphoma pts receiving chemotherapy (CT). However, the exact incidence of anemia with the current regimens and risk factors for severe anemia are not well established. Methods: A retrospective cohort study was conducted to determine the incidence of anemia requiring transfusions (Tx). Medical records of all newly referred lymphoma pts (n=1046) in 2003 were reviewed. Logistic regression analysis was performed to identify the clinical and laboratory features correlated with anemia in lymphoma pts during initial regimen received. Results: 425 pts who received ≥ 1 cycle of treatment at MDACC were included in this analysis. Median age was 57 (range 17–87) with 262 (62%) newly diagnosed. Most common first regimens were CHOP (29%), Hyper-CVAD ± Ara-c-MTX (23%), and ABVD (8%) (± rituxan- R).The total number of cycles 1638 (median 3, range, 1–10). The incidence of anemia requiring PRBC Tx was 32 % (136/425) of pts and 14% (231/1638) of cycles (median cycle-2 for Tx). The incidence of PRBC Tx ranged from 8% to 17 % in each cycle. The incidence of PRBC Tx among most common regimens were Hyper-CVAD/ Ara-c/MTX 69 %( 66/95), CHOP 23% (29/125), and ABVD 6% (2/34). In the univariate regression analysis, CT, stage, extranodal/BM involvement, histology, Hb, Ca, β2M, LDH, WBC/lymphocyte counts, were significantly associated with the Txs. Using multivariate logistic regression, baseline Hb (< 12 g/dL vs. ≥ 12 g/dL: OR 2.659, 95% CI 1.670 to 4.232, p< 0.0001), extra nodal involvement (± : OR 2.578, 95% CI 1.609 to 4.133, p<0.0001), and CT (high vs low risk: OR 3.889, 95% CI 2.446 to 6.183, p<0.0001) were the most important baseline risk factors for PRBC Txs. Conclusions: The incidence of anemia in this population is high in early cycles. Baseline pt characteristics including Hb (<12g/dL), extra nodal involvement, and high risk CT were found to be significant risk factors predictive for anemia and Txs. These findings could be useful to identify high risk pts for consideration of prophylaxis with erythropoietic agents for prevention of anemia. No significant financial relationships to disclose.

Fall Risk Factors in Older Female Lawn Bowls Players and Controls

2008 ◽  
Vol 17 (1) ◽  
pp. 123-130 ◽  
Author(s):  
Katherine Brooke-Wavell ◽  
Victoria C. Cooling
Keyword(s):  
Risk Factors ◽  
Range Of Motion ◽  
Fall Risk ◽  
Ultrasonic Attenuation ◽  
Balance Training ◽  
Knee Extensor ◽  
Time Range ◽  
Timed Up And Go ◽  
Fall Risk Factors ◽  
Knee Extensor Strength

Fall-risk factors were compared between older women who regularly participate in lawn bowls and controls. Participants were 74 healthy women age 60–75 yr. Postural stability, timed up-and-go score, isometric knee-extensor strength, reaction time, range of motion, and calcaneal broadband ultrasonic attenuation (BUA) were assessed. Bowlers and controls were similar in regard to mean age, height, and weight. Regular bowlers had significantly lower timed up-and-go times, reaction times, and sway while standing on a compliant surface. They had significantly higher knee-extensor strength, range of motion at ankle and shoulder, and calcaneal BUA. Although targeted strength and balance training might be necessary in treatment of the physical frailty that can contribute to falls and fractures in older people, it is possible that long-term participation in activity such as lawn bowls could help prevent this frailty.

scholarly journals Exploring the predictive factors for depression among hemodialysis patients: a case-control study

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S43-S44
Author(s):  
Syed Muhammad Jawad Zaidi ◽  
Mehwish Kaneez ◽  
Hamza Waqar Bhatti ◽  
Shanzeh Khan ◽  
Shafaq Fatima ◽  
...  
Keyword(s):  
Risk Factors ◽  
Depressive Symptoms ◽  
High Risk ◽  
Renal Disease ◽  
Predictive Factors ◽  
Hemodialysis Patients ◽  
High Risk Patients ◽  
Disease Prognosis ◽  
Risk Patients ◽  
Esrd Patients

AimsDepression remains an exceedingly ubiquitous entity that significantly depreciates the quality of life and disease prognosis among end-stage renal disease (ESRD) patients. Even though the deleterious effects of depression on ESRD patients are well-established in the literature, the predictive factors that predispose such patients to depression need to be explored. Our study thus aims to gauge these factors and create a predictive model for optimal psychiatric and medical management of such patients.MethodAll ESRD patients with a disease duration of at least one year underwent a complete psychiatric evaluation based on DSM-V guidelines preceded by a cognitive evaluation by Mini-Mental State Examination (MMSE). A total of 73 patients diagnosed with moderate to severe major depressive disorder were selected as cases. Patients suffering from recurrent psychotic episodes, having a past or family history of psychiatric illness, being already treated for depression, having any substance abuse (current or past), were excluded from the study. Following the similar guidelines, and exclusion criteria, 146 patients (two controls for each case) having no depression were selected as controls. The cases and controls were studied and matched for a myriad of sociodemographic factors. The various risk factors for depression were evaluated using univariate and multivariate binary logistics analysis.ResultThe significant risk factors for depression among hemodialysis patients were age (OR = 1.79, CI = 0.47–3.81), comorbidities (OR = 2.13, CI = 0.51–3.96), duration of renal disease (OR = 2.54, CI 0.63–4.28), duration of hemodialysis (OR = 2.36, CI = 0.89–4.11), unemployment (OR = 2.33, CI = 0.79–3.88), and being unmarried (OR = 1.93, CI = 0.44–3.53). Prospect of survival, financial instability, social stigmatization, and effect of comorbidities on ESRD were major concerns for the cases that attributed to their depressive symptoms.ConclusionThe factors that herald the onset of depression among hemodialysis patients include increasing age, presence of comorbidities, unemployment being unmarried, and increasing duration of hemodialysis. These factors will aid the clinicians to identify high-risk patients that require psychiatric consultation. We recommend prompt psychiatric intervention (pharmacologic or non-pharmacologic) and appropriate patient counseling so that the depressive symptoms can be alleviated and dismal disease prognosis can be prevented among such high-risk patients.

LEG STRENGTH AND HIP FRACTURE MORBIDITY — RESULTS OF 4 SEPARATE CASE STUDIES

2005 ◽  
Vol 09 (04) ◽  
pp. 183-194 ◽  
Author(s):  
Ray Marks
Keyword(s):  
Hip Fracture ◽  
Hospital Discharge ◽  
Functional Disability ◽  
Walking Speed ◽  
Muscle Power ◽  
Knee Extensor ◽  
Leg Strength ◽  
Post Surgery ◽  
Injured Side ◽  
Knee Extensor Strength

The purpose is to examine the importance of ipsilateral leg strength in mediating hip fracture disability. Leg strength measures were recorded and analyzed for 4 separate data sets: (1) 35 patients hospitalized for acute hip fractures; (2) 72 hip replacement surgical candidates with prior hip fracture histories; (3) 30 hip fracture patients followed prospectively for six months after hospital discharge; (4) 23 hip fracture cases interviewed two years after hospital discharge. (1) 78% of patients with acute hip fracture exhibited leg weakness on the injured side, and 41% exhibited knee extensor muscle weakness on the injured side; (2) 79% of patients readmitted for hip surgery, had deficient muscle power of the previously fractured leg and 33% had specific evidence of knee extensor weakness; (3) Interlimb knee extensor strength differentials greater than 10%, more commonly due to strength deficits on the injured side than the uninjured side, were present in 80% of cases examined six months post surgery, and affected walking speed. (4) knee extensor strength of the affected leg predicted the subject's walking speed, as did leg strength two years post surgery. The conclusion is that knee extensor strength deficits of the affected leg are common features of hip fracture patients, and may contribute to, or perpetuate, functional disability.

scholarly journals Incidence, persistence and risk factors of fear of falling in older adults: cohort study (2008–2013) in Rio de Janeiro, Brazil

2020 ◽  
Vol 54 ◽  
pp. 56
Author(s):  
Flávia Moura Malini Drummond ◽  
Roberto Alves Lourenço ◽  
Claudia De Souza Lopes
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Rio De Janeiro ◽  
Walking Speed ◽  
Fear Of Falling ◽  
Activity Level ◽  
Self Rated Health ◽  
History Of

OBJECTIVE: To evaluate the incidence and persistence of fear of falling in older adults and the clinical/functional, psychosocial and lifestyle-related risk factors. METHODS: A longitudinal study with 393 community-dwelling older adults aged 65 years and over (110 men/ 283 women) resident in the North Zone of the city of Rio de Janeiro, Brazil. The fear of falling was assessed by the Falls Efficacy Scale-I-BR. The explanatory variables assessed were: number of comorbidities and medicines, history of falls, fracture from falling, use of walking aids, functional dependence in basic and instrumental activities of daily living, hearing and visual impairment, hand grip strength, walking speed, self-rated health, body mass index, depressive symptoms, cognitive impairment, living alone and activity level. Incidence, persistence and risk factors were estimated. Multivariate analysis was performed using Poisson Regression, obtaining relative risks (RR) and corresponding to 95% confidence intervals. RESULTS: Among the 393 participants, fear of falling occurred in 33.5% and was persistent in 71.3%. Incidence was found to associate with using seven or more medicines and reporting worse activity level than the prior year. Risk factors for persistent fear were: using seven or more medicines, a history of one or two falls, reduced walking speed, hearing impairment, cognitive impairment, depressive symptoms and poor or very poor self-rated health. CONCLUSION: Fear of falling is a frequent and persistent condition. Many factors related to persistent fear showed no association with the incidence of fear, emphasizing the need for focused strategies to reduce risk factors that may be associated with the chronification of fear of falling.

Bidirectional Relationships Between School Connectedness and Internalizing Symptoms During Early Adolescence

2019 ◽  
Vol 40 (9) ◽  
pp. 1336-1368 ◽  
Author(s):  
Melanie Klinck ◽  
Anna Vannucci ◽  
Christine McCauley Ohannessian
Keyword(s):  
Depressive Symptoms ◽  
Anxiety Disorder ◽  
High Risk ◽  
Major Depression ◽  
Internalizing Problems ◽  
School Environment ◽  
Internalizing Symptoms ◽  
School Connectedness ◽  
Baseline Risk ◽  
Primary Study

School connectedness is an important feature to consider within the school environment because it likely accounts for why some youth thrive and others struggle with internalizing problems. Furthermore, internalizing problems typically do not occur in isolation of each other, but rather anxiety and depressive symptoms frequently co-occur and increase subsequent risk for each other. As such, the primary study objectives were to (a) evaluate the bidirectional relationships between school connectedness and internalizing symptoms and (b) examine whether being at high risk of an anxiety disorder or major depression moderated these relationships. Adolescents attending public middle schools ( N = 1,344; 11-14 years; 51% female; 52% White) completed surveys in school at baseline and at a 6-month follow-up. Baseline anxiety disorder risk status moderated the relationships between school connectedness and internalizing symptoms. Among adolescents at low risk of an anxiety disorder, higher baseline school connectedness predicted improvements in depressive symptoms and, conversely, higher baseline depressive symptoms predicted lower school connectedness. School connectedness and depressive symptoms were unrelated among adolescents at high risk of an anxiety disorder. There were no significant associations between school connectedness and anxiety symptoms, regardless of baseline risk for major depression. Implications for school-based intervention strategies are discussed, such as fostering school connectedness and screening for internalizing problems.

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