Is there a positive association between mammographic density and bone mineral density? Authors' response.
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Bone Density↗
Biomedical subjects
Gail Greendale
Publications and source records attributed to Gail Greendale.
Longitudinal trajectories of heavy drinking in adults in the United States of America.
AIMS: To estimate age, period, cohort and other demographic influences on heavy alcohol consumption and trajectories of heavy drinking in American adults. DESIGN: Prospective cohort of 14 127 participants, aged 25-74 years at baseline. Generalized estimating equations to model longitudinal change in the probability of heavy drinking and its association with demographic factors. Setting National, population-based sample of non-institutionalized civilians. MEASUREMENTS: Heavy alcohol consumption (usual number of drinks per occasion >or= five for men; >or= four for women) at baseline (1971-74) and three follow-ups until 1992. FINDINGS: Heavy alcohol consumption declined with increasing age (age effect) and tracked national average consumption (period effect). There was no cohort effect. Higher probability of heavy drinking was associated with male gender (relative risk: RR = 2.4), being not married (RR = 1.4), having less than high school education (RR = 1.7), having annual income below the median (RR = 1.5), not living in the South-east (RR = 1.7), and smoking (RR = 3.4). Getting married and quitting smoking during the study were each associated with reduction in heavy drinking (RR = 0.55 and 0.61, respectively). Slower age-related decline in the probability of heavy drinking was seen in men (P < 0.0001), married individuals (P = 0.03), and smokers (P = 0.05). CONCLUSIONS: Demographic predictors of trends in heavy drinking are different from those for trends in average alcohol consumption. The likelihood of heavy drinking declined more slowly with increasing age in men and smokers, suggesting that the negative health effects of alcohol in older ages may be greatest in these groups.
Adult↗
Alcohol use, comorbidity, and mortality.
OBJECTIVES: To examine the combined influence of alcohol use and comorbidity on 20-year mortality in older adults (average age 66 at the time of the baseline survey). DESIGN: Longitudinal analysis of a national probability sample-based cohort study. SETTING: Data sources were the National Health and Nutrition Examination Survey I (NHANES I), 1971-1974, and the NHANES Epidemiologic Followup Survey, 1992. PARTICIPANTS: Four thousand six hundred ninety-one adults aged 60 and older who provided data on alcohol use. MEASUREMENTS: The prevalence of at-risk drinking in older adults in the United States and the 20-year all-cause mortality risk associated with it. At-risk drinking status was determined from amount of alcohol consumed and comorbidities, using a previously validated method. RESULTS: The prevalence of at-risk drinking in the United States between 1971 and 1974 in older adults was 10% (18% of men, 5% of women). The majority of at-risk drinkers were identified as such because of their use of alcohol in amounts deemed risky in the presence of relevant comorbidities (69%) (e.g., drinking 2-3 drinks per day and having gout or anxiety or taking a medication for pain). In men, at-risk drinking was associated with higher mortality rates than not-at-risk drinking (hazard ratio=1.20, 95% confidence interval=1.01-1.41); abstinence was not associated with greater mortality. In women, neither abstinence nor at-risk drinking was associated with greater mortality rates. CONCLUSION: In this first, large population-based study of older adults examining the mortality risks of alcohol use and comorbidity, at-risk drinking was associated with greater mortality rates in men. These findings suggest that a lower threshold of alcohol use should be recommended for older adults with specific comorbidities to reduce mortality risks.
Aged↗
Disordered eating, menstrual irregularity, and bone mineral density in female runners.
PURPOSE: To examine the relationships between disordered eating, menstrual irregularity, and low bone mineral density (BMD) in young female runners. METHODS: Subjects were 91 competitive female distance runners aged 18-26 yr. Disordered eating was measured by the Eating Disorder Inventory (EDI). Menstrual irregularity was defined as oligo/amenorrhea (0-9 menses per year). BMD was measured by dual x-ray absorptiometry. RESULTS: An elevated score on the EDI (highest quartile) was associated with oligo/amenorrhea, after adjusting for percent body fat, age, miles run per week, age at menarche, and dietary fat, (OR [95% CI]: 4.6 [1.1-18.6]). Oligo/amenorrheic runners had lower BMD than eumenorrheic runners at the spine (-5%), hip (-6%), and whole body (-3%), even after accounting for weight, percent body fat, EDI score, and age at menarche. Eumenorrheic runners with elevated EDI scores had lower BMD than eumenorrheic runners with normal EDI scores at the spine (-11%), with trends at the hip (-5%), and whole body (-5%), after adjusting for differences in weight and percent body fat. Runners with both an elevated EDI score and oligo/amenorrhea had no further reduction in BMD than runners with only one of these risk factors. CONCLUSION: In young competitive female distance runners, (i) disordered eating is strongly related to menstrual irregularity, (ii) menstrual irregularity is associated with low BMD, and (iii) disordered eating is associated with low BMD in the absence of menstrual irregularity.
Absorptiometry, Photon↗
Use of conventional and complementary health care during the transition to menopause: longitudinal results from the Study of Women's Health Across the Nation (SWAN).
OBJECTIVE: Women beginning the transition to menopause now have access to complementary and alternative therapies (CAM) that were not universally available in the past. Little is known about the association between CAM use and the use of conventional health care during menopause. We investigated the longitudinal association between use of CAM therapies and utilization of conventional health care in a large, multiethnic sample of midlife women who were enrolled in the cohort phase of the Study of Women's Health Across the Nation (SWAN). DESIGN: We used generalized estimating equations, repeated measures modeling to examine the association between CAM use and the yearly number of conventional health-care contacts, adjusting for relevant covariates, during a two-year period. CAM use was evaluated longitudinally as continuous, incident (no CAM use at baseline), sporadic, or no use during the study period. RESULTS: Relative to nonusers, continuous CAM users had more conventional health-care contacts (beta 0.14, 95% CI 0.06, 0.21). Incident users and sporadic users also showed an excess in conventional health-care contacts (beta 0.14, CI 0.06, 0.22) and (beta 0.09, CI 0.01, 0.16), respectively. Ethnicity was independently associated with health-care contacts. Relative to white women, Japanese women had fewer contacts (beta -0.18, CI -0.31, -0.05). CONCLUSIONS: Despite being a generally healthy, well-educated and high-income population with good access to health care, CAM users were using more of both conventional and alternative health-care resources than women who did not use CAM. These findings have practical implications for conventional health-care practitioners, allied health professionals and CAM practitioners.
Adult↗