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PubMed2024

Contribution of copy number variations to education, socioeconomic status and cognition from a genome-wide study of 305,401 subjects.

Educational attainment (EA), socioeconomic status (SES) and cognition are phenotypically and genetically linked to health outcomes. However, the role of copy number variations (CNVs) in influencing EA/SES/cognition remains unclear. Using a large-scale (n = 305,401) genome-wide CNV-level association analysis, we discovered 33 CNV loci significantly associated with EA/SES/cognition, 20 of which were novel (deletions at 2p22.2, 2p16.2, 2p12, 3p25.3, 4p15.2, 5p15.33, 5q21.1, 8p21.3, 9p21.1, 11p14.3, 13q12.13, 17q21.31, and 20q13.33, as well as duplications at 3q12.2, 3q23, 7p22.3, 8p23.1, 8p23.2, 17q12 (105 kb), and 19q13.32). The genes identified in gene-level tests were enriched in biological pathways such as neurodegeneration, telomere maintenance and axon guidance. Phenome-wide association studies further identified novel associations of EA/SES/cognition-associated CNVs with mental and physical diseases, such as 6q27 duplication with upper respiratory disease and 17q12 (105 kb) duplication with mood disorders. Our findings provide a genome-wide CNV profile for EA/SES/cognition and bridge their connections to health. The expanded candidate CNVs database and the residing genes would be a valuable resource for future studies aimed at uncovering the biological mechanisms underlying cognitive function and related clinical phenotypes.

Humans↗
PubMed1981

Death education within health education: current status, future directions.

A national survey was conducted among 205 university level divisions/departments of health education to determine the current status of death education courses within the health education field. Forty-nine college and university health educators currently teaching the course returned usable instruments. Death education receives the same credit, utilizes similar grading systems and is generally managed much like other academic courses. Since the discipline is in its infancy and many teachers are relatively unprepared, respondents called for greater quality control and improved professional preparation. Several concerns accompanying the growth of death education were identified.

Attitude to Death↗
PubMed1984

Alcohol consumption among Mexican American and Anglo women: results of a survey along the U.S.--Mexico border.

A household probability survey of 1233 Mexican American women and 798 Anglo women residing along the U.S.-Mexico border was conducted. A higher proportion of abstainers was found among the Mexican Americans than among the Anglos in almost every social and demographic category examined (age, marital status, education and employment status). Because the level of alcohol consumption increased markedly with the years of education completed, almost all of the overall ethnic differences observed could be accounted for by the generally lower level of education among the Mexican Americans. However, ethnic subgroups of Mexican American women reported different levels of alcohol consumption that could not be accounted for by differences in education, suggesting that additional ethnic factors contribute to drinking patterns.

Adolescent↗
PubMed2005

Cognitive performance in cryptogenic epilepsy.

Cognitive impairment in epilepsy has begun to gain more attention in clinical practice. There is now a considerable amount of research relating to memory functioning in epilepsy, however, few studies specifically focused on cryptogenic epilepsy. We investigated the cognitive performance in cryptogenic epilepsy patients with the aid of cognitive ability screening instrument (CASI), based on cross-sectional and longitudinal aspects. A total of 100 patients who met the diagnostic criteria of cryptogenic epilepsy were recruited from a national university hospital. The patients with normal CASI scores were compared with those with abnormal ones. We also compared the follow-up CASI score after 3 years with the previous score in all cryptogenic epilepsy patients. Thirty-six per cent of cryptogenic epilepsy patients showed cognitive impairment. The variables correlated with higher risks of cognitive impairment were lower educational status, number of seizure types, duration of seizure and polytherapy, especially in the lower educational status. The correlation between CASI and the Mini-Mental State Examination was excellent. In the follow-up study, the abnormal group showed significant improvement in total CASI score. The normal group showed no significant change. We suggest that in cryptogenic epilepsy, lower educational status remains the most important factor in determining cognitive performance. Adequate treatment with antiepileptic drugs can improve cognitive performance in previously cognitively impaired patients.

Adult↗
PubMed1997

Education and other measures of socioeconomic status and risk of incident Alzheimer disease in a defined population of older persons.

OBJECTIVE: To assess the relations of 3 measures of socioeconomic status (education, occupational prestige, and income) to risk of incident clinically diagnosed Alzheimer disease (AD). DESIGN: Cohort study with an average observation of 4.3 years. SETTING: East Boston, Mass. a geographically defined community. PARTICIPANTS: A stratified random sample of 642 community residents 65 years of age and older who were free of AD at baseline. MAIN OUTCOME MEASURE: Clinical diagnosis of probable AD according to standard criteria, using structured uniform evaluation. RESULTS: The relations of the 3 measures of socioeconomic status to risk of disease were assessed using logistic regression analyses. In individual analyses, fewer years of formal schooling, lower income, and lower occupational status each predicted risk of incident AD; risk of disease decreased by approximately 17% for each year of education. In an analysis including all 3 measures, the effect of education on risk for disease remained approximately the same, but the effects of the other 2 measures were somewhat less and did not attain formal statistical significance, compared with separate analysis of each measure. CONCLUSIONS: Markers of lower socioeconomic status predict risk of developing incident AD. The mechanism of this relation is uncertain, but the possibility that it reflects unidentified and potentially reversible risk factors for the disease deserves careful investigation.

Aged↗
PubMed2003

Attitudes of patients to obstetric analgesia at the University College Hospital, Ibadan, Nigeria.

Pain relief, for different reasons, is controversial worldwide. We designed this study to assess the level of awareness of antenatal patients to analgesia in labour and to evaluate the effect of age, parity and educational status on the awareness and acceptability of pain relief in labour. A structured questionnaire was administered to 1,000 antenatal patients between 1 June 2000 and 31 May 2001. Spearman's correlation coefficient was applied to estimate the correlation between the ranked dependent variable (awareness and acceptability) and age, parity and educational status (independent variables). Awareness of pain relief methods was seen in only 27.1%. The most common method known was the use of systemic opioids (80%); only 10% were aware of epidural analgesia and about 14% knew of inhalational analgesia. Acceptance of methods was, however, 57.6%. The most common reason for non-acceptance was that 'The pain of labour is natural' in 76.5%, 12% feared complications to the baby and 25% gave other reasons. Age, parity and educational status did not affect awareness. Educational status had positive correlation (rho = 0.13, P < 0.05) with acceptance while age had a negative correlation (rho = -0.124, P<0.05). Awareness of obstetric analgesia is still relatively low in this environment; however, a high proportion of patients would accept analgesia in labour if offered.

Adult↗
PubMed1998

Sex differences in the course of depression: evidence from a longitudinal study of a representative sample of the Belgian population.

Outcome studies of major depression indicate high rates of relapse and chronicity, and social role theories imply that chronicity should be greater for women, together suggesting that the well-known sex difference in depression is, at least partially, the result of differences in chronicity. Due to a lack of prospective longitudinal research answers to this empirical question are missing. Furthermore, the results of the few available surveys of the general population are inconsistent, showing either higher chronicity for older women or a lack of sex differences in the overall course of depression. Using data from three waves of the Panel Study of Belgian Households (complete data for 3204 women and 2907 men, aged 16 years and older) sex differences in the persistence of depressive behavior are estimated. Depression is measured using a self-report inventory on three occasions separated by intervals of 1 year (1992, 1993, 1994). Results show a significant influence of sex, other sociodemographic characteristics, and depression severity at baseline on depression persistence. Women experience more symptoms for a longer period of time, a difference that can be partially ascribed to sex differences in employment status, education and marital status. The findings are discussed.

Adolescent↗
PubMed2001

Association between physical health status with selected factors.

A study, to determine the physical health status of children between the age of three to five years and its association with selected factors, was conducted in a village of Udupi district of Karnataka state in 1998. The objectives of the study were to assess the physical health status of children between the age of three and five years, to identify the selected factors under study like employment status of parents, age of parents, educational status of parents, birth order of the child, number of siblings of the child, gender of the child, child care arrangements and socio-economic status of parents and to find out the association between physical health status of children between the age of three and five years and selected factors. The study used system's model. Co-relational survey approach was used and data were collected from 100 samples. Tools were developed by the investigator and purposive sampling was used for selection of sample elements. A significant association was observed between the physical health status of the children and the employment status of the mother [chi square = 4.003, p < 0.05], and no significant association was found between physical health status and age of parents, educational status of parents, birth order of the child, number of siblings of the child, gender of the child, child care arrangements and socio economic status of parents.

Chi-Square Distribution↗
PubMed2002

Health-related quality of life for nasopharyngeal carcinoma patients with cancer-free survival after treatment.

PURPOSE: To evaluate the health-related quality of life (HR-QOL) of nasopharyngeal cancer (NPC) patients with cancer-free survival after treatment and to investigate the factors correlated with their HR-QOL. METHODS AND MATERIALS: One hundred eighty-two NPC patients with cancer-free survival of more than 2 years after treatment were enrolled in the study. Data from the same number of people without a history of cancer, who had come to the hospital for health checkups, were also collected for comparison. The Chinese SF-36 questionnaire and nine items about head-and-neck functional impairments (HNFI) were self-reported by all participants at the clinics. Data relating to sociodemographic factors, cancer stage, and treatment of NPC survivors were analyzed. RESULTS: Psychometric tests revealed the excellent internal reliability (Cronbach's alpha: 0.87-0.96) and discriminative validity of the Chinese SF-36 used in Taiwan. Most functional domains of the Chinese SF-36 and all nine HNFI items were significantly worse in NPC survivors than in control subjects. No cancer or treatment-related variables significantly correlated with any functional domains of SF-36 or any items of HNFI for NPC survivors. Economic status, educational level, occupational status, and the number of comorbidities were the variables that significantly correlated with most functional domains of SF-36 for NPC survivors. Patients with more sufficient economic status, higher educational levels, with employment, or without comorbidity tended to enjoy better HR-QOL as detected by the SF-36. Salivation, hearing, and swallowing dysfunctions were the top three HNFI that disturbed NPC survivors. Economic status remained the most significant variable correlated with HNFI, including salivation, swallowing, neck stiffness, taste, and phonation. Survivors with better economic status reported less severe HNFI. CONCLUSIONS: NPC survivors had worse HR-QOL than healthy control subjects in the study. Socioeconomic status was the most significant variable that correlated with the HR-QOL of NPC survivors. This result might indicate that patients' superior individual characteristics and financial resources are important variables determining their ability to cope with cancer and treatment complications affecting their HR-QOL.

Adult↗
PubMed1986

Migration as a demographic response: the age differentials.

"This study uses the theory of demographic response as the background against which regional human migration is examined as a response to selected environmental conditions for the 1,056 counties in the North Central Region [of the United States]. Specifically, this study addresses two migration-related questions concerning county populations in the North Central Region: (1) What are the socioeconomic, demographic, and ecological factors to which county populations respond in adjusting their migration behavior? (2) Do socially important age cohorts respond to these factors differently or in a similar manner?" Factors affecting migration are employment status, income levels, educational status, ethnic group, residence location, marital status, home ownership, and age. Data are from the U.S. Census Bureau for the period 1965-1970.

Age Factors↗
PubMed2004

Increasing trends of obesity in Sweden between 1996/97 and 2000/01.

BACKGROUND: During the last two decades, obesity has reached epidemic proportions in industrialised societies such as Sweden. OBJECTIVE: The first aim of this study is to examine whether the body mass index (BMI) and obesity increased between 1996/97 and 2000/01 in different subgroups in the Swedish population. The second aim is to examine whether there were any differences in BMI between subgroups of the population, characterised by age, gender, educational status, smoking habits, degree of urbanisation, and country of birth. The third aim is to examine whether BMI increased between the two periods after adjustment for all the explanatory variables. METHODS: This study is based on two cross-sectional, random samples of the entire population aged 16-84 y, the first from 1996/97 including 5622 men and 5940 women and the second from 2000/01 including 5515 men and 5838 women. To investigate the possible change in obesity between the two periods, a logistic model adjusted for age was applied, after stratification by gender. To study the relationship between BMI and the explanatory variables, and the possible change in the subgroups of the population between the two periods, a linear regression model was used. RESULTS: The total BMI mean increased by 0.4 units from 1996/97 to 2000/01 for both men and women. The prevalence of obesity also increased to about 10% in 2000/01. In some subgroups, the prevalence of obesity was especially high, for example, men and women aged 55-74 y, men with middle educational status, women with low educational status, former smokers, and Finnish-born men and women. CONCLUSIONS: These findings illustrate that both BMI and obesity increased in the Swedish population between 1996/97 and 2000/01. This increase in BMI and obesity is most likely due to environmental factors, such as diet and a sedentary lifestyle. Health interventions need to target both certain subgroups and the whole population.

Adolescent↗
PubMed1994

Age differences in the symptoms of depression: a latent trait analysis.

Our hypothesis was that older adults are less likely than younger adults to acknowledge dysphoria or anhedonia even at the same level of depression. Study subjects were 3,141 participants in Baltimore, Maryland, and 3,469 participants in the Durham-Piedmont region of North Carolina who had complete data on symptoms of depression active in the one month prior to interview, as well as several covariates thought to be related to depression. The effect of age on the endorsement of the dysphoria/anhedonia stem question from the section on Major Depression in the Diagnostic Interview Schedule was estimated in the two independently gathered samples employing structural equations with a measurement model. The results indicate that, even accounting for differences due to overall level of depressive symptoms, as well as gender, minority status, educational attainment, marital status, employment status, and cognitive impairment, dysphoria was less likely to be endorsed by persons 65 years of age and older. This bias against older adults may account in part for the low rates of Major Depression reported for older persons from epidemiologic studies employing the standard diagnostic criteria.

Adult↗
PubMed2006

Hyperinsulinemia and cognitive decline in a middle-aged cohort.

OBJECTIVE: Determining modifiable risks factors for cognitive decline and dementia are a public health priority as we seek to prevent dementia. Type 2 diabetes and related disorders such as hyperinsulinemia increase with aging and are increasing in the U.S. population. Our objective was to determine whether hyperinsulinemia is associated with cognitive decline among middle-aged adults without type 2 diabetes, dementia, or stroke in the Atherosclerosis Risk in Communities (ARIC) cohort. RESEARCH DESIGN AND METHODS: Middle-aged adults (aged 45-64 years at baseline) in the ARIC cohort had fasting insulin and glucose assessed between 1987 and 1989. Subjects with dementia, type 2 diabetes, or stroke at baseline were excluded from analysis. Three tests of cognitive function available at baseline and 6 years later were delayed word recall (DWR), digit symbol subtest (DSS), and first letter word fluency (WF). Cross-sectional comparisons and linear regression models were computed for cognitive tests at baseline and change in cognitive test scores to determine whether cognitive function was associated with two measures of insulin resistance, fasting insulin and homeostasis model assessment (HOMA). Linear regression models controlled for age, sex, race, marital status, education level, smoking status, alcohol use, depression, hypertension, and hyperlipidemia. RESULTS: In unadjusted and adjusted analyses, hyperinsulinemia based on fasting insulin and HOMA at baseline was associated with significantly lower baseline DWR, DSS, and WF scores and a greater decline over 6 years in DWR and WF. CONCLUSIONS: Insulin resistance is a potentially modifiable midlife risk factor for cognitive decline and dementia.

Cognition Disorders↗
PubMed2003

Dietary folate and depressive symptoms are associated in middle-aged Finnish men.

Several cross-sectional studies have focused on the low blood folate levels of depressed patients. However, no published studies have examined the association between dietary folate and current symptoms of depression in a general population. We investigated the association between dietary folate, cobalamin, pyridoxine and riboflavin and current symptoms of depression in a cross-sectional general population study. We recruited 2682 men aged between 42 and 60 y from eastern Finland. Those who had a previous history of psychiatric disorder were excluded (n = 146, 5.6% of the cohort). Depressive symptoms were assessed with the 18-item Human Population Laboratory Depression Scale. Those who scored 5 or more at baseline were considered to have elevated depressive symptoms (n = 228, 9.3% of the cohort). The participants were grouped into thirds according to their dietary folate intake. Those in the lowest third of energy-adjusted folate intake had a higher risk of being depressed [odds ratio (OR) 1.67, 95% CI = 1.19-2.35, P = 0.003] than those in the highest folate intake third. This increased risk remained significant after adjustment for smoking habits, alcohol consumption, appetite, BMI, marital status, education, adulthood socioeconomic status and total fat consumption (OR = 1.46, 95% CI = 1.01-2.12, P = 0.044). There were no associations between the intake of cobalamin, pyridoxine or riboflavin, and depression. These results indicate that nutrition may have a role in the prevention of depression.

Adult↗
PubMed2002

Education, socioeconomic status, and ocular dimensions in Chinese adults: the Tanjong Pagar Survey.

AIM: To relate indices of education, occupation, and socioeconomic status to ocular dimensions and refraction in an adult population. METHODS: A population based, cross sectional survey of adult Chinese aged 40-81 years residing in the Tanjong Pagar district in Singapore. Ocular dimensions, including axial length, anterior chamber depth, lens thickness, and vitreous chamber depth, were measured using an A-mode ultrasound device. Corneal radius of curvature and refraction were determined with an autorefractor, with refraction further refined subjectively, and lens nuclear opacity was graded clinically using the modified Lens Opacity Classification System III score. Data on education, occupation, income, and housing type were obtained from a standardised interview. RESULTS: Biometric data were available on 951 phakic subjects. After controlling for age, sex, occupation, income and housing type, higher education was associated with longer axial lengths (0.60 mm; 95% confidence interval (CI): 0.34, 0.85, for every 10 years of education), longer vitreous chambers (0.53 mm; 95% CI: 0.30, 0.77), and more myopic refractions (-1.50 dioptres, 95% CI: -2.08, -0.92). Adjustment for axial length attenuated the refractive association of education (-0.68 dioptre, 95% CI: -1.14, -0.21). Similarly, near work related occupations (managers, professionals, and office workers) and higher income were independently associated with longer axial lengths, longer vitreous chambers, and more myopic refractions, and adjustment for axial length attenuated the refractive associations. CONCLUSIONS: Adults with greater education, near work related occupations, and higher income are more likely to have longer axial lengths and vitreous chambers, and more myopic refractions. The refractive associations of education, occupation, and income are largely explained by variations in axial length.

Adult↗
PubMed2004

Urbanisation and incidence of psychosis and depression: follow-up study of 4.4 million women and men in Sweden.

BACKGROUND: Previous studies of differences in mental health between urban and rural populations are inconsistent. AIMS: To examine whether a high level of urbanisation is associated with increased incidence rates of psychosis and depression, after adjustment for age, marital status, education and immigrant status. METHOD: Follow-up study of the total Swedish population aged 25-64 years with respect to first hospital admission for psychosis or depression. Level of urbanisation was defined by population density and divided into quintiles. RESULTS: With increasing levels of urbanisation the incidence rates of psychosis and depression rose. In the full models, those living in the most densely populated areas (quintile 5) had 68-77% more risk of developing psychosis and 12-20% more risk of developing depression than the reference group (quintile 1). CONCLUSIONS: A high level of urbanisation is associated with increased risk of psychosis and depression for both women and men.

Adult↗