PubMed · 6532647
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M A Chamberlain, M Ellis, D Hughes. 1984. Joint protection.. https://pubmed.ncbi.nlm.nih.gov/6532647/
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Many studies have shown a protective effect of cigarette smoking on Parkinson's disease. However, criticism has been raised concerning confounding by genetic factors. We investigated the associations between Parkinson's disease and smoking, alcohol, coffee, area of living, and education in a co-twin control study. Because twins are matched for genetic and familial environmental factors, this design controls for confounding by these factors. We also examined control subjects unrelated to cases. Exposure information was taken from questionnaires answered in the 1960s and 1970s. Parkinson's disease cases were identified through the Swedish Inpatient Discharge Register (IDR) and the Cause of Death Register. In the unrelated control subject comparison, 476 Parkinson's disease cases and 2,380 control subjects were included. In the co-twin control comparison, 415 same-sex twin pairs were included. There was an inverse association between smoking and Parkinson's disease using unrelated control subjects and co-twin control cases. There was no association between Parkinson's disease and alcohol, coffee, or area of living. High educational level was associated with Parkinson's disease in the unrelated control subject comparison but not in the co-twin control comparison. We confirm the protective effect of smoking on Parkinson's disease and establish that the association is only partially explained by genetic and familial environmental factors.
OBJECTIVE: To test a hypothesis that Alzheimer's disease (AD) patients in nursing homes have higher mortality rate than do AD patients cared for at home and to investigate the predictors of mortality in AD. DESIGN: A one-year prospective follow-up in Korea. METHODS: A total of 252 subjects (107 in the community, 145 in a nursing home) were longitudinally assessed at baseline, 6 months and 12 months. Mortality rates between groups were compared using Kaplan-Meier curve and log-rank statistics. Relative risks (RRs) were examined by the Cox proportional hazards model. RESULTS: Overall one-year mortality rate in AD was 18.7%. There was no statistically significant difference in AD mortality rates between patients who continued to be cared for at home and AD patients in the nursing home. After controlling for age, group (nursing home or community), severity of dementia, Mini-Mental State Examination (MMSE) score and vascular risk factors, there remained advanced age [risk ratio (RR) 1.06; 95% confidence interval (CI) 1.04-1.09], advanced Global Deterioration Scale (GDS) stage (RR 1.98; 95% CI 1.41-2.77), longer duration of AD (RR 1.07; 95% CI 1.04-1.10), presence of tactile hallucination (RR 1.74; 95% CI 1.08-2.78), wandering (RR 1.89; 95% CI 1.18-3.02) and depression (RR 1.07; 95% CI 1.02-1.10) as independent predictors of mortality in AD. This may be the first study demonstrating presence of tactile hallucination as a strong predictor of mortality in AD. CONCLUSION: This study does not support the hypothesis of a higher AD mortality rate in nursing homes.
This paper uses longitudinal survey data from Taiwan to investigate the predictors of elderly mortality. The empirical analysis confirms a relationship between socioeconomic characteristics and mortality, but this relationship weakens considerably when estimates are conditional on the health status at the time of the first wave survey. In terms of predictive power, the models with an activities of daily living index fare better (as opposed to models with self-evaluated health or self-reported illnesses). Having said that there is a payoff to the consideration of self-evaluated health jointly with other 'objective' health indicators. Other findings include a strong association between life satisfaction and survival, which prevails even after controlling for other explanatory variables.