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Tian Y, Zhou X, Jiang Y, Pan Y, Liu X, Gu X. Bidirectional association between falls and multimorbidity in middle-aged and elderly Chinese adults: a national longitudinal study. Sci Rep 2024; 14:9109. [PMID: 38643241 PMCID: PMC11032330 DOI: 10.1038/s41598-024-59865-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 04/16/2024] [Indexed: 04/22/2024] Open
Abstract
This study explores the bidirectional association between multimorbidity and falls in Chinese middle-aged and elderly adults. Participants aged 45 and above from the China Health and Retirement Longitudinal Study were included. Binary logistic regression assessed the impact of chronic conditions on fall incidence (stage I), while multinomial logistic regression examined the relationship between baseline falls and multimorbidity (stage II). The fully adjusted odds ratios (ORs) for one, two, or three or more chronic conditions were 1.34, 1.65, and 2.02, respectively. Among participants without baseline falls, 28.61% developed two or more chronic conditions during follow-up, compared to 37.4% of those with a history of falls. Fully adjusted ORs for one, two, or three or more chronic conditions in those with a history of falls were 1.21, 1.38 and 1.70, respectively. The bidirectional relationship held in sensitivity and subgroup analyses. A bidirectional relationship exists between multimorbidity and falls in Chinese middle-aged and elderly adults. Strengthening chronic condition screening and treatment in primary healthcare may reduce falls risk, and prioritizing fall prevention and intervention in daily life is recommended.
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Affiliation(s)
- Ye Tian
- Department of Health Statistics, School of Public Health, Hainan Medical University, No. 3, Xue Yuan Road, Longhua District, Haikou, 571199, People's Republic of China
| | - Xingzhao Zhou
- Department of Health Statistics, School of Public Health, Hainan Medical University, No. 3, Xue Yuan Road, Longhua District, Haikou, 571199, People's Republic of China
| | - Yan Jiang
- Department of Health Statistics, School of Public Health, Hainan Medical University, No. 3, Xue Yuan Road, Longhua District, Haikou, 571199, People's Republic of China
| | - Yidan Pan
- Department of Health Statistics, School of Public Health, Hainan Medical University, No. 3, Xue Yuan Road, Longhua District, Haikou, 571199, People's Republic of China
| | - Xuefeidan Liu
- Department of Marine Pharmacy, School of Pharmacy, Hainan Medical University, No. 3, Xue Yuan Road, Longhua District, Haikou, 571199, People's Republic of China
| | - Xingbo Gu
- Department of Health Statistics, School of Public Health, Hainan Medical University, No. 3, Xue Yuan Road, Longhua District, Haikou, 571199, People's Republic of China.
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Yu X, Gain EP, Kedia SK. Bidirectional associations between alcohol drinking and depressive symptom scores among US older adults. J Affect Disord 2024; 349:48-53. [PMID: 38190853 DOI: 10.1016/j.jad.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/22/2023] [Accepted: 01/03/2024] [Indexed: 01/10/2024]
Abstract
BACKGROUND This study examines the bidirectional associations between alcohol drinking and depression in which low to moderate alcohol drinking may reduce the risk of depression, while the occurrence of depression may increase the amount of alcohol drinking as a coping strategy. METHOD Data for the community-dwelling older adults from the Medicare Current Beneficiary Survey (MCBS) 2016 to 2019 were analyzed using random intercept cross-lagged panel models to explore the within-individual causal associations for males and females separately. Socioeconomic status (SES), smoking and comorbidities were adjusted in the models. RESULTS Among 3388 older adults with three measures for the number of alcohol drinks and Patient Health Questionnaire (PHQ) depression scores, a prior increase in the number of drinks was related to a moderate non-significant decrease in PHQ scores in the follow-up, but a previous increase in the PHQ scores was significantly associated with a decrease in the number of drinks at the follow-up visit in the adjusted models (regression coefficient = -0.144, p = 0.017 for males; and coefficient = -0.11, p < 0.001 for females). CONCLUSION Prior depression may lead to reduced drinking in the follow up visits, but no bidirectional association was found among US older adults.
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Affiliation(s)
- Xinhua Yu
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, United States of America.
| | - Easter P Gain
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, United States of America
| | - Satish K Kedia
- Division of Social Behavioral Sciences, School of Public Health, University of Memphis, United States of America
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Wang X, Wang R, Zhang D. Bidirectional associations between sleep quality/duration and multimorbidity in middle-aged and older people Chinese adults: a longitudinal study. BMC Public Health 2024; 24:708. [PMID: 38443848 PMCID: PMC10916205 DOI: 10.1186/s12889-024-17954-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/01/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Multimorbidity and sleep disorder possess high incidence rates in the middle-aged and older people populations, posing a significant threat to quality of life and physical and mental health. However, investigators have previously only analysed the unidirectional association between sleep status and multimorbidity. We aimed to investigate bidirectional associations between sleep quality or duration and multimorbidity in middle-aged and older Chinese adults from a longitudinal perspective. METHOD We enrolled a total of 9823 participants 45 years and older from the China Health and Retirement Longitudinal Study from 2015 to 2018 in our study. Multimorbidity was defined as two or more coexisting chronic diseases in the same individual based on 14 self-reported disease questions. Sleep quality was classified as "good" (restless < 1 day per week) and "poor" (restless ≥ 1 days per week); and sleep duration was divided into short (< 6 h), medium (6-9 h), and long (> 9 h). The bidirectional association between multimorbidity and sleep condition was examined using multivariate logistic regression models with adjustments for covariates. RESULTS Individuals with poor sleep quality showed a significantly higher prevalence of multimorbidity in the future. The adjusted OR (95% CI) values of individuals with poor sleep quality with respect to developing two diseases, three diseases, and ≥ 4 diseases were 1.39 (1.19, 1.63), 1.56 (1.23, 2.03), and 2.36 (1.68, 3.33), respectively. In addition, individuals with multimorbidity exhibited a significantly higher risk of poor sleep quality in the future. Short sleep duration led to multimorbidity in the future (OR = 1.49; 95 CI%, 1.37-1.63), while multimorbidity contributed to short sleep duration (< 6 h) in the future (OR = 1.39; 95% CI, 1.27-1.51) after full adjustment. CONCLUSIONS There was a bidirectional association between sleep quality or short sleep duration and multimorbidity in middle-aged and older Chinese adults. We recommend that greater attention be given to clinical management among adults with sleep disorders or physical multimorbidities.
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Affiliation(s)
- Xiaoran Wang
- Institute of Hospital Management/Shenzhen International Graduate School, Tsinghua University, Shenzhen, China
| | - Rui Wang
- School of Nursing, Fudan University, Shanghai, China
| | - Dan Zhang
- Institute of Hospital Management/Shenzhen International Graduate School, Tsinghua University, Shenzhen, China.
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Zhang J, Jia X, Li Y, Zheng D, Guo X, Li H, Yang Q. The Association Between Serum Uric Acid and Cognitive Function Among Middle-Aged and Older Adults Without Hyperuricemia: The Mediating Role of Depressive Symptoms. J Gerontol A Biol Sci Med Sci 2024; 79:glad203. [PMID: 37606588 DOI: 10.1093/gerona/glad203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND The association between serum uric acid (SUA) and cognitive function remains unclear, especially among individuals without hyperuricemia. We examined the cross-sectional and longitudinal bidirectional associations between SUA and cognition, as well as the mediating effect of depressive symptoms among Chinese adults. METHODS Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS). SUA (continuous) and cognitive function (based on mental intactness and episodic memory) were measured at Wave 1 and Wave 3. Depressive symptoms (Center for Epidemiologic Studies Depression scale) were assessed at Wave 1. Bivariate latent change score models and mediation analysis were used to investigate these possible associations. RESULTS A total of 6 236 participants free of hyperuricemia (aged 58.3 ± 8.5 years) were included. After controlling for potential confounders, the SUA level was associated with cognition at baseline (standardized r = 0.042; p = .001). Higher baseline SUA level was associated with slower subsequent cognitive decline (standardized β = 0.026; p = .027), whereas baseline cognition was not significantly associated with subsequent change in SUA (standardized β = 0.003; p = .817). In mediation analysis, baseline SUA was indirectly associated with subsequent cognition via baseline depressive symptoms (mediation effect 13.3%; p < .001). CONCLUSIONS Higher baseline SUA level is associated with better baseline cognition and less subsequent cognitive decline among Chinese adults without hyperuricemia. Baseline depressive symptoms may partially mediate the association between baseline SUA and later cognition. Continued research is warranted to verify these findings and elucidate the causality and underlying mechanisms.
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Affiliation(s)
- Jiajia Zhang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xiuqin Jia
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yingying Li
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Medical Engineering for Cardiovascular Disease, Ministry of Education, Beijing, China
| | - Deqiang Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Haibin Li
- Department of Cardiac Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Qi Yang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Key Laboratory of Medical Engineering for Cardiovascular Disease, Ministry of Education, Beijing, China
- Beijing Laboratory for Cardiovascular Precision Medicine, Beijing, China
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Ma W, Wang H, Wen Z, Liu L, Zhang X. Potentially inappropriate medication and frailty in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2023; 114:105087. [PMID: 37311369 DOI: 10.1016/j.archger.2023.105087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 03/29/2023] [Revised: 05/18/2023] [Accepted: 06/03/2023] [Indexed: 06/15/2023]
Abstract
OBJECTIVES The purpose of this study was to systematically assess existing studies to demonstrate the association between potentially inappropriate medication (PIM) and frailty. DESIGN Systematic review and meta-analysis. METHODS We searched major electronic databases (PubMed, Web of Science, the Cochrane Library, Embase, CINHAL, PsycInfo, China National Knowledge Infrastructure, China Biology Medicine disk, Weipu, and Wanfang) from their inception until February 25, 2023 (data updated on May 4, 2023), for observational studies investigating PIM and frailty. I2 was used to measure the heterogeneity between studies quantitatively. A random effect model calculated pooled effect size owing to high heterogeneity. Subgroup analysis was conducted to explore sources of heterogeneity. Additionally, the studies' quality was evaluated using the Newcastle Ottawa Scale (a modified Newcastle Ottawa Scale was used to evaluate cross-sectional studies). RESULTS Twenty-four studies were included for systematic review, 14 of which were included in the meta-analysis. After pooling the effect size, the odds ratio with PIM as the dependent variable was 1.12 (95%CI: 1.01-1.25), and that with frailty as the dependent variable was 1.75 (95%CI: 1.25-2.43), indicating a bidirectional association between PIM and frailty. CONCLUSIONS PIM and frailty interact with each other and have a bidirectional association, thus providing additional information for early clinical identification and prevention of frailty, and medication safety management.
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Affiliation(s)
- Wenlian Ma
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hongyan Wang
- Dean Office, Sichuan Nursing Vocational College, Chengdu, China
| | - Zhifei Wen
- School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Linfeng Liu
- Dean Office, Sichuan Nursing Vocational College, Chengdu, China
| | - Xiangeng Zhang
- Dean Office, Sichuan Nursing Vocational College, Chengdu, China.
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Liu CC, Lin CY, Liu CH, Chang KC, Wang SK, Wang JY. Bidirectional association between major depressive disorder and dementia: Two population-based cohort studies in Taiwan. Compr Psychiatry 2023; 127:152411. [PMID: 37722203 DOI: 10.1016/j.comppsych.2023.152411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Major depressive disorder (MDD) and dementia are both major contributors to the global burden of disease. Despite existing literature on the association between MDD and dementia, there is a lack of a nationwide longitudinal cohort study that considers the competing risk of death. Therefore, this study assessed the bidirectional associations between MDD and dementia over an 11-year period in population-based settings, accounting for death as a competing risk. METHODS We conducted two population-based retrospective cohort studies in Taiwan. We identified 80,742 patients diagnosed with MDD in 2009-2010 and matched them with patients without MDD by sex, age, and year of diagnosis to assess the relative risk of dementia. We also identified 80,108 patients diagnosed with dementia in 2009-2010 and matched them with patients without dementia by sex, age, and year of diagnosis to assess the relative risk of MDD. All patients were followed until they received a diagnosis of new onset MDD or new onset dementia, their death, or the end of 2019. Cause-specific hazards models were used to estimate adjusted hazard ratios (aHRs). RESULTS The incidence density (ID) of dementia was higher in patients with MDD than in patients without MDD (7.63 vs. 2.99 per 1000 person-years), with an aHR of 2.71 (95% confidence interval [CI]: 2.55-2.88). The ID of MDD was higher in patients with dementia than in patients without dementia (12.77 vs. 4.69 per 1000 person-years), with an aHR of 2.47 (95% CI: 2.35-2.59). CONCLUSIONS This population-based study found a bidirectional association between MDD and dementia. Our findings suggest the need to identify dementia in patients with MDD and vice versa.
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Affiliation(s)
- Chih-Ching Liu
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taiwan.
| | - Chih-Yuan Lin
- Department of Neurology, Taipei City Hospital, Linsen Chinese Medicine Branch, Taipei, Taiwan; Institute of Health and Welfare Policy, School of Medicine, National Yang Ming Chiao Tung University, Taiwan
| | - Chien-Hui Liu
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taiwan; Division of Emergency Medical Service, New Taipei City Fire Department, New Taipei City, Taiwan
| | - Kun-Chia Chang
- Jianan Psychiatric Center, Ministry of Health and Welfare, Taiwan; Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Kai Wang
- Department of Pediatrics, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Jiun-Yi Wang
- Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taiwan.
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Feng Z, Ma Z, Hu W, He Q, Li T, Chu J, Chen X, Han Q, Sun N, Shen Y. Bidirectional Association Between Multimorbidity and Frailty and the Role of Depression in Older Europeans. J Gerontol A Biol Sci Med Sci 2023; 78:2162-2169. [PMID: 37487182 PMCID: PMC11009466 DOI: 10.1093/gerona/glad178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Although previous studies have reported an association between multimorbidity and frailty, its direction and mechanism remain unclear. This study aimed to investigate the direction of this association, as well as the role of depression among older Europeans. METHODS We used a cross-lagged panel design to evaluate the temporal relationship between multimorbidity and frailty and the role of depression. Multimorbidity status was assessed by the self-reporting of 14 chronic diseases. Frailty was assessed based on the frailty phenotype. The European-Depression Scale (EURO-D) was used to assess depression. RESULTS There was a bidirectional relationship between frailty and multimorbidity. More severe multimorbidity predicted greater frailty (β = 0.159; p < .001) and vice versa (β = 0.107; p < .001). All paths from multimorbidity to frailty were stronger than the paths from frailty to multimorbidity (b1-a1: β = 0.051; p < .001). Likewise, early multimorbidity change was a significant predictive factor for late frailty change (β = 0.064; p < .001) and vice versa (β = 0.048; p < .001). Depression in Wave 5 (T5) mediated the association between frailty in Wave 4 (T4) and multimorbidity in Wave 6 (T6; indirect effect: β = 0.004; bootstrap 95% confidence interval: 0.003, 0.006). CONCLUSIONS A positive, bidirectional association was observed between multimorbidity and frailty. Depression may be a potential cause of an increased risk of multimorbidity later in life in frail older adults. Early monitoring of frailty and depression may slow the progression of multimorbidity, thereby interrupting the vicious cycle.
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Affiliation(s)
- Zhaolong Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Ze Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Wei Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Qida He
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Tongxing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jiadong Chu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Xuanli Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Qiang Han
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Na Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yueping Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
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Tu KC, Yu RY, Lin YH, Chien CC, Lu CL. Bidirectional association between infectious gastroenteritis and inflammatory bowel disease: a population-based study. Eur J Med Res 2023; 28:337. [PMID: 37697336 PMCID: PMC10494362 DOI: 10.1186/s40001-023-01324-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 08/27/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Intertwined association between infectious gastroenteritis (IGE) and inflammatory bowel disease (IBD) has not been investigated clearly. We aimed to examine the bidirectional association between IGE and IBD. METHODS A bidirectional study using the Taiwan National Health Insurance Research Database was designed. Through a case-control design, we identified 2899 new IBD cases during 2006-2017 and matched to 28,990 non-IBD controls. We used conditional logistic regression model to estimate odds ratios (OR) of IBD for previous IGE in different exposure time-windows within 5-years before IBD diagnosis and Poisson regression model to estimate incidence rate ratio (IRR) of subsequent IGE for IBD group to non-IBD group. RESULTS The mean age at the initial IBD diagnosis was 41 years. More IBD patients (21.49%) than controls (12.60%) had been exposed to IGE during > 6 months to 5 years before IBD diagnosis, the OR of IBD for IGE was 1.89 [95% confidence interval: 1.69-2.11]. Excess OR decreased as IGE exposure time before the index date increased. More IGE episodes were associated with additional increase in IBD risk (OR: 1.64, 2.19, 2.57, 3.50, and 4.57 in patients with 1, 2, 3, 4, and ≥ 5 IGE episodes, respectively). The IRR of having IGE for IBD group to non-IBD group was 2.42 before IBD diagnosis and increased to 5.74 after IBD diagnosis. CONCLUSIONS These findings suggested an IGE-IBD bidirectional association. More attention is needed for physicians to develop preventive strategies and be aware of the higher risk of subsequent IGE in IBD patients.
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Affiliation(s)
- Kuan-Chieh Tu
- Department of Cardiology, Chi-Mei Medical Center, Tainan, Taiwan
| | - Ru-Yi Yu
- Graduate Institute of Food Safety, College of Agriculture and Natural Resources, South District, National Chung Hsing University, 145 Xingda Road, Taichung, 402, Taiwan
| | - Yu-Hsuan Lin
- Graduate Institute of Food Safety, College of Agriculture and Natural Resources, South District, National Chung Hsing University, 145 Xingda Road, Taichung, 402, Taiwan
| | | | - Chin-Li Lu
- Graduate Institute of Food Safety, College of Agriculture and Natural Resources, South District, National Chung Hsing University, 145 Xingda Road, Taichung, 402, Taiwan.
- Department of Food Science and Biotechnology, College of Agriculture and Natural Resources, National Chung Hsing University, Taichung, Taiwan.
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
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Hu W, Chu J, Zhu Y, Chen X, Sun N, Han Q, Li T, Feng Z, He Q, Wu J, Shen Y. The Longitudinal Association Between Frailty, Cognition, and Quality of Life in Older Europeans. J Gerontol B Psychol Sci Soc Sci 2023; 78:809-818. [PMID: 36702742 PMCID: PMC10413812 DOI: 10.1093/geronb/gbad013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES Evidence on the association between frailty and quality of life (QoL) is mostly limited to cross-sectional studies. Thus, the temporal order and potential mechanisms of this association are largely unknown. Our study examines both the directionality of this association and the role of cognition in this association in longitudinal data. METHODS Cross-lagged panel models were employed to examine the temporal relationship between frailty and QoL, as well as cognition's role among 19,649 older adults in Europe. Frailty, QoL, and cognition were assessed using the health deficit index, CASP-12, and 3 standard cognitive tests, respectively. RESULTS We observed a bidirectional association between frailty and QoL and their dynamics. High initial levels of frailty predicted poorer QoL later and vice versa (β = -0.151 and -0.052, p < .001). The early change in frailty predicted the late change in QoL, and vice versa (β = -0.093 and -0.061, p < .001). Frailty or its early change drives this interrelationship. Cognition at Wave 5 partially mediated frailty's effect at Wave 4 on QoL at Wave 6 (indirect effect: β = -0.005, 95% confidence interval = -0.006, -0.004). DISCUSSION Our findings supported that early prevention of frailty and its risk factors may have more influential protective effects on later physical and mental health, as well as the need for ongoing screening for mental health in aging population. Also, the maintenance of good cognitive performance may help interrupt this possible vicious cycle linking frailty and QoL decline.
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Affiliation(s)
- Wei Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jiadong Chu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yixian Zhu
- School of Radiation Medicine and Protection, Soochow University, Medical College of Soochow University, Suzhou, China
| | - Xuanli Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Na Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Qiang Han
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Tongxing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Zhaolong Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Qida He
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Jun Wu
- Department of Oncology, The Third Affiliated Hospital of Soochow University, Changzhou, Jiangsu, China
| | - Yueping Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
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Mo C, Peng W, Luo Y, Tang S, Liu M. Bidirectional relationship between fear of falling and frailty among community-dwelling older adults: A longitudinal study. Geriatr Nurs 2023; 51:286-292. [PMID: 37031580 DOI: 10.1016/j.gerinurse.2023.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/10/2023] [Revised: 03/21/2023] [Accepted: 03/21/2023] [Indexed: 04/11/2023]
Abstract
This study aims to examine the bidirectional association between fear of falling (FOF) and frailty among community-dwelling older adults. Longitudinal analyses were conducted over a representative sample of 5,829 community-dwelling individuals ≥65 years from the National Health and Aging Trends Study. FOF was ascertained by asking participants whether they worried about falling and if this worry ever limited their activities. Frailty status was assessed based on frailty phenotype. At baseline, 71.4% of participants reported no FOF, 16.7% reported FOF without fear-related activity restriction (FAR), and 11.9% reported FOF with FAR. The proportion of robust, pre-frail and frail respondents at baseline was 36.1%, 48.7% and 15.2%, respectively. Multinomial logistic regression models indicated FOF with and without FAR predicted pre-frailty and frailty. Pre-frailty predicted FOF with and without FAR, while frailty only predicted FOF with FAR. Tailored intervention strategies are needed for preventing adverse outcomes of FOF and frailty among the older population.
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Affiliation(s)
- Cen Mo
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road of Yuelu District, Changsha 410013, China
| | - Wenting Peng
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road of Yuelu District, Changsha 410013, China
| | - Yuqian Luo
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road of Yuelu District, Changsha 410013, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road of Yuelu District, Changsha 410013, China
| | - Minhui Liu
- Xiangya School of Nursing, Central South University, 172 Tongzipo Road of Yuelu District, Changsha 410013, China.
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Li L, Liu J, Wu Y. A population-based study of the bidirectional association between chronic disease and depression in two prospective Chinese cohorts. Asian J Psychiatr 2023; 81:103456. [PMID: 36630834 DOI: 10.1016/j.ajp.2023.103456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023]
Affiliation(s)
- Long Li
- Department of Acupuncture and Massage, School of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China.
| | - Junwei Liu
- Orthopaedics Department of Traditional Chinese Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China.
| | - Yongli Wu
- Department of Acupuncture and Massage, School of Traditional Chinese Medicine, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China; Orthopaedics Department of Traditional Chinese Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China; Key Laboratory of Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China.
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12
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Liu M, Peng W, Miyawaki CE, Mo C, Luo Y, Gong N. The bidirectional relationship between homebound status and falls among older adults: a longitudinal study. BMC Geriatr 2022; 22:923. [PMID: 36457078 PMCID: PMC9714142 DOI: 10.1186/s12877-022-03588-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 11/04/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Previous research has shown an association between homebound status and falls among older adults. However, this association was primarily drawn from cross-sectional studies. This study aimed to determine the bidirectional relationship between homebound status and falls among older adults in the community. METHODS We used data of the community-dwelling older adults from 2011 to 2015 of the National Health and Aging Trends Study, a nationally representative survey of Medicare Beneficiaries in the United States (Sample 1 [No falls at baseline]: N = 2,512; Sample 2 [Non-homebound at baseline]: N = 2,916). Homebound status was determined by the frequency, difficulty, and needing help for outdoor mobility. Falls were ascertained by asking participants whether they had a fall in the last year. Generalized estimation equation models were used to examine the bidirectional association between homebound status and falls longitudinally. RESULTS Participants with no falls at baseline (n = 2,512) were on average, 76.8 years old, non-Hispanic whites (70.1%), and female (57.1%). After adjusting for demographics and health-related variables, prior year homebound status significantly contributed to falls in the following year (Odds ratio [OR], 1.28, 95% CI: 1.09-1.51). Participants who were non-homebound at baseline (n = 2,916) were on average, 75.7 years old, non-Hispanic white (74.8%), and female (55.8%). Previous falls significantly predicted later homebound status (OR, 1.26, 95% CI: 1.10-1.45) in the full adjusted model. CONCLUSION This is the first longitudinal study to determine the bidirectional association between homebound status and falls. Homebound status and falls form a vicious circle and mutually reinforce each other over time. Our findings suggest the importance of developing programs and community activities that reduce falls and improve homebound status among older adults.
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Affiliation(s)
- Minhui Liu
- grid.216417.70000 0001 0379 7164Xiangya School of Nursing, Central South University, Changsha, China
| | - Wenting Peng
- grid.216417.70000 0001 0379 7164Xiangya School of Nursing, Central South University, Changsha, China
| | - Christina E. Miyawaki
- grid.266436.30000 0004 1569 9707Graduate College of Social Work, University of Houston, Houston, TX USA
| | - Cen Mo
- grid.216417.70000 0001 0379 7164Xiangya School of Nursing, Central South University, Changsha, China
| | - Yuqian Luo
- grid.216417.70000 0001 0379 7164Xiangya School of Nursing, Central South University, Changsha, China
| | - Ni Gong
- grid.431010.7The Third Xiangya Hospital of Central South University, 138 Tongzipo Road of Yuelu District, Changsha, 410013 China
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Yang X, Guo WJ, Tao YJ, Meng YJ, Wang HY, Li XJ, Zhang YM, Zeng JK, Tang WJ, Wang Q, Deng W, Zhao LS, Ma XH, Li ML, Xu JJ, Li J, Liu YS, Tang Z, Du XD, Hao W, Coid JW, Lee S, Greenshaw AJ, Li T. A bidirectional association between internet addiction and depression: A large-sample longitudinal study among Chinese university students. J Affect Disord 2022; 299:416-24. [PMID: 34906641 DOI: 10.1016/j.jad.2021.12.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 12/04/2021] [Accepted: 12/09/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Internet addiction (IA) is associated with adverse consequences, especially for younger people. Evidence indicates that IA is associated with depression, but no studies have yet investigated potential common vulnerability between them. METHODS IA (measured by the Young's 20-item Internet Addiction Test Scale) and depressive symptoms (measured by the Patient Health Questionnaire-9 Scale) among 12 043 undergraduates were surveyed at baseline and at a respective 12 month follow-up for each participant. Application of a cross-lagged panel model approach (CLPM) revealed an association between IA and depression after adjusting for demographic variables. RESULTS Rates of baseline IA and depression were 5.47% (95% CI: 5.07%, 5.88%) and 3.85% (95% CI: 3.51%, 4.20%), respectively; increasing to 9.47% (95% CI: 8.94%, 9.99%) and 5.58% (95% CI: 5.17%,5.99%), respectively, at follow-up. Rates of new-incidences of IA and depression over 12 months were 7.43% (95% CI: 6.95%, 7.91%) and 4.47% (95% CI: 4.09%, 4.84%), respectively. Models in the present analysis revealed that baseline depression had a significant net-predictive effect on follow-up IA, and baseline IA had a significant net-predictive effect on follow-up depression. LIMITATIONS The follow-up survey response rate was moderate (54.69%) in this analysis of university students. Moreover, the IAT-20 scale did not allow differentiate between specific forms of Internet activity. CONCLUSIONS Common vulnerability and bidirectional cross-causal effects may both contribute to the association between IA and depression, with common vulnerability likely playing a more significant role than cross-causal effects.
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Zheng J, Li J, Pei T, Zhu T, Cheong IH, Li S, Wang X, Hall BJ, Li X, Wang H. Depressive symptoms and chronic lung disease in middle-aged and older Chinese adults: Prospective bidirectional association and mediation analysis. J Affect Disord 2022; 297:283-293. [PMID: 34688671 DOI: 10.1016/j.jad.2021.10.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND We investigated the prospective bidirectional association between depressive symptoms and chronic lung disease (CLD) and explored biologically and behaviorally relevant mediators in this bidirectional association among Chinese middle-aged and older population in the China Health and Retirement Longitudinal Study. METHODS Multivariable-adjusted Cox proportional hazard models were used to examine baseline depressive symptoms in relation to incident CLD risk among 12,546 adults and examine CLD condition in association with incidence of elevated depressive symptoms among 6,929 participants from 2011 to 2018. Elevated depressive symptoms were assessed with the 10-item Center for Epidemiologic Studies Depression scale and CLD was determined by self-reported physician diagnosis. Causal mediation analysis was performed to examine the direct and indirect effects of a priori selected nine blood biomarkers and four lifestyle factors in the bidirectional association. RESULTS Elevated depressive symptoms significantly increased CLD risk by 68% (HR=1.68, 95%CI=1.46-1.93) after a mean follow-up of 5.9 years and the strong positive association was consistently shown in almost all the subgroups. Having positive CLD status at baseline was associated with 17% increased risk of developing elevated depressive symptoms (HR=1.17, 95%CI=1.01-1.35) during an average of 4.6 years follow-up period. Significant inflammatory, metabolic or pulmonary function related mediators were not identified. LIMITATIONS Inadequate follow-up time and limited mediator variable information may reduce chance of identifying significant mediators. CONCLUSIONS Elevated depressive symptoms and CLD were mutual risk factors in middle-aged and older Chinese adults. Early screening and treatment of depression is needed to reduce CLD risk and related comorbidities including new-onset depression so as to relieve substantial disease burdens of CLD and depression in China.
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Affiliation(s)
- Jiali Zheng
- Department of Epidemiology and Biostatistics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Jingmeng Li
- Department of Food Safety and Toxicology, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Tianduo Pei
- Department of Food Safety and Toxicology, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Tianren Zhu
- Department of Food Safety and Toxicology, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Io Hong Cheong
- State Key Laboratory of Oncogenes and Related Genes, Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Sha Li
- Department of Food Safety and Toxicology, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Xiaonan Wang
- Department of Food Safety and Toxicology, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
| | - Brian J Hall
- Global Public Health, New York University Shanghai, Shanghai, 200122 China
| | - Xiaoguang Li
- Department of Food Safety and Toxicology, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China; State Key Laboratory of Oncogenes and Related Genes, Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China.
| | - Hui Wang
- Department of Food Safety and Toxicology, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China; State Key Laboratory of Oncogenes and Related Genes, Center for Single-Cell Omics, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China.
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Ye B, Xie R, Mishra SR, Dai X, Chen H, Chen X, Li D, Yuan C, Xu X. Bidirectional association between physical multimorbidity and subclinical depression in Chinese older adults: Findings from a prospective cohort study. J Affect Disord 2022; 296:169-174. [PMID: 34601304 DOI: 10.1016/j.jad.2021.09.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 09/08/2021] [Accepted: 09/21/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND Both physical multimorbidity and subclinical depression pose a significant threat to aging population worldwide. The association between these conditions appeared to be in a bidirectional way, however the joint causal relationship yet to be fully understood in elderly Chinese population. METHODS A total of 4605 Chinese elders from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2015) were included for the present study. Physical multimorbidity was defined as having two or more self-reported chronic physical conditions. Subclinical depression was defined by ≥ 12 scores assessed using the 10-item Centre for Epidemiological Studies Depression Scale. The bidirectional association between physical multimorbidity and subclinical depression was examined using multivariable logistic regression models, adjusting for covariates. RESULTS During study period, 23.99% of participant reported incident episode of subclinical depression and 21.36% reported physical multimorbidity. In fully adjusted model, those with physical multimorbidity were two times more likely to have subclinical depression (OR = 2.05, 95% CI: 1.71-2.46). Besides that, subclinical depression was associated with physical multimorbidity (OR = 1.84, 95% CI: 1.50-2.46), but in slightly less magnitude. Furthermore, the bidirectional association remains statistically significant across different subgroups. LIMITATIONS Chronic conditions were all self-reported and we couldn't adjust for all confounders, which may be subject to measurement error. CONCLUSIONS Physical multimorbidity and subclinical depression was associated in a bidirectional way in elderly Chinese population, which highlights the necessary of covering a broad spectrum of aspects of clinical management among adults with physical multimorbidity or subclinical depression.
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Affiliation(s)
- Bingqi Ye
- The Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310058, China
| | - Renxiang Xie
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Shiva Raj Mishra
- Academy for Data Science and Global Health, Bharatpur, Chitwan, Nepal; School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Xiaochen Dai
- Department of Health Metrics Science, School of Medicine, University of Washington, Seattle, USA
| | - Hui Chen
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Xiao Chen
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Duanhui Li
- The Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310058, China
| | - Changzheng Yuan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, USA.
| | - Xiaolin Xu
- The Second Affiliated Hospital and School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310058, China; School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, Australia.
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Qiao Y, Liu S, Li G, Lu Y, Wu Y, Shen Y, Ke C. Longitudinal Follow-Up Studies on the Bidirectional Association between ADL/IADL Disability and Multimorbidity: Results from Two National Sample Cohorts of Middle-Aged and Elderly Adults. Gerontology 2021; 67:563-571. [PMID: 34182559 DOI: 10.1159/000513930] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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: 07/20/2020] [Accepted: 12/20/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Few studies have investigated the bidirectional relationship between disability and multimorbidity, which are common conditions among the older population. Based on the data from the China Health and Retirement Longitudinal Study (CHARLS) and the Survey of Health, Ageing and Retirement in Europe (SHARE), we aimed to investigate the bidirectional relationship between disability and multimorbidity. METHODS The activities of daily living (ADLs) and the instrumental activities of daily living (IADLs) scales were used to measure disability. In stage I, we used multinomial logistic regression to assess the longitudinal association between ADL/IADL disability and follow-up multimorbidity. In stage II, binary logistic regression was used to evaluate the multimorbidity effect on future disability. RESULTS Compared with those free of disability, people with disability possessed ascending risks for developing an increasing number of diseases. For ADL disability, the odds ratio (OR) (95% confidence interval [CI]) values of developing ≥4 diseases were 4.10 (2.58, 6.51) and 6.59 (4.54, 9.56) in CHARLS and SHARE; for IADL disability, the OR (95% CI) values were 2.55 (1.69, 3.84) and 4.85 (3.51, 6.70) in CHARLS and SHARE. Meanwhile, the number of diseases at baseline was associated, in a dose-response manner, with future disability. Compared with those without chronic diseases, participants carrying ≥4 diseases had OR (95% CI) values of 4.82 (3.73, 6.21)/4.66 (3.65, 5.95) in CHARLS and 3.19 (2.59, 3.94)/3.28 (2.71, 3.98) in SHARE for developing ADL/IADL disability. CONCLUSION The consistent findings across 2 national longitudinal studies supported a strong bidirectional association between disability and multimorbidity among middle-aged and elderly adults. Thus, tailored interventions should be taken to prevent the mutual development of disability and multimorbidity.
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Affiliation(s)
- Yanan Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Siyuan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Guochen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Yanqiang Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Ying Wu
- Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yueping Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Chaofu Ke
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China
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Viswanathan V, Puvvula A, Jamthikar AD, Saba L, Johri AM, Kotsis V, Khanna NN, Dhanjil SK, Majhail M, Misra DP, Agarwal V, Kitas GD, Sharma AM, Kolluri R, Naidu S, Suri JS. Bidirectional link between diabetes mellitus and coronavirus disease 2019 leading to cardiovascular disease: A narrative review. World J Diabetes 2021; 12:215-237. [PMID: 33758644 PMCID: PMC7958478 DOI: 10.4239/wjd.v12.i3.215] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/20/2020] [Accepted: 02/11/2021] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a global pandemic where several comorbidities have been shown to have a significant effect on mortality. Patients with diabetes mellitus (DM) have a higher mortality rate than non-DM patients if they get COVID-19. Recent studies have indicated that patients with a history of diabetes can increase the risk of severe acute respiratory syndrome coronavirus 2 infection. Additionally, patients without any history of diabetes can acquire new-onset DM when infected with COVID-19. Thus, there is a need to explore the bidirectional link between these two conditions, confirming the vicious loop between "DM/COVID-19". This narrative review presents (1) the bidirectional association between the DM and COVID-19, (2) the manifestations of the DM/COVID-19 loop leading to cardiovascular disease, (3) an understanding of primary and secondary factors that influence mortality due to the DM/COVID-19 loop, (4) the role of vitamin-D in DM patients during COVID-19, and finally, (5) the monitoring tools for tracking atherosclerosis burden in DM patients during COVID-19 and "COVID-triggered DM" patients. We conclude that the bidirectional nature of DM/COVID-19 causes acceleration towards cardiovascular events. Due to this alarming condition, early monitoring of atherosclerotic burden is required in "Diabetes patients during COVID-19" or "new-onset Diabetes triggered by COVID-19 in Non-Diabetes patients".
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Affiliation(s)
- Vijay Viswanathan
- M Viswanathan Hospital for Diabetes, M Viswanathan Diabetes Research Centre, Chennai 600013, India
| | - Anudeep Puvvula
- Annu’s Hospitals for Skin and Diabetes, Nellore 524101, Andhra Pradesh, India
| | - Ankush D Jamthikar
- Department of Electronics and Communications, Visvesvaraya National Institute of Technology, Nagpur 440010, Maharashtra, India
| | - Luca Saba
- Department of Radiology, University of Cagliari, Monserrato 09045, Cagliari, Italy
| | - Amer M Johri
- Department of Medicine, Division of Cardiology, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Vasilios Kotsis
- 3rd Department of Internal Medicine, Hypertension Center, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki 541-24, Greece
| | - Narendra N Khanna
- Department of Cardiology, Indraprastha APOLLO Hospitals, New Delhi 110020, India
| | - Surinder K Dhanjil
- Stroke Diagnosis and Monitoring Division, AtheroPoint™ LLC, CA 95661, United States
| | - Misha Majhail
- Stroke Diagnosis and Monitoring Division, AtheroPoint™, Roseville, CA 95661, United States
| | - Durga Prasanna Misra
- Department of Clinical Immunology and Rheumatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
| | - Vikas Agarwal
- Departments of Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
| | - George D Kitas
- Academic Affairs, Dudley Group NHS Foundation Trust, Dudley DY1 2HQ, United Kingdom
- Arthritis Research UK Epidemiology Unit, Manchester University, Manchester M13 9PL, United Kingdom
| | - Aditya M Sharma
- Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA 22908, United States
| | - Raghu Kolluri
- OhioHealth Heart and Vascular, Ohio, OH 43082, United States
| | - Subbaram Naidu
- Electrical Engineering Department, University of Minnesota, Duluth, MN 55812, United States
| | - Jasjit S Suri
- Stroke Diagnosis and Monitoring Division, AtheroPoint™, Roseville, CA 95661, United States
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Liu Y, Du Z, Ji J, Li J, Bi D, Tang F. Bidirectional association between serum carcinoembryonic antigen and metabolic syndrome among the Chinese male population: two cohort studies. Lipids Health Dis 2020; 19:233. [PMID: 33148263 PMCID: PMC7643476 DOI: 10.1186/s12944-020-01411-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/20/2020] [Indexed: 11/11/2022] Open
Abstract
Purpose Previous studies have shown that serum carcinoembryonic antigen (CEA) is independently associated with metabolic syndrome (MetS). However, these studies were mainly cross-sectional analyses, and cause was not clarified. In the present study, two bidirectional cohort studies were conducted to investigate the bidirectional associations between CEA and MetS using a Chinese male sample cohort. Methods The initial longitudinal cohort included 9629 Chinese males enrolled from January 2010 to December 2015. Two bidirectional cohorts were conducted in the study: subcohort A (from CEA to MetS, n = 6439) included participants without MetS at baseline to estimate the risk of developing incident MetS; subcohort B (from MetS to CEA, n = 8533) included participants without an elevated CEA level (Hyper-CEA) at baseline to examine the risk of developing incident Hyper-CEA. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models. Results In subcohort A, the incidence densities of MetS among participants with and without Hyper-CEA were 84.56 and 99.28 per 1000 person-years, respectively. No significant effects of Hyper-CEA on incident MetS were observed in subcohort A (HR, 0.89; 95% CI, 0.71 to 1.12; P = 0.326). In subcohort B, a higher incidence density of Hyper-CEA was found among participants with MetS (33.42 and 29.13 per 1000 person-years for those with and without MetS, respectively). For nonsmoking participants aged > 65 years, MetS increased the risk of incident Hyper-CEA (HR, 1.87; 95% CI, 1.09 to 3.20; P = 0.022). Conclusion For the direction of CEA on incident MetS, no significant association was observed. For the direction of MetS on incident Hyper-CEA, MetS in nonsmoking elderly men could increase the risk of incident Hyper-CEA, while this association was not found in other stratified participants. The clinical implications of the association between CEA and MetS should be interpreted with caution. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-020-01411-7.
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Affiliation(s)
- Yafei Liu
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China.,Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhaohui Du
- Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA
| | - Jiadong Ji
- Department of Data Science, School of Statistics, Shandong University of Finance and Economics, Jinan, China
| | - Jingru Li
- School of Public Health, Weifang Medical University, Weifang, China
| | - Deming Bi
- Department of Surgery, Zhangqiu District Hospital of Traditional Chinese Medicine, Jinan, China.
| | - Fang Tang
- Center for Big Data Research in Health and Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, China. .,Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
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Siddiqi A, Zafar S, Sharma A, Quaranta A. Awareness of Diabetic Patients Regarding the Bidirectional Association between Periodontal Disease and Diabetes Mellitus: A Public Oral Health Concern. J Contemp Dent Pract 2020; 21:1270-1274. [PMID: 33850074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
AIM AND OBJECTIVE The literature regarding the perception of the two-way relationship between diabetes mellitus and periodontal disease representing diabetic patients living in Australia is scarce. The study aimed to evaluate the knowledge and attitudes of diabetic patients regarding the bidirectional link and the role of medical healthcare professionals in providing oral health advice to their patients. MATERIALS AND METHODS A convenience sample of diabetic patients attending general practice-based medical and dental centers was invited to complete a questionnaire-based survey. The survey was anonymous, and the responses of the participants were not identifiable. RESULTS A total of 241 participants completed the questionnaire; however, three survey responses were excluded as most of the critical questions were not answered. The majority (87.81%) of the participants reported with type 2 diabetes mellitus, while 11.76% had type 1 diabetes mellitus. Just over 61% of the participants reported brushing their teeth twice a day. The majority of participants (66.38%) said that their medical practitioner/diabetic educator never asked or examined their oral hygiene or any issues with the gums or teeth. The study noted that 54% of the participants never received any information regarding the bidirectional relationship between periodontal disease and diabetes mellitus and were unaware of the association. CONCLUSION Patients with diabetes mellitus lack knowledge of the bidirectional association between periodontal disease and diabetes mellitus. In this regard, the study urged the need to implement European Federation of Periodontology and International Diabetes Federation guidelines effectively. Medical healthcare professionals and dentists should provide mutual care and should consider every patient as a shared responsibility. CLINICAL SIGNIFICANCE Early detection of the disease, timely referrals, and a collaborative approach will enhance patient care and improve the quality of life of individuals living with periodontal disease.
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Affiliation(s)
- Allauddin Siddiqi
- Department of Periodontics and Implantology, School of Dentistry and Oral Health, Griffith University, Griffith Health Centre (G40), Gold Coast, Australia, Phone: +61404111998, e-mail:
| | - Sobia Zafar
- Department of Paediatric Dentistry, School of Dentistry, The University of Queensland, Herston, Australia
| | - Ajay Sharma
- School of Dentistry and Oral Health, Griffith University, Griffith Health Centre (G40), Gold Coast, Australia
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Da Silva MA, Martins SS. Mutual Influences on Bullying Perpetration and Substance Use Among Adolescents in the United States. J Adolesc Health 2020; 67:384-391. [PMID: 32576485 PMCID: PMC7483941 DOI: 10.1016/j.jadohealth.2020.04.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/22/2020] [Accepted: 04/26/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE Identifying temporal pattern of associations between bullying perpetration and substance use among youth is useful for optimal targeting of intervention and prevention. We examined the mutual influences on bullying perpetration and substance use and test the cumulative effects of bullying perpetration and substance use over time. METHODS We used data from the Population Assessment of Tobacco and Health cohort study, a nationally representative sample of youth, on bullying perpetration and substance use at three points in time over 3 years. We analyzed the associations of bullying perpetration with alcohol, cannabis and cigarette use using binary logistic regressions. The 13,068 youths aged 12-17 years at baseline (2013-2014) were included in the analytical sample. RESULTS Cross-sectional associations between bullying perpetration and substance use were found at baseline (odds ratio [OR]alcohol = 1.62, 95% confidence interval [CI] 1.33-1.97; ORmarijuana = 1.28, 95% CI .99-1.66; ORcigarette = 1.86, 95% CI 1.44-2.39). Cumulative episodic and frequent bullying perpetration over three data waves predicted an increased likelihood of substance use at follow-up (ORs between 1.18, 95% CI 1.02-1.36 and 2.13, 95% CI 1.66-2.74). Conversely, both episodic and frequent substance use predicted an increased probability of bullying others at follow-up (ORs between 1.50, 95% CI 1.20-1.86, and 2.10, 95% CI 1.69-2.61). CONCLUSIONS Associations between bullying perpetration and substance use appears to be bidirectional. In addition, episodic bullying perpetrators displayed intermediate levels of risk, suggesting a graded association between bullying perpetration pattern and substance use.
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Affiliation(s)
- Marine Azevedo Da Silva
- Institute for Health and Social Policy, McGill University,
Montreal, Quebec, Canada,Department of Epidemiology, Mailman School of Public
Health, Columbia University, New York, New York,Address correspondence to: Marine Azevedo Da
Silva, Ph.D., McGill versity, Institute for Health and Social Policy, Meredith,
Charles, House, 302, 1130 Pine Avenue West, Montreal, Quebec H3A 1A3, Canada.
(M.A. Da Silva)
| | - Silvia S. Martins
- Department of Epidemiology, Mailman School of Public
Health, Columbia University, New York, New York
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Jeon SW, Chang Y, Lim SW, Cho J, Kim HN, Kim KB, Kim J, Kim YH, Shin DW, Oh KS, Shin YC, Ryu S. Bidirectional association between blood pressure and depressive symptoms in young and middle-age adults: A cohort study. Epidemiol Psychiatr Sci 2020; 29:e142. [PMID: 32665058 DOI: 10.1017/S2045796020000542] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
AIMS To evaluate the bidirectional relationship between blood pressure (BP) and depressive symptoms using a large prospective cohort study. METHODS Prospective cohort study was performed in 276 244 adults who participated in a regular health check-up and were followed annually or biennially for up to 5.9 years. BP levels were categorised according to the 2017 American College of Cardiology and American Heart Association hypertension guidelines. Depressive symptoms were assessed using Centre for Epidemiologic Studies-Depression (CESD) questionnaire and a cut-off score of ≥25 was regarded as case-level depressive symptoms. RESULTS During 672 603.3 person-years of follow-up, 5222 participants developed case-level depressive symptoms. The multivariable-adjusted hazard ratios (HRs) [95% confidence interval (CI)] for incident case-level depressive symptoms comparing hypotension, elevated BP, hypertension stage 1 and hypertension stage 2 to normal BP were 1.07 (0.99-1.16), 0.93 (0.82-1.05), 0.89 (0.81-0.97) and 0.81 (0.62-1.06), respectively (p for trend <0.001). During 583 615.3 person-years of follow-up, 27 787 participants developed hypertension. The multivariable-adjusted HRs (95% CI) for incident hypertension comparing CESD 16-24 and ⩾25 to CESD < 16 were 1.05 (1.01-1.11) and 1.12 (1.03-1.20), respectively (p for trend <0.001) and in the time-dependent models, corresponding HRs (95% CI) were 1.12 (1.02-1.24) and 1.29 (1.10-1.50), respectively (p for trend <0.001). CONCLUSIONS In this large cohort study of young and middle-aged individuals, higher BP levels were independently associated with a decreased risk for developing case-level depressive symptoms and depressive symptoms were also associated with incident hypertension. Further studies are required to elucidate the mechanisms underlying the bidirectional association between BP levels and incident depression.
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SILVA MAZEVEDODA, GONZALEZ JC, PERSON GL, MARTINS SS. Bidirectional Association Between Bullying Perpetration and Internalizing Problems Among Youth. J Adolesc Health 2020; 66:315-322. [PMID: 31780386 PMCID: PMC7285807 DOI: 10.1016/j.jadohealth.2019.09.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 09/03/2019] [Accepted: 09/18/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE Identification of the temporal pattern of associations between bullying perpetration and mental health problems among youth is needed for the optimal targeting of intervention and prevention. We examined the bidirectional association between bullying perpetration and internalizing problems among youth in the U.S. METHODS We used data from the prospective cohort study of the Population Assessment of Tobacco and Health waves 1 (September 12, 2013, to December 14, 2014) and 2 (October 23, 2014, to October 30, 2015), a nationally representative sample of youth. We analyzed the associations of bullying perpetration with internalizing problems using binary and multinomial logistic regressions. The 13,200 youths aged 12-17 years were included in the analytic sample. RESULTS There was a cross-sectional association between bullying perpetration and moderate/high lifetime internalizing problems (ORmoderate vs. no/low = 3.13, 95% CI 2.67-3.65; and ORhigh vs. no/low = 8.77, 95% CI 7.53-10.20). In the prospective analyses, bullying perpetration was associated with increased likelihood of moderate/high internalizing problems at follow-up (ORmoderate vs. no/low = 1.49, 95% CI 1.15-1.94; and ORhigh vs. no/low = 1.71, 95% CI 1.23-2.38), and youth with moderate/high internalizing problems had higher odds of bullying perpetration at follow-up (ORmoderate = 1.95, 95% CI 1.65-2.31; and ORhigh = 3.21, 95% CI 2.74-3.76). CONCLUSIONS The association between bullying perpetration and internalizing problems appears to be bidirectional. Bullying behaviors prevention and intervention strategies among youth should consider how to take into account and handle negative feelings and mental health problems.
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Affiliation(s)
- Marine AZEVEDO DA SILVA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA,Corresponding author; ; mail address: Columbia University Mailman School of Public Health, 722 W 168th Street, Room R515, New York, NY 10032; telephone: +1 212 342 4549
| | | | - Gregory L. PERSON
- Department of Public Health Sciences, Xavier University of Louisiana, New Orleans, LA, USA
| | - Silvia S. MARTINS
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Min C, Kim M, Oh DJ, Choi HG. Bidirectional association between psoriasis and depression: Two longitudinal follow-up studies using a national sample cohort. J Affect Disord 2020; 262:126-132. [PMID: 31733456 DOI: 10.1016/j.jad.2019.10.043] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 10/17/2019] [Accepted: 10/28/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Few studies have investigated the bidirectional association between psoriasis and depression. The aim of our study was to identify the association between psoriasis and depression. METHODS Data collected by the Korean Health Insurance Review and Assessment from 2002 to 2013 were used. In study I, psoriasis patients (n = 10,932) were matched 1:4 with control I group participants. In study II, depression patients (n = 60,383) were matched 1:4 with control II group participants. Matching was performed for age, sex, income, and region of residence. The stratified Cox-proportional hazard model was used to calculate the hazard ratio (HR) with crude and adjusted models. RESULTS In study I, the adjusted HR for depression was 1.13 (95% confidence interval (CI) = 1.03-1.24) in the psoriasis group compared to the control I group. In study II, the adjusted HR for depression was 1.11 (95% CI = 1.00-1.22) in the depression group compared to the control II group. In the subgroup analyses, the adjusted HRs for depression were 1.24 (95% CI = 1.00 - 1.53) in females aged < 40 years and 1.31 (95% CI = 1.04 - 1.66) in males aged ≥ 60 years. In the subgroup analyses from study II, the adjusted HRs for psoriasis were 1.56 (95% CI = 1.15 - 2.12) in males aged < 40 years and 1.35 (95% CI = 1.04 - 1.75) in males aged ≥ 60 years. CONCLUSIONS We suggest that psoriasis and depression might have a bidirectional association.
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Affiliation(s)
- Chanyang Min
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, South Korea; Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, South Korea; Graduate School of Public Health, Seoul National University, Seoul, South Korea
| | - Miyoung Kim
- Department of Laboratory Medicine, Hallym University College of Medicine, Anyang, South Korea
| | - Dong Jun Oh
- Department of Internal medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hyo Geun Choi
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, South Korea; Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, South Korea.
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Narmandakh A, Roest AM, Jonge PD, Oldehinkel AJ. The bidirectional association between sleep problems and anxiety symptoms in adolescents: a TRAILS report. Sleep Med 2019; 67:39-46. [PMID: 31887607 DOI: 10.1016/j.sleep.2019.10.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 08/01/2019] [Accepted: 10/27/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Previous studies have suggested a bidirectional association between sleep problems and anxiety symptoms in adolescents. These studies used methods that do not separate between-person effects from within-person effects, and therefore their conclusions may not pertain to within-person mutual influences of sleep and anxiety. We examined bidirectional associations between sleep problems and anxiety during adolescence and young adulthood while differentiating between person effects from within-person effects. METHODS Data came from the Dutch TRacking Adolescents' Individual Lives Survey (TRAILS), a prospective cohort study including six waves of data spanning 15 years. Young adolescents (N = 2230, mean age at baseline 11.1 years) were followed every 2-3 years until young adulthood (mean age 25.6 years). Sleep problems and anxiety symptoms were measured by the Youth Self-Report, Adult Self-Report and Nottingham Health Profile. Temporal associations between sleep and anxiety were investigated using the random intercept cross-lagged panel model. RESULTS Across individuals, sleep problems were significantly associated with (β = 0.60, p < 0.001). At the within-person level, there were significant cross-sectional associations between sleep problems and anxiety symptoms at all waves (β = 0.12-0.34, p < 0.001). In addition, poor sleep predicted greater anxiety symptoms between the first and second, and between the third and fourth assessment wave. The reverse association was not statistically significant. CONCLUSIONS Within-person associations between sleep problems and anxiety are considerably weaker than between-person associations. Yet, our findings tentatively suggest that poor sleep, especially during early and mid-adolescence, may precede anxiety symptoms, and that anxiety might be prevented by alleviating sleep problems in young adolescents.
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Affiliation(s)
- Altanzul Narmandakh
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center of Groningen, University of Groningen, the Netherlands.
| | - Annelieke M Roest
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Developmental Psychology, University of Groningen, the Netherlands
| | - Peter de Jonge
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Developmental Psychology, University of Groningen, the Netherlands
| | - Albertine J Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center of Groningen, University of Groningen, the Netherlands
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Koolhaas CM, Kocevska D, Te Lindert BHW, Erler NS, Franco OH, Luik AI, Tiemeier H. Objectively measured sleep and body mass index: a prospective bidirectional study in middle-aged and older adults. Sleep Med 2019; 57:43-50. [PMID: 30897455 DOI: 10.1016/j.sleep.2019.01.034] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 01/17/2019] [Accepted: 01/22/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND In recent years, short sleep has been increasingly recognized as a risk factor for obesity. However, current evidence has so far been limited to cross-sectional studies or longitudinal studies using self-reported sleep. Therefore, we explored the directionality of the association between objectively measured sleep and body mass index (BMI). METHODS The study consists of 1031 participants from the general population (52% women, 45-91 years at baseline). Sleep, BMI and waist circumference (WC) were measured twice across a follow-up of six years. BMI and WC were measured at the research center. Total sleep time (TST, hrs), sleep onset latency (SOL, min), sleep efficiency (SE, %) and wake after sleep onset (WASO, min) were estimated by a wrist-worn actigraph. In addition, cross-sectional and longitudinal associations in both directions were explored. RESULTS An hour shorter TST was cross-sectionally associated with approximately 0.5 kg/m2 higher BMI. Longitudinally, longer TST and higher SE were associated with lower BMI (βTST = -0.75, 95% CI: -1.08, -0.42; βSE = -0.04, 95% CI: -0.08, -0.01). Conversely, one kg/m2 higher BMI was prospectively associated with 0.02 h shorter TST (95% CI: -0.03, -0.01), and this association was more pronounced over time. Results from analyses with WC were in line with those of BMI. CONCLUSIONS This is the first study to explore bidirectionality in the association between objectively measured sleep and BMI in a large population of middle-aged and older adults. Indices of poor sleep were associated with higher and less stable BMI across time. Conversely, a high BMI was associated with a decrease in sleep duration. This confirms that the relation between sleep and body size is bidirectional, and changes in either sleep or BMI are likely to co-occur with changes in health through multiple pathways.
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Affiliation(s)
- Chantal M Koolhaas
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Desana Kocevska
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center, the Netherlands
| | - Bart H W Te Lindert
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience (NIN), An Institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Nicole S Erler
- Department of Biostatistics, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Institute of Social and Preventive Medicine, University of Bern, Switzerland
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, the Netherlands; Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center, the Netherlands; Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, USA
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Tseng CC, Hu LY, Liu ME, Yang AC, Shen CC, Tsai SJ. Bidirectional association between Bell's palsy and anxiety disorders: A nationwide population-based retrospective cohort study. J Affect Disord 2017; 215:269-273. [PMID: 28359982 DOI: 10.1016/j.jad.2017.03.051] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 03/01/2017] [Accepted: 03/24/2017] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Bell's palsy and anxiety disorders share numerous risk factors (e.g., immune response, ischemia, and psychological stress). However, there have been no studies on the bidirectional temporal association between the two illnesses. In this study, we used the Taiwan National Health Insurance Research Database (NHIRD) to test the bidirectional association between Bell's palsy and anxiety disorders. We hypothesized that patients with Bell's palsy would have an increased risk of subsequent anxiety disorders later in life and that, conversely, those with anxiety disorders would have an increased likelihood of developing Bell's palsy later in life. METHODS We conducted two retrospective cohort studies using Taiwan's National Health Insurance Research Database (NHIRD). Study 1 included 8070 patients diagnosed with anxiety disorders and 32,280 controls without anxiety disorders who were matched with sex, age, and enrollment date to analyze the following risk of Bell's palsy among both groups. Study 2 included 4980 patients with Bell's palsy and 19,920 controls without Bell's palsy who were matched with sex, age, and enrollment date to analyze the following risk of anxiety disorders among both groups. The patient records selected for the studies were dated between January 1, 2000, and December 31, 2004. All subjects were observed until their outcomes of interest, death or December 31, 2009. RESULTS After adjustment for age, sex, comorbidities, urbanization, and income, the hazard ratio (HR) for patients with anxiety disorders to contract Bell's palsy was 1.53 (95% CI, 1.21-1.94, P<.001), and the HR for patients with Bell's palsy to develop an anxiety disorder was 1.59 (95% CI, 1.23-2.06, P<.001). CONCLUSION This study found a bidirectional temporal association between Bell's palsy and anxiety disorders. After one of these conditions develops, the morbidity rate for the other significantly increases. Additional studies are required to determine whether these two conditions share the same pathogenic mechanisms, and whether successfully treating one will reduce the morbidity rate for the other.
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Affiliation(s)
- Chih-Chieh Tseng
- Department of Psychiatry, Beitou branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan; National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Li-Yu Hu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Mu-En Liu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Albert C Yang
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Cheng-Che Shen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Chiayi Branch, Taichung Veterans General Hospital, Chiayi, Taiwan.
| | - Shih-Jen Tsai
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
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Su CC, Chi MH, Lin SH, Yang YK. Bidirectional association between autism spectrum disorder and epilepsy in child and adolescent patients: a population-based cohort study. Eur Child Adolesc Psychiatry 2016; 25:979-87. [PMID: 26791195 DOI: 10.1007/s00787-016-0817-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 01/08/2016] [Indexed: 11/26/2022]
Abstract
This study aimed to assess whether there is a bidirectional association between autism spectrum disorder (ASD) and epilepsy in child and adolescent patients. The National Health Insurance Research Database of Taiwan was used to conduct two cohort studies of patients who were under 18 years of age during the period 1997-2008. Cohort 1 comprised patients with newly diagnosed ASD but excluded those diagnosed with epilepsy prior to ASD. A non-ASD comparison group was matched to each case in terms of age and sex. Cohort 2 comprised patients with newly diagnosed epilepsy but excluded those diagnosed with ASD prior to epilepsy. A non-epilepsy comparison group was matched to each case in terms of age and sex. We calculated the incidence of epilepsy in patients with ASD and hazard ratio (HR) to estimate the risk of epilepsy in association with ASD in cohort 1, and the reverse in cohort 2. In cohort 1, the incidence of epilepsy was 13.7 in the ASD group and 1.3 in the non-ASD group (per 1000 person-years). The adjusted HR for epilepsy was 8.4 (95 % CI 5.5-12.7) in the ASD group when compared with the non-ASD group. In cohort 2, the incidence of ASD was 3.4 in the epilepsy group and 0.3 in the non-epilepsy group (per 1000 person-years). The adjusted HR for ASD was 8.4 (95 % CI 6.2-11.4) in the epilepsy group when compared with the non-epilepsy group. A bidirectional association was, therefore, found to exist between ASD and epilepsy. These findings implicate that ASD and epilepsy probably share common risk factors. However, further studies are required to reveal more detail on the mechanism of this bidirectional association.
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Affiliation(s)
- Chien-Chou Su
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 704, Taiwan
- Institue of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mei Hung Chi
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 704, Taiwan.
| | - Shin-Hsien Lin
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 704, Taiwan
- Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Yen Kuang Yang
- Department of Psychiatry, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Road, North Dist., Tainan, 704, Taiwan
- Addiction Research Center, National Cheng Kung University, Tainan, Taiwan
- Department of Psychiatry, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Abstract
Two experiments were conducted to examine bidirectional semantic associations between power and weight using a priming paradigm. Bidirectionality in the relationship between power and weight was demonstrated, utilising tasks that were identical except that the orders in which the stimuli were presented were reversed. In Experiment 1, an empty scale leaning either leftward or rightward was used as a priming stimulus, and a scale that appeared in equilibrium with a pair of power words was used as a target stimulus. In Experiment 2, a scale with a pair of words that appeared in equilibrium was used as a priming stimulus, and an empty scale leaning either leftward or rightward was used as a target stimulus. We identified interaction effects between power and weight in both experiments. Associations between power and weight provide evidence for both conceptual metaphor views and evolutionary theory. The bidirectionality of metaphorical effects is in line with the strong version of metaphoric structuring. Both language and experiential correlations play important roles in the development of the mapping between power and weight.
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Affiliation(s)
- Xiaoling He
- School of Psychology, South China Normal University, Guangzhou, China
| | - Jun Chen
- School of Psychology, South China Normal University, Guangzhou, China
| | - Jianan Li
- School of Psychology, South China Normal University, Guangzhou, China
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