Pub Date : 2024-09-07DOI: 10.1101/2024.09.06.24313199
Pik Fang Kho, Laurel Stell, Shirin Jimenez, Daniela Zanetti, Daniel J Panyard, Kathleen L Watson, Ashish Sarraju, Ming-Li Chen, Lars Lind, John R Petrie, Khin N Chan, Holly Fonda, Kyla Kent, Jonathan N Myers, Latha Palaniappan, Fahim Abbasi, Themistocles L. Assimes
Objective South Asians (SAs) may possess a unique predisposition to insulin resistance (IR). We explored this possibility by investigating the relationship between ‘gold standard’ measures of adiposity, fitness, selected proteomic biomarkers, and insulin sensitivity among a cohort of SAs and Europeans (EURs).
{"title":"Associations between accurate measures of adiposity and fitness, blood proteins, and insulin sensitivity among South Asians and Europeans","authors":"Pik Fang Kho, Laurel Stell, Shirin Jimenez, Daniela Zanetti, Daniel J Panyard, Kathleen L Watson, Ashish Sarraju, Ming-Li Chen, Lars Lind, John R Petrie, Khin N Chan, Holly Fonda, Kyla Kent, Jonathan N Myers, Latha Palaniappan, Fahim Abbasi, Themistocles L. Assimes","doi":"10.1101/2024.09.06.24313199","DOIUrl":"https://doi.org/10.1101/2024.09.06.24313199","url":null,"abstract":"<strong>Objective</strong> South Asians (SAs) may possess a unique predisposition to insulin resistance (IR). We explored this possibility by investigating the relationship between ‘gold standard’ measures of adiposity, fitness, selected proteomic biomarkers, and insulin sensitivity among a cohort of SAs and Europeans (EURs).","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background The COVID-19 pandemic was associated with an increase in conspiracy theories worldwide. However, the prevalence of COVID-19 conspiracy beliefs among Japanese has remained unclear. This study aimed to estimate the prevalence and correlates of COVID-19 conspiracy beliefs in Japan using a nationwide survey of 28,175 residents aged 16–81 years old.
{"title":"Correlates of COVID-19 conspiracy theory beliefs in Japan: A nationally-representative cross-sectional survey","authors":"Yukihiro Sato, Ichiro Kawachi, Yasuaki Saijo, Eiji Yoshioka, Ken Osaka, Takahiro Tabuchi","doi":"10.1101/2024.09.06.24313228","DOIUrl":"https://doi.org/10.1101/2024.09.06.24313228","url":null,"abstract":"<strong>Background</strong> The COVID-19 pandemic was associated with an increase in conspiracy theories worldwide. However, the prevalence of COVID-19 conspiracy beliefs among Japanese has remained unclear. This study aimed to estimate the prevalence and correlates of COVID-19 conspiracy beliefs in Japan using a nationwide survey of 28,175 residents aged 16–81 years old.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.1101/2024.09.05.24313049
Michelle Pfaffenlehner, Max Behrens, Daniela Zöller, Kathrin Ungethüm, Kai Günther, Viktoria Rücker, Jens-Peter Reese, Peter Heuschmann, Miriam Kesselmeier, Flavia Remo, André Scherag, Harald Binder, Nadine Binder, the EVA4MII project
Background The integration of real-world evidence (RWE) from real-world data (RWD) in clinical research is crucial for bridging the gap between clinical trial results and real-world outcomes. Analyzing routinely collected data to generate clinical evidence faces methodological concerns like confounding and bias, similar to prospectively documented observational studies. This study focuses on additional limitations frequently reported in the literature, providing an overview of the challenges and biases inherent to analyzing routine clinical care data, including health claims data (hereafter: routine data).
{"title":"Methodological Challenges using Routine Clinical Care Data for Real-World Evidence: a Rapid Review utilizing a systematic literature search and focus group discussion","authors":"Michelle Pfaffenlehner, Max Behrens, Daniela Zöller, Kathrin Ungethüm, Kai Günther, Viktoria Rücker, Jens-Peter Reese, Peter Heuschmann, Miriam Kesselmeier, Flavia Remo, André Scherag, Harald Binder, Nadine Binder, the EVA4MII project","doi":"10.1101/2024.09.05.24313049","DOIUrl":"https://doi.org/10.1101/2024.09.05.24313049","url":null,"abstract":"<strong>Background</strong> The integration of real-world evidence (RWE) from real-world data (RWD) in clinical research is crucial for bridging the gap between clinical trial results and real-world outcomes. Analyzing routinely collected data to generate clinical evidence faces methodological concerns like confounding and bias, similar to prospectively documented observational studies. This study focuses on additional limitations frequently reported in the literature, providing an overview of the challenges and biases inherent to analyzing routine clinical care data, including health claims data (hereafter: routine data).","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.1101/2024.09.05.24312293
Eleanor Sanderson, Dan Rosoff, Tom Palmer, Kate Tilling, George Davey Smith, Gibran Hemani
Mendelian randomization (MR) is an approach to causal inference that utilises genetic variants to obtain estimates of the causal effect of an exposure on an outcome in the presence of unobserved confounding. MR relies on a set of assumptions to obtain unbiased effect estimates, one of these assumptions is that there is no pathway from the genetic variants to the outcome that does not act through the exposure. Increasing genome-wide association study (GWAS) sample sizes for the exposure enables discovery of instrumental variables with smaller effect sizes. We illustrate through simulations how smaller effect sizes could arise from genetic variants that act through traits that have greater liability to confound an exposure-outcome relationship. When such genetic variants are selected as instruments this can bias the MR effect estimate obtained from that instrument in the same direction as the confounded observational association but with larger magnitude. Through simulation we illustrate how the total bias of the MR estimates increases across a range of standard MR estimation methods increases as the proportion of the genetic instruments that are associated with the confounder increases. However, if such heritable confounders are known and can be instrumented, the confounder free effect estimate can be obtained through applying a pre-estimation filtering to standard MR methods, removing instruments that explain more variation in that confounder than the exposure, or by estimating effects through multivariable MR. We highlight the potential for SNPs identified in GWAS to be associated with potential confounders through examination of a recent GWAS of C-Reactive Protein. Finally, we illustrate our approach through estimation of the causal effect of age at menarche on type 2 diabetes, hypothesising that the MR effect estimate may be biased by confounding due to the inclusion of genetic variants associated with early life adiposity as instruments.
{"title":"Bias from heritable confounding in Mendelian randomization studies","authors":"Eleanor Sanderson, Dan Rosoff, Tom Palmer, Kate Tilling, George Davey Smith, Gibran Hemani","doi":"10.1101/2024.09.05.24312293","DOIUrl":"https://doi.org/10.1101/2024.09.05.24312293","url":null,"abstract":"Mendelian randomization (MR) is an approach to causal inference that utilises genetic variants to obtain estimates of the causal effect of an exposure on an outcome in the presence of unobserved confounding. MR relies on a set of assumptions to obtain unbiased effect estimates, one of these assumptions is that there is no pathway from the genetic variants to the outcome that does not act through the exposure. Increasing genome-wide association study (GWAS) sample sizes for the exposure enables discovery of instrumental variables with smaller effect sizes. We illustrate through simulations how smaller effect sizes could arise from genetic variants that act through traits that have greater liability to confound an exposure-outcome relationship. When such genetic variants are selected as instruments this can bias the MR effect estimate obtained from that instrument in the same direction as the confounded observational association but with larger magnitude. Through simulation we illustrate how the total bias of the MR estimates increases across a range of standard MR estimation methods increases as the proportion of the genetic instruments that are associated with the confounder increases. However, if such heritable confounders are known and can be instrumented, the confounder free effect estimate can be obtained through applying a pre-estimation filtering to standard MR methods, removing instruments that explain more variation in that confounder than the exposure, or by estimating effects through multivariable MR. We highlight the potential for SNPs identified in GWAS to be associated with potential confounders through examination of a recent GWAS of C-Reactive Protein. Finally, we illustrate our approach through estimation of the causal effect of age at menarche on type 2 diabetes, hypothesising that the MR effect estimate may be biased by confounding due to the inclusion of genetic variants associated with early life adiposity as instruments.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.1101/2024.09.05.24313151
Solomon Nortey, Ernest Akorly, Mark Dadzie, Stephen E. Moore
Buruli Ulcer, a devastating skin disease caused by Mycobacterium Ulcerans, poses considerable public health challenges in endemic areas. This article focuses on the use of fractional optimal control theory to prevent the spread of Buruli ulcers via integrated public health interventions. We formulated a mathematical model using the Atangana-Baleanu-Caputo fractional order derivative operator. We investigated the model’s existence and uniqueness and presented numerical simulations using the predict-evaluate-correct-evaluate (PECE) method of Adam-Bashforth Moulton. We also study the fractional optimal control problem (FOCP) to minimize the spread of the disease in the endemic regions. We employ the Fractional Pontryagin’s Maximum Principle (FPMP) and implement the forward-backward method to determine the extremals of the problem. Four control strategies were implemented: promoting health education on the use of protective clothing, enhancing vaccination rates, improving treatment protocols for infected individuals, and spraying insecticides to reduce water-bug populations. After examining the optimal control dynamics of the Buruli ulcer transmission model via multiple simulations with and without control, we discover that there is a substantial decrease in the population of infected humans and the water-bug population. Hence we conclude that the best strategy to implement is by applying all the control strategies suggested.
{"title":"Public Health Interventions for Fractional Optimal Control of Buruli Ulcer","authors":"Solomon Nortey, Ernest Akorly, Mark Dadzie, Stephen E. Moore","doi":"10.1101/2024.09.05.24313151","DOIUrl":"https://doi.org/10.1101/2024.09.05.24313151","url":null,"abstract":"Buruli Ulcer, a devastating skin disease caused by <em>Mycobacterium Ulcerans</em>, poses considerable public health challenges in endemic areas. This article focuses on the use of fractional optimal control theory to prevent the spread of Buruli ulcers via integrated public health interventions. We formulated a mathematical model using the Atangana-Baleanu-Caputo fractional order derivative operator. We investigated the model’s existence and uniqueness and presented numerical simulations using the predict-evaluate-correct-evaluate (PECE) method of Adam-Bashforth Moulton. We also study the fractional optimal control problem (FOCP) to minimize the spread of the disease in the endemic regions. We employ the Fractional Pontryagin’s Maximum Principle (FPMP) and implement the forward-backward method to determine the extremals of the problem. Four control strategies were implemented: promoting health education on the use of protective clothing, enhancing vaccination rates, improving treatment protocols for infected individuals, and spraying insecticides to reduce water-bug populations. After examining the optimal control dynamics of the Buruli ulcer transmission model via multiple simulations with and without control, we discover that there is a substantial decrease in the population of infected humans and the water-bug population. Hence we conclude that the best strategy to implement is by applying all the control strategies suggested.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.1101/2024.09.04.24312946
Elyse Letts, Sarah M da Silva, Natascja Di Cristofaro, Sara King-Dowling, Joyce Obeid
Background Accelerometers are increasingly used to measure physical activity and sedentary time in toddlers. Data cleaning or wear time validation can impact outcomes of interest, particularly in young children who spend less time awake. However, no study has systematically compared wear time validation strategies in toddlers. As such, the objective of this study is to compare different fully-automated methods of distinguishing wear and non-wear time (counts and raw data algorithms) to the semi-automated (counts with logbooks) criterion method in toddlers.
{"title":"Beyond the (log)book: Comparing accelerometer non-wear detection techniques in toddlers","authors":"Elyse Letts, Sarah M da Silva, Natascja Di Cristofaro, Sara King-Dowling, Joyce Obeid","doi":"10.1101/2024.09.04.24312946","DOIUrl":"https://doi.org/10.1101/2024.09.04.24312946","url":null,"abstract":"<strong>Background</strong> Accelerometers are increasingly used to measure physical activity and sedentary time in toddlers. Data cleaning or wear time validation can impact outcomes of interest, particularly in young children who spend less time awake. However, no study has systematically compared wear time validation strategies in toddlers. As such, the objective of this study is to compare different fully-automated methods of distinguishing wear and non-wear time (counts and raw data algorithms) to the semi-automated (counts with logbooks) criterion method in toddlers.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-06DOI: 10.1101/2024.09.05.24313134
J. Bradley Layton, Arnstein Lindaas, Stella G Muthuri, Patricia C. Lloyd, Morgan M. Richey, Joann F. Gruber, Hai Lyu, Mollie M. McKillop, Lisa S. Kowarski, Christine Bui, Shelby S. Fisher, Tainya C. Clarke, Angela S. Cheng, Zhiruo Wan, Pablo Freyria Duenas, Yangping Chen, Timothy Burrell, Minya Sheng, Azadeh Shoaibi, Yoganand Chillarige, Jeffrey Beers, Mary S. Anthony, Richard A. Forshee, Steven A. Anderson
Purpose This study evaluated the association between coronavirus disease 2019 (COVID-19) diagnosis and adverse events (AEs), including cardiovascular AEs and appendicitis, in US adults before the introduction of COVID-19 vaccines. Real-world studies of AEs after COVID-19 suggest that diagnoses of AEs and COVID-19 frequently occur on the same day and may be a source of bias.
{"title":"Evaluating the Risk of Cardiovascular Adverse Events and Appendicitis After COVID-19 Diagnosis in Adults in the United States: Implications of the Start of Follow-Up","authors":"J. Bradley Layton, Arnstein Lindaas, Stella G Muthuri, Patricia C. Lloyd, Morgan M. Richey, Joann F. Gruber, Hai Lyu, Mollie M. McKillop, Lisa S. Kowarski, Christine Bui, Shelby S. Fisher, Tainya C. Clarke, Angela S. Cheng, Zhiruo Wan, Pablo Freyria Duenas, Yangping Chen, Timothy Burrell, Minya Sheng, Azadeh Shoaibi, Yoganand Chillarige, Jeffrey Beers, Mary S. Anthony, Richard A. Forshee, Steven A. Anderson","doi":"10.1101/2024.09.05.24313134","DOIUrl":"https://doi.org/10.1101/2024.09.05.24313134","url":null,"abstract":"<strong>Purpose</strong> This study evaluated the association between coronavirus disease 2019 (COVID-19) diagnosis and adverse events (AEs), including cardiovascular AEs and appendicitis, in US adults before the introduction of COVID-19 vaccines. Real-world studies of AEs after COVID-19 suggest that diagnoses of AEs and COVID-19 frequently occur on the same day and may be a source of bias.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-04DOI: 10.1101/2024.09.02.24312930
Yanhua Chen, Peicheng Wang, Qiaoyuan He, Jiming Zhu, Mika Kivimaki, Gill Livingston, Andrew Sommerlad
Background: Depression is a pressing public health issue and may be affected by multifaceted urban living, yet the specific urbanicity elements associated is unclear. Using a multidimensional urbanicity scale, we explored the association between urbanicity and its components with the risk of depressive symptoms. Methods: This study used data from four waves of the China Health and Retirement Longitudinal Study, including 12,515 participants aged ≥45 years at baseline in 2011 in 450 rural and urban communities, and 8,766 with 7 years of follow-up. Multilevel logistics regression and Cox proportional hazards regression models examined the cross-sectional and longitudinal associations between urbanicity and depressive symptoms. Results: Living in areas with the highest tertile of urbanicity was associated with a 61% lower risk of depressive symptoms cross-sectionally (odds ratio (OR): 0.39, 95% confidence interval (CI): 0.30-0.50) and 33% lower risk longitudinally (hazard ratio (HR): 0.67, 95% CI: 0.58-0.77) compared to those living in areas with the lowest tertile of urbanicity. Among components, higher population density (OR: 0.92, 95% CI: 0.87-0.97), better education (OR: 0.94, 95% CI: 0.89-0.99), transportation (OR: 0.95, 95% CI: 0.92-0.98), sanitation (OR: 0.96, 95% CI: 0.93-0.98) was associated with lower odds of depressive symptoms, while greater population educational and socioeconomic diversity (OR, 1.08; 95% CI, 1.03-1.13) had opposite effect. Better economic conditions (HR: 0.94, 95% CI: 0.90-0.98) and availability of social services (HR, 0.96; 95% CI, 0.93-0.99) were longitudinally associated with reduced risk of developing depressive symptoms during 7 years of follow-up. Additionally, differences in associated components were found between urban and rural residents and between midlife and older adults. Conclusions: Our findings underscore the complex links of urban living with depressive symptoms among middle-aged and older adults, highlighting the need to consider a multidimensional urbanicity perspective to understand the urbanicity-mental health nexus. Tailored urban planning policies should consider the associated urbanicity components, along with temporal effectiveness, urban-rural disparities, and age group differences.
{"title":"Association between urbanicity and depressive symptoms among Chinese middle-aged and older adults","authors":"Yanhua Chen, Peicheng Wang, Qiaoyuan He, Jiming Zhu, Mika Kivimaki, Gill Livingston, Andrew Sommerlad","doi":"10.1101/2024.09.02.24312930","DOIUrl":"https://doi.org/10.1101/2024.09.02.24312930","url":null,"abstract":"Background: Depression is a pressing public health issue and may be affected by multifaceted urban living, yet the specific urbanicity elements associated is unclear. Using a multidimensional urbanicity scale, we explored the association between urbanicity and its components with the risk of depressive symptoms.\u0000Methods: This study used data from four waves of the China Health and Retirement Longitudinal Study, including 12,515 participants aged ≥45 years at baseline in 2011 in 450 rural and urban communities, and 8,766 with 7 years of follow-up. Multilevel logistics regression and Cox proportional hazards regression models examined the cross-sectional and longitudinal associations between urbanicity and depressive symptoms.\u0000Results: Living in areas with the highest tertile of urbanicity was associated with a 61% lower risk of depressive symptoms cross-sectionally (odds ratio (OR): 0.39, 95% confidence interval (CI): 0.30-0.50) and 33% lower risk longitudinally (hazard ratio (HR): 0.67, 95% CI: 0.58-0.77) compared to those living in areas with the lowest tertile of urbanicity. Among components, higher population density (OR: 0.92, 95% CI: 0.87-0.97), better education (OR: 0.94, 95% CI: 0.89-0.99), transportation (OR: 0.95, 95% CI: 0.92-0.98), sanitation (OR: 0.96, 95% CI: 0.93-0.98) was associated with lower odds of depressive symptoms, while greater population educational and socioeconomic diversity (OR, 1.08; 95% CI, 1.03-1.13) had opposite effect. Better economic conditions (HR: 0.94, 95% CI: 0.90-0.98) and availability of social services (HR, 0.96; 95% CI, 0.93-0.99) were longitudinally associated with reduced risk of developing depressive symptoms during 7 years of follow-up. Additionally, differences in associated components were found between urban and rural residents and between midlife and older adults.\u0000Conclusions: Our findings underscore the complex links of urban living with depressive symptoms among middle-aged and older adults, highlighting the need to consider a multidimensional urbanicity perspective to understand the urbanicity-mental health nexus. Tailored urban planning policies should consider the associated urbanicity components, along with temporal effectiveness, urban-rural disparities, and age group differences.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-04DOI: 10.1101/2024.09.02.24312919
Peicheng Wang, Ruihua Li, Yanhua Chen
Background The relationship between resilience trajectories and cognitive health is not well understood. This study aimed to identify subgroups of psychological resilience trajectories in a national sample of older adults and to examine the association with cognitive impairment over time. Methods This study used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018, and 2,788 respondents were included in this prospective analysis. Using a group‐based trajectory modeling approach, we identified resilience trajectory groups within a 6-year period. Cox proportional hazards models were used to assess the relationship between the resilience trajectory groups and cognitive impairment. Results Three distinct trajectories of psychological resilience, including decreasing resilience group (n=131,7.1%), persistent middle resilience group (n=1,808, 58.1%), and persistent high resilience group (n=849, 34.8%). During the 6-year follow-up, compared to those with persistent high resilience, participants with persistent middle resilience (HR = 1.43, 95% CI = 1.14-1.79) and decreasing resilience (HR = 2.46, 95% CI = 1.76-3.43) remained consistent associated with a higher risk of cognitive impairment. Subgroup analysis showed that, the associations between resilience trajectories and cognitive impairment varied by lifestyle and health conditions. Conclusions Psychological resilience is a relatively stable trait among older adults in China, with most individuals maintaining a persistently high or middle level of resilience throughout the follow-up period; however, declining psychological resilience was significantly associated with the risk of cognitive impairment. Therefore, developing targeted interventions to strengthen psychological resilience in older adults is crucial for promoting cognitive health and successful aging, especially for those who have unhealthy lifestyles and with poorer health conditions.
背景 抗逆力轨迹与认知健康之间的关系尚不十分清楚。本研究旨在从全国老年人样本中识别心理复原力轨迹的亚组，并研究其与认知障碍随时间变化的关系。方法 本研究使用了2008年至2018年中国健康长寿纵向调查（CLHLS）的数据，共有2788名受访者被纳入此次前瞻性分析。通过基于群体的轨迹建模方法，我们确定了6年内的恢复力轨迹群体。结果 心理复原力有三种不同的轨迹，包括复原力下降组（人数=131，7.1%）、持续中等复原力组（人数=1,808，58.1%）和持续高复原力组（人数=849，34.8%）。在为期6年的随访中，与持续高复原力组相比，持续中等复原力组（HR = 1.43，95% CI = 1.14-1.79）和复原力下降组（HR = 2.46，95% CI = 1.76-3.43）的受试者发生认知障碍的风险仍然较高。分组分析表明，生活方式和健康状况不同，抗逆力轨迹与认知障碍之间的关联也不同。结论 心理复原力在中国老年人中是一个相对稳定的特质，大多数人在整个随访期间都能保持持续的高或中等复原力水平；然而，心理复原力的下降与认知障碍的风险显著相关。因此，制定有针对性的干预措施来增强老年人的心理复原力对于促进认知健康和成功老龄化至关重要，尤其是对于那些生活方式不健康和健康状况较差的老年人。
{"title":"Longitudinal trajectories of psychological resilience and cognitive impairment among older adults: evidence from a national cohort study","authors":"Peicheng Wang, Ruihua Li, Yanhua Chen","doi":"10.1101/2024.09.02.24312919","DOIUrl":"https://doi.org/10.1101/2024.09.02.24312919","url":null,"abstract":"Background The relationship between resilience trajectories and cognitive health is not well understood. This study aimed to identify subgroups of psychological resilience trajectories in a national sample of older adults and to examine the association with cognitive impairment over time.\u0000Methods This study used data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018, and 2,788 respondents were included in this prospective analysis. Using a group‐based trajectory modeling approach, we identified resilience trajectory groups within a 6-year period. Cox proportional hazards models were used to assess the relationship between the resilience trajectory groups and cognitive impairment.\u0000Results Three distinct trajectories of psychological resilience, including decreasing resilience group (n=131,7.1%), persistent middle resilience group (n=1,808, 58.1%), and persistent high resilience group (n=849, 34.8%). During the 6-year follow-up, compared to those with persistent high resilience, participants with persistent middle resilience (HR = 1.43, 95% CI = 1.14-1.79) and decreasing resilience (HR = 2.46, 95% CI = 1.76-3.43) remained consistent associated with a higher risk of cognitive impairment. Subgroup analysis showed that, the associations between resilience trajectories and cognitive impairment varied by lifestyle and health conditions. Conclusions Psychological resilience is a relatively stable trait among older adults in China, with most individuals maintaining a persistently high or middle level of resilience throughout the follow-up period; however, declining psychological resilience was significantly associated with the risk of cognitive impairment. Therefore, developing targeted interventions to strengthen psychological resilience in older adults is crucial for promoting cognitive health and successful aging, especially for those who have unhealthy lifestyles and with poorer health conditions.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-04DOI: 10.1101/2024.09.03.24312945
Prosper Narh, Michael Asante Ofosu, Elliot Owusu Addo, Daniel Wiafe Preko, Grace Aba Bart-Plange, Roselyn Oforiwaa Acquah
Background Diabetes is a serious medical condition marked by high blood sugar levels, leading to complications in organs like the kidney, liver, and heart. Previous research has identified diabetes as a primary risk factor for congestive heart failure (CHF), a condition where stiffened heart muscles hinder oxygenated blood circulation. Despite its severity, few studies have examined CHF prognosis in diabetic patients. This study aims to provide survival estimates and provide their comparisons among predictors, assess mortality risks based on specific variables, and reveal patient outcome patterns.
{"title":"Life Expectancy Exploration of Heart Failure Patients Presenting with Diabetes","authors":"Prosper Narh, Michael Asante Ofosu, Elliot Owusu Addo, Daniel Wiafe Preko, Grace Aba Bart-Plange, Roselyn Oforiwaa Acquah","doi":"10.1101/2024.09.03.24312945","DOIUrl":"https://doi.org/10.1101/2024.09.03.24312945","url":null,"abstract":"<strong>Background</strong> Diabetes is a serious medical condition marked by high blood sugar levels, leading to complications in organs like the kidney, liver, and heart. Previous research has identified diabetes as a primary risk factor for congestive heart failure (CHF), a condition where stiffened heart muscles hinder oxygenated blood circulation. Despite its severity, few studies have examined CHF prognosis in diabetic patients. This study aims to provide survival estimates and provide their comparisons among predictors, assess mortality risks based on specific variables, and reveal patient outcome patterns.","PeriodicalId":501071,"journal":{"name":"medRxiv - Epidemiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142213427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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