Co- and multimorbidity patterns in an unselected Norwegian population: cross-sectional analysis based on the HUNT Study and theoretical reflections concerning basic medical models

2014 ◽  
Vol 2 (3) ◽  
pp. 335 ◽  
Author(s):  
Margret Olafia Tomasdottir ◽  
Linn Getz ◽  
Johann A Sigurdsson ◽  
Halfdan Petursson ◽  
Anna Luise Kirkengen ◽  
...  
Keyword(s):  
Allostatic Load ◽  
Age Groups ◽  
Population Based ◽  
Health Study ◽  
Cross Sectional ◽  
Disease Clusters ◽  
Diagnostic Categories ◽  
Norwegian Population ◽  
Somatic Diseases ◽  
Sectional Analysis

Rationale and aims: Accumulating evidence shows that diseases tend to cluster in diseased individuals, so-called multimorbidity. The aim of this study was to analyze multimorbidity patterns, empirically and theoretically, to better understand the phenomenon. Population and methods: The Norwegian population-based Nord-Trøndelag Health Study HUNT 3 (2006-8), with 47,959 individuals aged 20-79 years. A total of 21 relevant, longstanding diseases/malfunctions were eligible for counting in each participant. Multimorbidity was defined as two or more chronic conditions.Results: Multimorbidity was found in 18% of individuals aged 20 years. The prevalence increased with age in both sexes. The overall age-standardized prevalence was 42% (39% for men, 46% for women). ‘Musculoskeletal disorders’ was the disease-group most frequently associated with multimorbidity. Three conditions, strategically selected to represent different diagnostic domains according to biomedical tradition; gastro-esophageal reflux, thyroid disease and dental problems, were all associated with both mental and somatic comorbid conditions. Conclusions and implications: Multimorbidity appears to be prevalent in both genders and across age-groups, even in the affluent and relatively equitable Norwegian society. The disease clusters typically transcend biomedicine’s traditional demarcations between mental and somatic diseases and between diagnostic categories within each of these domains. A new theoretical approach to disease development and recovery is warranted, in order to adequately tackle ‘the challenge of multimorbidity’, both empirically and clinically. We think the concept allostatic load can be systematically developed to “capture” the interrelatedness of biography and biology and to address the fundamental significance of “that, which gains” versus “that, which drains” any given human being.

scholarly journals Mediterranean Diet Adherence Modulates Anthropometric Measures by TCF7L2 Genotypes among Puerto Rican Adults

2019 ◽  
Vol 150 (1) ◽  
pp. 167-175 ◽  
Author(s):  
Mercedes Sotos-Prieto ◽  
Caren E Smith ◽  
Chao-Qiang Lai ◽  
Katherine L Tucker ◽  
José M Ordovas ◽  
...  
Keyword(s):  
Waist Circumference ◽  
Puerto Rican ◽  
Mediterranean Diet ◽  
Population Based ◽  
Dietary Factors ◽  
Health Study ◽  
Anthropometric Measures ◽  
Cross Sectional ◽  
Sectional Analysis ◽  
Tcf7l2 Rs7903146

ABSTRACT Background Transcription factor 7–like 2 (TCF7L2) genetic variants that predispose individuals to type 2 diabetes (T2D) show inconsistent associations with anthropometric traits. Interaction between TCF7L2 genotypes and dietary factors may help explain these observations. Objective We aimed to examine the potential modulation of TCF7L2-rs7903146 and rs12255372 on anthropometric markers by a Mediterranean diet (MedDiet). Methods Cross-sectional analysis was conducted in 1120 participants (aged 45–75 y) of the Boston Puerto Rican Health Study. Anthropometric variables were measured, and polymorphisms were genotyped using standardized protocols. Diet was assessed using a validated FFQ. The MedDiet was defined based on adherence to 9 food and nutrient components using sex-specific population-based median cut-offs; high adherence was defined as meeting ≥4 components. Haplotypes were tested for association with obesity traits, independently and via interaction with the MedDiet. Results TCF7L2-rs7903146 showed significant interaction with the MedDiet influencing BMI, weight, and waist circumference. The T risk-allele carriers (CT + TT) with a high MedDiet score had lower weight (77.3 ± 1.0 compared with CC 80.9 ± 1.0 kg; P = 0.013) and waist circumference (99.2 ± 0.9 compared with CC 102.2 ± 0.9 cm; P = 0.021), when compared with CC participants. A low MedDiet score resulted in no significant differences between genotypes. For TCF7L2-rs12255372, we found significant interactions with the MedDiet for weight (P-interaction = 0.034) and BMI (P-interaction = 0.036). The T allele carriers with a higher MedDiet score showed a trend of lower but no significant differences when compared with CC participants for BMI (P = 0.19), weight (P = 0.09), and waist circumference (P = 0.11). We found significant interactions between the 2 risk-carrying haplotypes and the MedDiet compared with the common haplotype (GC), with lower BMI (β ± SE, TT: −1.53 ± 0.68; P-interaction = 0.024), weight (TT: −4.16 ± 1.77; P-interaction = 0.019), and waist circumference (GT: −5.07 ± 2.50; P-interaction = 0.042) at a high MedDiet score. Conclusion Puerto Ricans with the TCF7L2-rs7903146 and rs12255372 T2D risk genotypes, although still high, had better anthropometric profiles when adhering to a MedDiet, suggesting that this diet may offset unfavorable genetic predisposition.

Old Age and Loneliness: Cross-sectional and Longitudinal Analyses in the Tampere Longitudinal Study on Aging

2004 ◽  
Vol 23 (2) ◽  
pp. 157-168 ◽  
Author(s):  
Marja Jylhä
Keyword(s):  
Longitudinal Study ◽  
Age Groups ◽  
Population Based ◽  
Household Composition ◽  
Older Age ◽  
Cross Sectional ◽  
Prospective Longitudinal Study ◽  
Sectional Analysis ◽  
Prospective Longitudinal

ABSTRACTThe purpose of this study was to examine whether older age is associated with increasing loneliness in people aged 60 and over. Data came from TamELSA, a population-based prospective longitudinal study in Tampere, Finland. The follow-up time was 20 years. Loneliness was measured by a single question – “Do you feel lonely?“ – with the possible answers often, sometimes, or never. Cross-sectional analysis showed that the percentage of subjects feeling lonely increased toward older age groups, but in a multivariate analysis, only household composition and social participation were independently associated with loneliness. Longitudinal analysis showed that loneliness increased with higher age. Over a 10-year period, loneliness increased most in those who, at baseline, were married and living alone with their spouse. In conclusion, only a minority of older people continuously suffer from loneliness. Loneliness does increase with age, not because of age per se, but because of increasing disability and decreasing social integration.

scholarly journals The association between clusters of chronic conditions and psychological well-being in younger and older people—A cross-sectional, population-based study from the Lolland-Falster Health Study, Denmark

2020 ◽  
Vol 10 ◽  
pp. 2235042X2098118
Author(s):  
Lars Hermann Tang ◽  
Lau Caspar Thygesen ◽  
Tora Grauers Willadsen ◽  
Randi Jepsen ◽  
Karen la Cour ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Primary Outcome ◽  
Age Groups ◽  
Well Being ◽  
Population Based ◽  
Cross Sectional Study ◽  
Health Study ◽  
Cross Sectional ◽  
Population Based Study ◽  
Psychological Well Being

Aim: To investigate the association between clusters of conditions and psychological well-being across age groups. Method: This cross-sectional study used data collected in the Danish population-based Lolland-Falster Health Study. We included adults over the age of 18 years. Self-reported chronic conditions were divided into 10 groups of conditions. The primary outcome was psychological well-being (the WHO-5 Well-Being Index). Factor analysis constructed the clusters of conditions, and regression analysis investigated the association between clusters and psychological well-being. Results: Of 10,781 participants, 31.4% were between 18 and 49 years, 35.7% were between 50 and 64 years and 32.9% were above ≥65 years. 35.2% had conditions represented in 1 and 32.9% in at least 2 of 10 condition groups. Across age groups, living with one or more chronic conditions was associated with poorer psychological well-being. Two chronic condition patterns were identified; one comprised cardiovascular, endocrine, kidney, musculoskeletal and cancer conditions, the second mental, lung, neurological, gastrointestinal and sensory conditions. Both patterns were associated with poorer psychological well-being (Pattern 1: −4.5 (95% CI: −5.3 to −3.7), Pattern 2: −9.1 (95% CI −13.8 to −8.2). For pattern 2, participants ≥65 years had poorer psychological well-being compared to younger (−12.6 (95% CI −14.2 to −11.0) vs −6.6 (95% CI: −7.8 to −5.4) for 18–49 years and −8.7 (95% CI: −10.1 to −7.3) for 50–64 years, interaction: p ≤ 0.001) Conclusion: Living with one or more chronic conditions is associated with poorer psychological well-being. Findings point toward a greater focus on supporting psychological well-being in older adults with both mental and somatic conditions.

scholarly journals Decomposing the educational gradient in allostatic load across European populations. What matters the most: differentials in exposure or in susceptibility?

2020 ◽  
pp. jech-2020-213946
Author(s):  
Giovanni Veronesi ◽  
Frank Kee ◽  
Blanaid Hicks ◽  
Hannah Forrest ◽  
Hugh Tunstall-Pedoe ◽  
...  
Keyword(s):  
Allostatic Load ◽  
Alcohol Intake ◽  
Age Groups ◽  
Differential Susceptibility ◽  
Cross Sectional ◽  
Metabolic Markers ◽  
Socially Disadvantaged ◽  
Wear And Tear ◽  
Z Scores ◽  
Sectional Analysis

BackgroundWe investigate whether socially disadvantaged individuals are more susceptible to the detrimental effects of smoking and alcohol intake on allostatic load (AL), a marker of physiological ‘wear and tear’, resulting from adaptation to chronic stress.MethodsIn a cross-sectional analysis, 27 019 men and 26 738 women aged 35–74 years were identified from 21 European cohorts in the BiomarCaRE consortium. We defined three educational classes (EDs) according to years of schooling and an AL score as the sum of z-scores of eight selected biomarkers from the cardiovascular, metabolic and inflammatory systems. We used the Oaxaca-Blinder decomposition to disentangle the ED gradient in AL score into the differential exposure (DE, attributable to different distribution of smoking and alcohol intake across EDs) and the differential susceptibility (DS, attributable to a different effect of risk factors on AL across EDs) components.ResultsLess-educated men (mean AL difference: 0.68, 95% CI 0.57 to 0.79) and women (1.52, 95% CI 1.40 to 1.64) had higher AL scores. DE accounted for 7% and 6% of the gradient in men and women, respectively. In men, combining smoking and alcohol intake, DS accounted for 42% of the gradient (smoking DS coefficient=0.177, 26% of the gradient; alcohol DS coefficient=0.109; 16%, not statistically significant). DS contribution increased to 69% in metabolic markers. DS estimates were consistent across age groups, irrespective of comorbidities and robust to unmeasured confounding. No DS was observed in women.ConclusionsIn men, a DS mechanism substantially contributes to the educational class gradient in allostatic load.

The German Version of the Satisfaction With Life Scale (SWLS)

2011 ◽  
Vol 27 (2) ◽  
pp. 127-132 ◽  
Author(s):  
Heide Glaesmer ◽  
Gesine Grande ◽  
Elmar Braehler ◽  
Marcus Roth
Keyword(s):  
Convergent Validity ◽  
Satisfaction With Life ◽  
Age Groups ◽  
Population Based ◽  
Factorial Invariance ◽  
Satisfaction With Life Scale ◽  
Small Samples ◽  
Cross Sectional ◽  
Confirmatory Factor Analyses ◽  
Life Scale

The Satisfaction with Life Scale (SWLS) is the most commonly used measure for life satisfaction. Although there are numerous studies confirming factorial validity, most studies on dimensionality are based on small samples. A controversial debate continues on the factorial invariance across different subgroups. The present study aimed to test psychometric properties, factorial structure, factorial invariance across age and gender, and to deliver population-based norms for the German general population from a large cross-sectional sample of 2519 subjects. Confirmatory factor analyses supported that the scale is one-factorial, even though indications of inhomogeneity of the scale have been detected. Both findings show invariance across the seven age groups and both genders. As indicators of the convergent validity, a positive correlation with social support and negative correlation with depressiveness was shown. Population-based norms are provided to support the application in the context of individual diagnostics.

scholarly journals The association between serum alanine aminotransferase and hypertension: A national based cross-sectional analysis among over 21 million Chinese adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiajing Jia ◽  
Ying Yang ◽  
Fangchao Liu ◽  
Minjin Zhang ◽  
Qin Xu ◽  
...  
Keyword(s):  
Alanine Aminotransferase ◽  
Elevated Serum ◽  
Population Based ◽  
Reproductive Age ◽  
Chinese Adults ◽  
Cross Sectional ◽  
Serum Alanine Aminotransferase ◽  
Cross Sectional Analysis ◽  
Registration Data ◽  
Sectional Analysis

Abstract Background Inconsistent results were found in the association between serum alanine aminotransferase (ALT) and hypertension among population-based studies. This study evaluated the association between ALT and hypertension among Chinese reproductive-age population by utilizing registration data from National Free Pre-pregnancy Checkups Project in 2016–2017. Methods The 21,103,790 registered participants were eligible for analysis, including women who were 20–49 years old and men who were 20–59 years old with available data for ALT and blood pressure (BP). Logistic regression was conducted to estimate odds ratio (OR) for the association between ALT and hypertension as a binary outcome. Linear regression was used to examine the association between ALT and BP as a continuous outcome. Results In total, 4.21% of the participants were hypertensive, and 11.67% had elevated ALT (> 40 U/L). Hypertension prevalence was 3.63% and 8.56% among participants with normal and elevated ALT levels. A strong linear relationship was found between serum ALT levels and the odds of hypertension after adjustment for potential confounders. The multivariable-adjusted ORs for hypertension were 1, 1.22 (1.21, 1.22), 1.67 (1.65 1.68), 1.78 (1.76, 1.80), and 1.92 (1.90, 1.94) in participants with ALT levels of ≤ 20, 20.01–40, 40.01–60, 60.01–80, and > 80 U/L, respectively. Systolic and diastolic BPs rose by 1.83 and 1.20 mmHg on average, for each 20 U/L increase in ALT (P for trend < 0.001). The association was consistent among subgroups and tended to be stronger among populations who are overweight (body mass index ≥ 24 kg/m2) (χ2 = 52,228, P < 0.001), alcohol drinking (χ2 = 100,730, P < 0.001) and cigarette smoking (χ2 = 105,347, P < 0.001). Conclusions Our cross-sectional analysis suggested a linear association between serum ALT and hypertension or BP, which indicated that abnormal liver metabolism marked by elevated serum ALT could play a role in hypertension or elevated BP condition.

scholarly journals The Association of Periodontitis and Peripheral Arterial Occlusive Disease in a Prospective Population-Based Cross-Sectional Cohort Study

2021 ◽  
Vol 10 (10) ◽  
pp. 2048
Author(s):  
Nicole Jacobi ◽  
Carolin Walther ◽  
Katrin Borof ◽  
Guido Heydecke ◽  
Udo Seedorf ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peripheral Arterial Occlusive Disease ◽  
Ankle Brachial Index ◽  
Population Based ◽  
Arterial Occlusive Disease ◽  
Occlusive Disease ◽  
Health Study ◽  
Cross Sectional ◽  
Severe Periodontitis ◽  
Peripheral Arterial

Objectives: Peripheral arterial occlusive disease (PAOD) and periodontitis are common chronic diseases, which together affect almost 1 billion people worldwide. There is growing evidence suggesting a relationship between chronic inflammatory conditions such as periodontitis and PAOD. This study aims to determine an association between both entities using high quality research data and multiple phenotypes derived from an epidemiological cohort study. Design: This population-based cross-sectional cohort study included data from 3271 participants aged between 45 and 74 years enrolled in the Hamburg City Health Study (NCT03934957). Material & Methods: An ankle-brachial-index below 0.9, color-coded ultrasound of the lower extremity arteries, and survey data was used to identify participants with either asymptomatic or symptomatic PAOD. Periodontitis data was collected at six sites per tooth and included the probing depth, gingival recession, clinical attachment loss, and bleeding on probing index. Multivariate analyses using logistic regression models were adjusted for variables including age, sex, smoking, education, diabetes, and hypertension. Results: The baseline characteristics differed widely between participants neither affected by periodontitis nor PAOD vs. the group where both PAOD and severe periodontitis were identified. A higher rate of males, higher age, lower education level, smoking, diabetes, and cardiovascular disease was observed in the group affected by both diseases. After adjusting, presence of severe periodontitis (odds ratio 1.265; 97.5% CI 1.006–1.591; p = 0.045) was independently associated with PAOD. Conclusion: In this cross-sectional analysis of a prospective cohort study, an independent association between periodontitis and PAOD was revealed. The results of the current study emphasize a potential for preventive medicine in an extremely sensitive target population. Future studies should determine the underlying factors modifying the relationship between both diseases.

scholarly journals Self-reported Diagnosis of Rheumatoid Arthritis or Ankylosing Spondylitis Has Low Accuracy: Data from the Nord-Trøndelag Health Study

2017 ◽  
Vol 44 (8) ◽  
pp. 1134-1141 ◽  
Author(s):  
Vibeke Videm ◽  
Ranjeny Thomas ◽  
Matthew A. Brown ◽  
Mari Hoff
Keyword(s):  
Rheumatoid Arthritis ◽  
Ankylosing Spondylitis ◽  
Population Based ◽  
Self Report ◽  
Health Study ◽  
Primary Study ◽  
Case File ◽  
Norwegian Population ◽  
Case Files ◽  
Accuracy Data

Objective.Self-reported diagnoses of inflammatory arthritis are not accurate. The primary study aim was to ascertain self-reported diagnoses of rheumatoid arthritis (RA) and ankylosing spondylitis (AS) in the Norwegian population-based Nord-Trøndelag Health Study (HUNT) using hospital case files. The secondary aim was to provide updated estimates of the prevalence and incidence of RA and AS.Methods.All inhabitants ≥ 20 years old from the county of Nord-Trøndelag were invited. Data from 70,805 unique participants from HUNT2 (1995–1997) and HUNT3 (2006–2008) were included. For participants who self-reported RA or AS, case files from all 3 hospitals in the catchment area were evaluated using standardized diagnostic criteria.Results.Of 2703 self-reported cases of RA, 19.1% were verified in hospital files. Of 1064 self-reported cases of AS, 15.8% were verified. Of 259 cases self-reporting both RA and AS, 8.1% had RA and 5.4% had AS. Overall, a self-report of 1 or both diagnoses could not be verified in 82.1%, including 22.8% with insufficient information or no case file. The prevalence of RA was 768 (95% CI 705–835) per 100,000. The incidence of RA from HUNT2 to HUNT3 was 0.48 (0.41–0.56) per 1000 per year. The prevalence of AS was 264 (228–305) per 100,000. The incidence of AS from HUNT2 to HUNT3 was 0.19 (0.15–0.24) per 1000 per year.Conclusion.Self-reported diagnoses of RA and AS are often false-positive. The prevalence and incidence of RA were comparable to reports from similar populations. The incidence of AS was higher than previously reported in a mixed population from Norway.

scholarly journals Daily Sitting for Long Periods Increases the Odds for Subclinical Atheroma Plaques

2021 ◽  
Vol 10 (6) ◽  
pp. 1229
Author(s):  
Jose Luis Perez-Lasierra ◽  
Martin Laclaustra ◽  
Pilar Guallar-Castillón ◽  
Jose Antonio Casasnovas ◽  
Jose Antonio Casajús ◽  
...  
Keyword(s):  
Physical Activity ◽  
Subclinical Atherosclerosis ◽  
Sitting Time ◽  
Health Study ◽  
Activity Levels ◽  
Cross Sectional ◽  
Trained Personnel ◽  
Atherosclerosis Development ◽  
Sectional Analysis ◽  
The Relationship

Sedentarism is a risk factor for cardiovascular disease (CVD), but currently it is not clear how a sedentary behavior such as long sitting time can affect atherosclerosis development. This study examined the relationship between sitting time and the prevalence of carotid and femoral subclinical atherosclerosis. A cross-sectional analysis based on a subsample of 2082 participants belonging to the Aragon Workers’ Health Study was carried out. Ultrasonography was used to assess the presence of plaques in carotid and femoral territories; the validated Spanish version of the questionnaire on the frequency of engaging in physical activity used in the Nurses’ Health Study and the Health Professionals’ was used to assess physical activity and sitting time; and demographic, anthropometric, and clinical data were obtained by trained personnel during the annual medical examination. Participants were categorized into <9 h/day and ≥9 h/day sitting time groups. After adjusting for several confounders, compared with participants that remain seated <9 h/day, those participants who remain seated ≥9 h/day had, respectively, OR = 1.25 (95%CI: 1.01, 1.55, p < 0.05) and OR = 1.38 (95%CI: 1.09, 1.74, p < 0.05) for carotid and any-territory plaque presence. Remaining seated ≥9 h/day is associated with higher odds for carotid and any-territory plaque presence independently of physical activity levels and other cardiovascular risk factors.

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