1
|
Islamoska S, Hansen JM, Hansen ÅM, Garde AH, Waldemar G, Nabe-Nielsen K. The association between migraine and dementia - a national register-based matched cohort study. Public Health 2022; 213:54-60. [PMID: 36351328 DOI: 10.1016/j.puhe.2022.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Migraine and dementia, two major public health challenges, are associated, but more knowledge is needed to understand their relationship. Objectives of this study were to investigate 1) the association between non-self-reported measures of migraine and dementia, and whether dementia was associated with 2) migraine without aura (MO) and with aura (MA) in combination with migraine medication use, and 3) migraine severity operationalized as the number of migraine prescriptions. STUDY DESIGN Matched cohort study. METHODS National register data were obtained from individuals born between 1934 and 1958. Migraine cases (aged 25-58 years) were identified by migraine diagnoses and redeemed migraine medication. Migraine cases were matched with non-cases (N = 340,850) and date of diagnosis or medication redemption was defined as index year. Dementia was identified by dementia diagnoses and redeemed dementia medication. RESULTS We observed a 1.46 (95% CI: 1.26-1.69) times higher dementia rate in individuals with a migraine diagnosis and a 0.86 (95% CI: 0.76-0.97) times lower rate when using migraine medication. We found the highest dementia rate among individuals with MA, who also used migraine medication (HR = 2.23; 95% CI: 1.19-4.17), and the lowest rate among individuals with MO, who also used medication (HR = 1.25; 95% CI: 0.75-2.10). The number of migraine medication prescriptions was not associated with dementia. CONCLUSIONS Being registered with a migraine diagnosis was associated with a higher dementia rate, while use of prescribed migraine medication was not. The differences in the dementia rate among migraine cases identified via diagnoses versus medications warrants further investigation.
Collapse
Affiliation(s)
- S Islamoska
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark.
| | - J M Hansen
- Danish Headache Center, Rigshospitalet - Glostrup, Valdemar Hansens Vej 5, 2600 Glostrup, Denmark.
| | - Å M Hansen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark; The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, Denmark.
| | - A H Garde
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark; The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, Denmark.
| | - G Waldemar
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Inge Lehmannsvej 8, 2100 Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
| | - K Nabe-Nielsen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark.
| |
Collapse
|
2
|
Bräuner EV, Hansen ÅM, Doherty DA, Dickinson JE, Handelsman DJ, Hickey M, Skakkebæk NE, Juul A, Hart R. The association between in-utero exposure to stressful life events during pregnancy and male reproductive function in a cohort of 20-year-old offspring: The Raine Study. Hum Reprod 2020; 34:1345-1355. [PMID: 31143949 DOI: 10.1093/humrep/dez070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 04/12/2019] [Accepted: 04/18/2019] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Is exposure to gestational stress in the critical time window for the normal differentiation and growth of male reproductive tissue associated with male reproductive function in offspring in later life? SUMMARY ANSWER Exposure to stressful life events (SLEs) in early, but not late gestation, are associated with reduced adult male reproductive function, consistent with the hypothesis that events during early prenatal life programme adult male reproductive function. WHAT IS ALREADY KNOWN Animal studies suggest that gestational stress may impact on the reproductive function of male offspring, but human evidence is sparse. STUDY DESIGN, SIZE, DURATION Using a prospective longitudinal cohort, we examined the association between number and type of maternal stressors during pregnancy in both early and late gestation and reproductive function in 643 male Generation 2 (offspring) at age 20 years. Mothers and their male Generation 2 (offspring) from The Raine Study participated. Mothers prospectively reported SLEs during pregnancy recorded at gestational weeks 18 and 34 using a standardized 10-point questionnaire. PARTICIPANTS/MATERIALS, SETTING, METHODS The 643 male Generation 2 (offspring) underwent testicular ultrasound examination and semen analysis and provided serum for reproductive hormone analysis. Multivariate linear regression analysis was used to examine associations. MAIN RESULTS AND ROLE OF CHANCE Of 643 recruited males, 407 (63%) were exposed to at least one SLE in early gestation. Fewer SLEs were reported in late gestation (n = 343, 53%). Maternal SLE exposure in early gestation was negatively associated with total sperm count (β = -0.31, 95% CI -0.58; -0.03), number of progressive motile sperm (β = -0.15, 95% CI -0.31; 0.00) and morning serum testosterone concentration (β = -0.04, 95% CI -0.09; -0.00). No similar effects of maternal SLE exposure in late pregnancy were detected. The large sample size and an objective detailed direct assessment of adult male reproductive function with strict external quality control for sperm quality, as well as detailed prospectively collected information on prenatal SLEs in two distinct time windows of pregnancy reported by the women in early and late gestation along with other risk factors, imply minimal possibility of recall, information bias and selection bias. When assessing our results, we adjusted for a priori chosen confounders, but residual confounding or confounding by factors unbeknown to us cannot be ruled out. LIMITATIONS, REASONS FOR CAUTION It is not possible to measure how SLEs impacted differently on the mother's experience or perception of stress. Resilience (coping) gradients may alter cortisol levels and thus modify the associations we observed and the mothers' own perception of stress severity may have provided a more precise estimate of her exposure. WIDER IMPLICATIONS OF THE FINDINGS Our findings suggest that exposure to SLEs in early, but not late gestation, are associated with reduced adult male reproductive function. Improved support for women with exposure to SLEs during pregnancy, particularly during the first trimester, may improve the reproductive health of their male offspring in later life. Intervention studies of improved pregnancy support could provide more insight into this association and more information is needed about the potential specific epigenetic mechanisms underlying this association. STUDY FUNDING/COMPETING INTEREST(S) The male fertility sub-study was funded by NHMRC Grant 634 457. The core management of the Raine Study is funded by University of Western Australia, Curtin University, Telethon Kids Institute, Women and Infants Research Foundation, Edith Cowan University, Murdoch University, The University of Notre Dame Australia and Raine Medical Research foundation. Dr Bräuner's salary was supported by Læge Sofus Carl Emil Friis og Hustru Olga Doris Friis foundation in Denmark. All authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- E V Bräuner
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen Denmark.,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | - Å M Hansen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,The National Research Centre for the Working Environment, Copenhagen Denmark
| | - D A Doherty
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, Western Australia, Australia
| | - J E Dickinson
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, Western Australia, Australia
| | - D J Handelsman
- ANZAC Research Institute, University of Sydney, Sydney NSW Australia
| | - M Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia
| | - N E Skakkebæk
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen Denmark.,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | - A Juul
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen Denmark.,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Denmark
| | - R Hart
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, Western Australia, Australia.,Fertility Specialists of Western Australia, Bethesda Hospital, Claremont, Western Australia, Australia
| |
Collapse
|
3
|
Sørensen JK, Jensen MA, Hansen ÅM, Rugulies R, Garde AH. Diurnal rhythms of cortisol and melatonin in night eating and non-night eating male police officers. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Working during the night has in previous studies been associated with behavioural changes and diseases. Disturbance between behavioural and biological circadian rhythms have been suggested as a possible mechanism linking night work with cardiovascular diseases and pre-diabetic changes. The aim of this study was to investigate if night eating during two, four and seven consecutive night shifts is associated with differences in the diurnal rhythms of cortisol and melatonin in male police officers in Denmark.
Methods
We conducted an experimental study among 37 male police officers in Denmark who all collected data on the last night shift in three different work schedules with two, four and seven consecutive night shifts, respectively. Night eating was self-reported and defined as eating at least one main meal between midnight and early morning. Differences in the diurnal rhythms of concentrations of cortisol and melatonin in saliva were tested by phase changes and amplitude differences.
Results
Sixteen (43.2%) police officers ate a main meal during the last night shift in all three work schedules. The timing of the lowest cortisol concentration was on average delayed with 2:10 hours (95% CI 0:24-3:56 hours) and the level of the lowest cortisol concentration was on average supressed with 66% (95% CI 47-94%) for night eaters compared to non-night eaters. There was no association with number of consecutive night shifts. The phase and amplitude of melatonin were not statistically significantly different between night eaters and non-night eaters.
Conclusions
Night eating behaviour is associated with differences in the diurnal rhythm of cortisol in Danish male police officers working during the night. The difference in cortisol rhythm between night eaters and non-night eaters on night shifts is not affected by the number of consecutive night shifts.
Key messages
Night eating behaviour is associated with differences in the diurnal rhythm of cortisol. Future studies should focus on potential health outcomes of night eating behaviour among night workers.
Collapse
Affiliation(s)
- J K Sørensen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - M A Jensen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - ÅM Hansen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - R Rugulies
- The National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - A H Garde
- The National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
4
|
De Dobbeleer L, Beyer I, Hansen ÅM, Molbo D, Mortensen EL, Lund R, Bautmans I. Grip Work Measurement with the Jamar Dynamometer: Validation of a Simple Equation for Clinical Use. J Nutr Health Aging 2019; 23:221-224. [PMID: 30697635 DOI: 10.1007/s12603-019-1155-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Previously, we developed and validated an easy test to measure muscle fatigability during sustained maximal handgrip contraction in older persons using a Martin Vigorimeter device. This study aimed at validating the equation to estimate grip work (GW) during sustained maximal handgrip contraction, by monitoring continuously the grip strength (GS) decay using a Jamar Dynamometer-like (JD) device. DESIGN Cross sectional, explorative study. SETTING Data collection took place at The National Research Centre for the Working Environment in Copenhagen, Denmark. PARTICIPANTS 962 subjects, belonging to a subgroup of the Copenhagen Aging and Midlife Biobank, were enrolled. METHODS GS was recorded continuously during sustained maximal contraction until it dropped to 50% of its maximum and fatigue resistance (FR, time to fatigue) was noted. GW, area under the force-time curve, was compared to its estimate which was calculated as GWestimated=GSmax*0.75*FR. RESULTS Excellent correlation was found between GWestimated and GWmeasured (R²=0.98 p<0.001). The equation slightly overestimated GW by 6.04 kg*s (95% CI[-0.08, 12.15]) with a coefficient of variation method error of 6%. CONCLUSION GW estimation is a valid parameter reflecting muscle work output during a sustained maximal grip effort in healthy middle-aged community-dwelling persons when using a JD. GW estimation is a promising outcome parameter in comprehensive geriatric assessment and its validation for commonly used instruments in geriatric practice will increase its clinical implementation.
Collapse
Affiliation(s)
- L De Dobbeleer
- Prof. Dr. Ivan Bautmans, Gerontology department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090 Brussels, Belgium, Tel: +3224774207; E-mail:
| | | | | | | | | | | | | |
Collapse
|
5
|
Netterstrøm B, Hansen ÅM, Isaacson D, Simonsen AM, Weihe P. Physiological reactions to long-term fishing in the Barents Sea. Occup Med (Lond) 2018; 68:109-115. [PMID: 29444322 DOI: 10.1093/occmed/kqy006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Fishing in distant waters for months may induce physiological stress. Aims To assess the physiological stress reactions in fishermen working for 2-3 months continuously in 6-h shifts on trawlers in the Barents Sea. Methods The crew of five trawlers fishing in the Barents Sea from January to April 2004 were invited to participate. In the week before and 5-7 days after the trip, the following measures were collected: salivary cortisol four times a day, 24-h urinary cortisol, blood pressure, heart rate, serum cholesterol, serum high-density lipoprotein (HDL-cholesterol), HbA1c (glycosylated haemoglobin) and weight. In addition, 24-h urinary cortisol, blood pressure and heart rate were measured three times. A questionnaire on health, social conditions and work environment was obtained after the trip. Results In total, 136 men agreed to participate. Full data were obtained for 96 fishermen (70%). A significant decrease in salivary and urinary cortisol was found during the trip. Adjustment for age, body mass index, smoking, shift work schedule and time of day for sample collection did not change this finding. Systolic and diastolic blood pressure declined significantly and remained significantly lower after the trip compared to before the trip. Serum cholesterol/HDL ratio declined significantly, whereas triglycerides, HbA1c and weight were unchanged. Conclusions Working up to 3 months on 6-h shifts, 84 h a week, with moderate physical activity, even in artificial light and cold weather on a ship, did not result in increased physiological stress.
Collapse
Affiliation(s)
- B Netterstrøm
- Department of Occupational and Environmental Medicine, University Hospital, Bispebjerg, Copenhagen, Denmark
| | - Å M Hansen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark
| | - D Isaacson
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Faroe Islands
| | - A M Simonsen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Faroe Islands
| | - P Weihe
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Faroe Islands
| |
Collapse
|
6
|
Affiliation(s)
- S Mikkelsen
- Department of Occupational and Environmental Medicine,Bispebjerg University Hospital,Copenhagen,Denmark
| | - J H Andersen
- Department of Occupational Medicine,Danish Ramazzini Centre, The Regional Hospital West Jutland,Herning,Denmark
| | - J P Bonde
- Department of Occupational and Environmental Medicine,Bispebjerg University Hospital,Copenhagen,Denmark
| | - Å M Hansen
- Department of Public Health,University of Copenhagen,Copenhagen,Denmark
| | - H Kolstad
- Department of Occupational Medicine,Danish Ramazzini Centre, Aarhus University Hospital,Århus,Denmark
| | - J F Thomsen
- Department of Occupational and Environmental Medicine,Bispebjerg University Hospital,Copenhagen,Denmark
| |
Collapse
|
7
|
Nordentoft M, Jensen MA, Hansen ÅM, Rugulies R, Garde AH. Does napping affect quality of primary sleep among police officers working at night? Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx186.339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Nordentoft
- National Research Centre for the Working Environment; Dep. Public Health, University of Copenhagen, Copenhagen, Denmark
| | - MA Jensen
- National Research Centre for the Working Environment; Dep. Public Health, University of Copenhagen, Copenhagen, Denmark
| | - ÅM Hansen
- National Research Centre for the Working Environment; Dep. Public Health, University of Copenhagen, Copenhagen, Denmark
| | - R Rugulies
- National Research Centre for the Working Environment; Dep. Public Health, University of Copenhagen, Copenhagen, Denmark
| | - AH Garde
- National Research Centre for the Working Environment; Dep. Public Health, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
8
|
Hannerz H, Møller SV, Dyreborg J, Bonde JP, Hansen J, Kolstad HA, Hansen ÅM, Garde AH, Larsen AD. Night work and risk of accidental injuries. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx189.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H Hannerz
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - SV Møller
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - J Dyreborg
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - JP Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark
| | - J Hansen
- Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - HA Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, University of Aarhus, Aarhus, Denmark
| | - ÅM Hansen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - AH Garde
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - AD Larsen
- The National Research Centre for the Working Environment, Copenhagen, Denmark
| |
Collapse
|
9
|
Maynard S, Keijzers G, Hansen ÅM, Osler M, Molbo D, Bendix L, Møller P, Loft S, Moreno-Villanueva M, Bürkle A, Hvitby CP, Schurman SH, Stevnsner T, Rasmussen LJ, Avlund K, Bohr VA. Associations of subjective vitality with DNA damage, cardiovascular risk factors and physical performance. Acta Physiol (Oxf) 2015; 213:156-70. [PMID: 24703498 DOI: 10.1111/apha.12296] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 12/09/2013] [Accepted: 03/27/2014] [Indexed: 12/21/2022]
Abstract
AIM To examine associations of DNA damage, cardiovascular risk factors and physical performance with vitality, in middle-aged men. We also sought to elucidate underlying factors of physical performance by comparing physical performance parameters to DNA damage parameters and cardiovascular risk factors. METHODS We studied 2487 participants from the Metropolit cohort of 11 532 men born in 1953 in the Copenhagen Metropolitan area. The vitality level was estimated using the SF-36 vitality scale. Cardiovascular risk factors were determined by body mass index (BMI), and haematological biochemistry tests obtained from non-fasting participants. DNA damage parameters were measured in peripheral blood mononuclear cells (PBMCs) from as many participants as possible from a representative subset of 207 participants. RESULTS Vitality was inversely associated with spontaneous DNA breaks (measured by comet assay) (P = 0.046) and BMI (P = 0.002), and positively associated with all of the physical performance parameters (all P < 0.001). Also, we found several associations between physical performance parameters and cardiovascular risk factors. In addition, the load of short telomeres was inversely associated with maximum jump force (P = 0.018), with lowered significance after exclusion of either arthritis sufferers (P = 0.035) or smokers (P = 0.031). CONCLUSION Here, we show that self-reported vitality is associated with DNA breaks, BMI and objective (measured) physical performance in a cohort of middle-aged men. Several other associations in this study verify clinical observations in medical practice. In addition, the load of short telomeres may be linked to peak performance in certain musculoskeletal activities.
Collapse
Affiliation(s)
- S. Maynard
- Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Department of Cellular and Molecular Medicine; University of Copenhagen; Copenhagen Denmark
| | - G. Keijzers
- Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Department of Cellular and Molecular Medicine; University of Copenhagen; Copenhagen Denmark
- Danish Aging Research Center; University of Southern Denmark; Odense Denmark
| | - Å.-M. Hansen
- Department of Public Health; University of Copenhagen; Copenhagen Denmark
- National Research Centre for the Working Environment; Copenhagen Denmark
| | - M. Osler
- Danish Aging Research Center; University of Southern Denmark; Odense Denmark
- Research Centre for prevention and Health; Glostrup University Hospital; Glostrup Denmark
| | - D. Molbo
- Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Department of Public Health; University of Copenhagen; Copenhagen Denmark
| | - L. Bendix
- Danish Aging Research Center; University of Southern Denmark; Odense Denmark
- Department of Public Health; University of Copenhagen; Copenhagen Denmark
| | - P. Møller
- Department of Public Health; University of Copenhagen; Copenhagen Denmark
| | - S. Loft
- Department of Public Health; University of Copenhagen; Copenhagen Denmark
| | | | - A. Bürkle
- Molecular Toxicology Group; University of Konstanz; Konstanz Germany
| | - C. P. Hvitby
- Danish Aging Research Center; University of Southern Denmark; Odense Denmark
- Department of Molecular Biology and Genetics; University of Aarhus; Aarhus Denmark
| | - S. H. Schurman
- Clinical Research Program; National Institute of Environmental Health Sciences; National Institutes of Health; Research Triangle Park NC USA
| | - T. Stevnsner
- Danish Aging Research Center; University of Southern Denmark; Odense Denmark
- Department of Molecular Biology and Genetics; University of Aarhus; Aarhus Denmark
| | - L. J. Rasmussen
- Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Department of Cellular and Molecular Medicine; University of Copenhagen; Copenhagen Denmark
| | - K. Avlund
- Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Danish Aging Research Center; University of Southern Denmark; Odense Denmark
- Department of Public Health; University of Copenhagen; Copenhagen Denmark
| | - V. A. Bohr
- Center for Healthy Aging; University of Copenhagen; Copenhagen Denmark
- Laboratory of Molecular Gerontology; National Institute on Aging; National Institutes of Health; Baltimore MD USA
| |
Collapse
|
10
|
Abstract
The purpose of this study was to determine whether recovery from burnout is associated with improved cognitive functioning, and whether such improvement is associated with changes in hypothalamic-pituitary-adrenal axis activity and return to work. Forty-five former burnout patients were followed up after 1.5 years with a neuropsychological examination, diurnal salivary cortisol measurements, dexamethasone suppression test (DST), and self-ratings of cognitive problems. At follow-up, improved cognitive performance was observed on several tests of short-term memory and attention. Self-rated cognitive problems decreased considerably, but this decrease was unrelated to the improvement on neuropsychological tests. Diurnal salivary cortisol concentrations at awakening, 30 min after awakening, and in the evening, did not change from baseline to follow-up, nor did the cortisol awakening response. However, slightly, but significantly, stronger suppression of cortisol in response to the DST was observed at follow-up. Improvements in subjective or objective cognitive functioning and changes in diurnal cortisol concentration were unrelated to the extent of work resumption. However, a decreased DST response at follow-up was partially related to improved cognitive performance and work resumption. The clinical implications are that burnout seems to be associated with slight and significantly reversible cognitive impairment, and that self-rated cognitive change during recovery poorly reflects objective cognitive change.
Collapse
Affiliation(s)
- K Österberg
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, SE-221 85 Lund, Sweden.
| | | | | | | |
Collapse
|