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Bull C, Trott M, Najman JM, Arnautovska U, Siskind D, Warren N, Kisely S. Associations between child maltreatment and hospital admissions for alcohol and other substance use-related disorders up to 40 years of age: Results from the Childhood Adversity and Lifetime Morbidity study. Addiction 2024; 119:1253-1263. [PMID: 38634806 DOI: 10.1111/add.16479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/15/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND AND AIMS Evidence on the associations between child maltreatment (CM), alcohol use disorders (AUDs) and other substance use disorders (SUDs) comes largely from retrospective studies. These rely on self-reported data, which may be impacted by recall bias. Using prospective CM reports to statutory agencies, we measured associations between CM notifications and inpatient admissions for AUDs and SUDs up to 40 years of age. DESIGN, SETTING AND PARTICIPANTS Observational study linking administrative health data from Queensland, Australia to prospective birth cohort data comprising both agency-reported and substantiated notifications of CM. MEASUREMENTS Outcomes were inpatient admissions for AUDs and SUDs based on ICD-10-Australian modification (AM)-coded primary diagnoses. Unadjusted and adjusted logistic regression analyses were undertaken. FINDINGS Ten per cent (n = 609) of the cohort had a history of agency-reported or substantiated CM notifications before age 15. These individuals had higher adjusted odds of being admitted for AUDs and SUDs. For AUDs, the adjusted odds of inpatient admission were 2.86 [95% confidence interval (CI) = 1.73-4.74] greater where there was any previous agency-reported CM and 3.38 (95% CI = 1.94-5.89) greater where there was any previous substantiated CM. For SUDs, the adjusted odds of inpatient admission were 3.34 (95% CI = 2.42-4.61) greater where there was any previous agency-reported CM and 2.98 (95% CI = 2.04-4.36) greater where there was any previous substantiated CM. CONCLUSIONS People with a history of child maltreatment appear to have significantly higher odds of inpatient admissions for alcohol use disorders and other substance use disorders up to 40 years of age compared to people with no history of child maltreatment.
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Affiliation(s)
- Claudia Bull
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia
- The ALIVE National Centre for Mental Health Research Translation, The University of Queensland, Woolloongabba, QLD, Australia
- Queensland Centre for Mental Health Research, The University of Queensland, Woolloongabba, QLD, Australia
| | - Mike Trott
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia
- Queensland Centre for Mental Health Research, The University of Queensland, Woolloongabba, QLD, Australia
| | - Jake Moses Najman
- School of Public Health, The University of Queensland, Herston, QLD, Australia
- School of Social Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Urska Arnautovska
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia
- Queensland Centre for Mental Health Research, The University of Queensland, Woolloongabba, QLD, Australia
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
| | - Dan Siskind
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia
- Queensland Centre for Mental Health Research, The University of Queensland, Woolloongabba, QLD, Australia
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
| | - Nicola Warren
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
| | - Steve Kisely
- Princess Alexandra Hospital Southside Clinical Unit, Greater Brisbane Clinical School, Faculty of Medicine, The University of Queensland, Woolloongabba, QLD, Australia
- The ALIVE National Centre for Mental Health Research Translation, The University of Queensland, Woolloongabba, QLD, Australia
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia
- Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
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Jalenques I, Guiguet-Auclair C, Morand D, Bourlot F, Lauron S, Mitelman N, Hartmann A, Rondepierre F. Agreement between self-, mother and father proxy-reports on health-related quality of life in adolescents with Tourette syndrome. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02418-6. [PMID: 38613676 DOI: 10.1007/s00787-024-02418-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/13/2024] [Indexed: 04/15/2024]
Abstract
This study aimed to investigate agreement and discrepancies between parent proxy- and adolescent self-reports on assessments of adolescents' health-related quality of life (HRQoL), and the role that individual factors may play in parent-adolescent agreement, in a sample of adolescents with Tourette syndrome (TS) compared to a control group of healthy adolescents. Adolescents aged 12-18 years diagnosed with TS were recruited with their parents from primary and secondary referral centres. Adolescent healthy controls were matched for gender and age. Adolescents and each of their parents completed a set of questionnaires including a HRQoL evaluation of adolescent, the 'Vécu et Santé Perçue de l'Adolescent'. Mother-adolescent, father-adolescent and mother-father agreements on adolescents' HRQoL scores were investigated at individual and group level, both in TS and control groups. Data were available for 75 adolescents, 75 mothers and 63 fathers, in the TS group. Agreement between mother, father proxy-reports and TS adolescents self-reports of HRQoL varied from poor to good, without significant difference with the control group. In TS group, mothers and fathers underestimated adolescents' HRQoL in 'Psychological well-being' subscale and mothers underestimated it in 'Physical 'well-being' subscale, while controls overestimated adolescents' HRQoL in these subscales. Larger mother-adolescent discrepancies for 'Psychological well-being' and 'Physical well-being' subscales were associated with internalizing symptoms. Regarding future studies, comprehensive evaluation of the various dimensions of adolescents' HRQoL with TS requires the integration of the perspectives of both adolescents, mothers and fathers. Clinicians should take into account this point to provide comprehensive care and services.
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Affiliation(s)
- Isabelle Jalenques
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, Service de Psychiatrie de l'Adulte A et Psychologie Médicale, Centre de Compétences Gilles de la Tourette, CNRS, Institut Pascal, F-63000, Clermont-Ferrand Cedex, France.
| | - Candy Guiguet-Auclair
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, F-63000, Clermont-Ferrand, France
| | - Dominique Morand
- Direction de la Recherche Clinique et de l'Innovation, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France
| | - Fabien Bourlot
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, Service de Psychiatrie de l'Adulte A Et Psychologie Médicale, CNRS, Institut Pascal, F-63000, Clermont-Ferrand, France
| | - Sophie Lauron
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, Service de Psychiatrie de l'Adulte A Et Psychologie Médicale, CNRS, Institut Pascal, F-63000, Clermont-Ferrand, France
| | - Nathan Mitelman
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, Service de Psychiatrie de l'Adulte A Et Psychologie Médicale, CNRS, Institut Pascal, F-63000, Clermont-Ferrand, France
| | - Andreas Hartmann
- Département de Neurologie, Pôle des Maladies du Système Nerveux, Groupe Hospitalier Pitié-Salpêtrière, Centre de Référence 'Syndrome Gilles de la Tourette', 75013, Paris, France
| | - Fabien Rondepierre
- Service de Psychiatrie de l'Adulte A et Psychologie Médicale, Centre de Compétences Gilles de la Tourette, CHU Clermont-Ferrand, 63003, Clermont-Ferrand, France
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Ishtiak-Ahmed K, Rohde C, Otte C, Gasse C, Köhler-Forsberg O. Comparative effectiveness of selective serotonin reuptake inhibitors (SSRIs) for depression in 43,061 older adults with chronic somatic diseases: A Danish target trial emulation study. Gen Hosp Psychiatry 2024; 87:83-91. [PMID: 38354442 DOI: 10.1016/j.genhosppsych.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE To investigate the comparative effectiveness of commonly used selective serotonin reuptake inhibitors (SSRIs) for comorbid depression in older adults with chronic somatic diseases by applying a target-trial-emulation framework. METHODS Danish target-trial-emulation study including 43,061 individuals aged ≥65 years (54.1% females, mean age 77.8 years) with a first redeemed prescription for depression with sertraline (n = 6673), escitalopram (n = 7104) or citalopram (n = 29,284) in 2006-2017. Individuals had cancer, cardiovascular diseases (CVD), chronic-obstructive-pulmonary-disease (COPD)/asthma, diabetes, neurodegenerative disorders, or osteoporosis. Outcomes were treatment switching, combination/augmentation, psychiatric hospital contact for depression, and any psychiatric in-patient care. Follow-up was one year and adjusted Cox regression analyses calculated hazard rate ratios (HRR) within each somatic disease. RESULTS Across all six disease groups and four outcomes, we found that citalopram use, compared with sertraline, was associated with lower risks in several analyses, with statistically significant results in cancer, CVD, COPD/asthma, and diabetes (e.g., HRRs for psychiatric hospital contacts for depression/any psychiatric in-patient care ranging between 0.47 and 0.61). For escitalopram, compared with sertraline, some analyses indicated poorer outcomes with significantly higher risks for combination/augmentation treatment (HRRs ranging between 1.15 and 1.40). CONCLUSIONS Although observational studies are prone to confounding, these findings indicate clinically relevant differences between the SSRIs, with better outcomes in citalopram users and poorer outcomes in escitalopram users than sertraline, urging the need for clinical studies in this vulnerable patient population.
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Affiliation(s)
- Kazi Ishtiak-Ahmed
- Department of Affective Disorders, Aarhus University Hospital Psychiatry, 8200 Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University, 8200 Aarhus N, Denmark.
| | - Christopher Rohde
- Department of Affective Disorders, Aarhus University Hospital Psychiatry, 8200 Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University, 8200 Aarhus N, Denmark
| | - Christian Otte
- Department of Psychiatry and Neurosciences, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany; German Center for Mental Health (DZPG), Berlin, Germany
| | - Christiane Gasse
- Department of Affective Disorders, Aarhus University Hospital Psychiatry, 8200 Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University, 8200 Aarhus N, Denmark; Department of Psychiatry and Neurosciences, Charité Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany
| | - Ole Köhler-Forsberg
- Psychosis Research Unit, Aarhus University Hospital - Psychiatry, 8200 Aarhus N, Denmark; Department of Clinical Medicine, Aarhus University, 8200 Aarhus N, Denmark
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Petit P, Gondard E, Gandon G, Moreaud O, Sauvée M, Bonneterre V. Agricultural activities and risk of Alzheimer's disease: the TRACTOR project, a nationwide retrospective cohort study. Eur J Epidemiol 2024; 39:271-287. [PMID: 38195954 PMCID: PMC10995077 DOI: 10.1007/s10654-023-01079-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 11/02/2023] [Indexed: 01/11/2024]
Abstract
Data regarding Alzheimer's disease (AD) occurrence in farming populations is lacking. This study aimed to investigate whether, among the entire French farm manager (FM) workforce, certain agricultural activities are more strongly associated with AD than others, using nationwide data from the TRACTOR (Tracking and monitoring occupational risks in agriculture) project. Administrative health insurance data (digital electronic health/medical records and insurance claims) for the entire French agricultural workforce, over the period 2002-2016, on the entire mainland France were used to estimate the risk of AD for 26 agricultural activities with Cox proportional hazards model. For each analysis (one for each activity), the exposed group included all FMs that performed the activity of interest (e.g. crop farming), while the reference group included all FMs who did not carry out the activity of interest (e.g. FMs that never farmed crops between 2002 and 2016). There were 5067 cases among 1,036,069 FMs who worked at least one year between 2002 and 2016. Analyses showed higher risks of AD for crop farming (hazard ratio (HR) = 3.72 [3.47-3.98]), viticulture (HR = 1.29 [1.18-1.42]), and fruit arboriculture (HR = 1.36 [1.15-1.62]). By contrast, lower risks of AD were found for several animal farming types, in particular for poultry and rabbit farming (HR = 0.29 [0.20-0.44]), ovine and caprine farming (HR = 0.50 [0.41-0.61]), mixed dairy and cow farming (HR = 0.46 [0.37-0.57]), dairy farming (HR = 0.67 [0.61-0.73]), and pig farming (HR = 0.30 [0.18-0.52]). This study shed some light on the association between a wide range of agricultural activities and AD in the entire French FMs population.
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Affiliation(s)
- Pascal Petit
- CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, Univ. Grenoble Alpes, 38000, Grenoble, France.
- Centre Régional de Pathologies Professionnelles et Environnementales, CHU Grenoble Alpes, 38000, Grenoble, France.
- AGEIS, Univ. Grenoble Alpes, 38000, Grenoble, France.
| | - Elise Gondard
- CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, Univ. Grenoble Alpes, 38000, Grenoble, France
| | - Gérald Gandon
- Centre Régional de Pathologies Professionnelles et Environnementales, CHU Grenoble Alpes, 38000, Grenoble, France
| | - Olivier Moreaud
- Centre Mémoire de Ressources et de Recherche, CHU Grenoble Alpes, 38000, Grenoble, France
- Laboratoire de Psychologie et Neurocognition, UMR 5105, CNRS, LPNC, Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, 38000, Grenoble, France
| | - Mathilde Sauvée
- Centre Mémoire de Ressources et de Recherche, CHU Grenoble Alpes, 38000, Grenoble, France
- Laboratoire de Psychologie et Neurocognition, UMR 5105, CNRS, LPNC, Univ. Grenoble Alpes, Univ. Savoie Mont Blanc, 38000, Grenoble, France
| | - Vincent Bonneterre
- CNRS, UMR 5525, VetAgro Sup, Grenoble INP, CHU Grenoble Alpes, TIMC, Univ. Grenoble Alpes, 38000, Grenoble, France
- Centre Régional de Pathologies Professionnelles et Environnementales, CHU Grenoble Alpes, 38000, Grenoble, France
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Tweedie-Cullen RY, Leong K, Wilson BC, Derraik JGB, Albert BB, Monk R, Vatanen T, Creagh C, Depczynski M, Edwards T, Beck K, Thabrew H, O'Sullivan JM, Cutfield WS. Protocol for the Gut Bugs in Autism Trial: a double-blind randomised placebo-controlled trial of faecal microbiome transfer for the treatment of gastrointestinal symptoms in autistic adolescents and adults. BMJ Open 2024; 14:e074625. [PMID: 38320845 PMCID: PMC10860090 DOI: 10.1136/bmjopen-2023-074625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 01/19/2024] [Indexed: 02/15/2024] Open
Abstract
INTRODUCTION Autism (formally autism spectrum disorder) encompasses a group of complex neurodevelopmental conditions, characterised by differences in communication and social interactions. Co-occurring chronic gastrointestinal symptoms are common among autistic individuals and can adversely affect their quality of life. This study aims to evaluate the efficacy of oral encapsulated faecal microbiome transfer (FMT) in improving gastrointestinal symptoms and well-being among autistic adolescents and adults. METHODS AND ANALYSIS This double-blind, randomised, placebo-controlled trial will recruit 100 autistic adolescents and adults aged 16-45 years, who have mild to severe gastrointestinal symptoms (Gastrointestinal Symptoms Rating Scale (GSRS) score ≥2.0). We will also recruit eight healthy donors aged 18-32 years, who will undergo extensive clinical screening. Recipients will be randomised 1:1 to receive FMT or placebo, stratified by biological sex. Capsules will be administered over two consecutive days following an overnight bowel cleanse with follow-up assessments at 6, 12 and 26 weeks post-treatment. The primary outcome is GSRS score at 6 weeks. Other assessments include anthropometry, body composition, hair cortisol concentration, gut microbiome profile, urine/plasma gut-derived metabolites, plasma markers of gut inflammation/permeability and questionnaires on general well-being, sleep quality, physical activity, food diversity and treatment tolerability. Adverse events will be recorded and reviewed by an independent data monitoring committee. ETHICS AND DISSEMINATION Ethics approval for the study was granted by the Central Health and Disability Ethics Committee on 24 August 2021 (reference number: 21/CEN/211). Results will be published in peer-reviewed journals and presented to both scientific and consumer group audiences. TRIAL REGISTRATION NUMBER ACTRN12622000015741.
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Affiliation(s)
| | - Karen Leong
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Brooke C Wilson
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Benjamin B Albert
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Ruth Monk
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
- Autism New Zealand Inc, Wellington, New Zealand
| | - Tommi Vatanen
- Liggins Institute, The University of Auckland, Auckland, New Zealand
- Research Program for Clinical and Molecular Metabolism, University of Helsinki, Helsinki, Finland
| | - Christine Creagh
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | | | - Taygen Edwards
- Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Kathryn Beck
- School of Sport Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - Hiran Thabrew
- Psychological Medicine, University of Auckland, Auckland, New Zealand
| | | | - Wayne S Cutfield
- Liggins Institute, The University of Auckland, Auckland, New Zealand
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Fu M, He R, Zhang Z, Ma F, Shen L, Zhang Y, Duan M, Zhang Y, Wang Y, Zhu L, He J. Multinomial machine learning identifies independent biomarkers by integrated metabolic analysis of acute coronary syndrome. Sci Rep 2023; 13:20535. [PMID: 37996510 PMCID: PMC10667512 DOI: 10.1038/s41598-023-47783-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/18/2023] [Indexed: 11/25/2023] Open
Abstract
A multi-class classification model for acute coronary syndrome (ACS) remains to be constructed based on multi-fluid metabolomics. Major confounders may exert spurious effects on the relationship between metabolism and ACS. The study aims to identify an independent biomarker panel for the multiclassification of HC, UA, and AMI by integrating serum and urinary metabolomics. We performed a liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based metabolomics study on 300 serum and urine samples from 44 patients with unstable angina (UA), 77 with acute myocardial infarction (AMI), and 29 healthy controls (HC). Multinomial machine learning approaches, including multinomial adaptive least absolute shrinkage and selection operator (LASSO) regression and random forest (RF), and assessment of the confounders were applied to integrate a multi-class classification biomarker panel for HC, UA and AMI. Different metabolic landscapes were portrayed during the transition from HC to UA and then to AMI. Glycerophospholipid metabolism and arginine biosynthesis were predominant during the progression from HC to UA and then to AMI. The multiclass metabolic diagnostic model (MDM) dependent on ACS, including 2-ketobutyric acid, LysoPC(18:2(9Z,12Z)), argininosuccinic acid, and cyclic GMP, demarcated HC, UA, and AMI, providing a C-index of 0.84 (HC vs. UA), 0.98 (HC vs. AMI), and 0.89 (UA vs. AMI). The diagnostic value of MDM largely derives from the contribution of 2-ketobutyric acid, and LysoPC(18:2(9Z,12Z)) in serum. Higher 2-ketobutyric acid and cyclic GMP levels were positively correlated with ACS risk and atherosclerosis plaque burden, while LysoPC(18:2(9Z,12Z)) and argininosuccinic acid showed the reverse relationship. An independent multiclass biomarker panel for HC, UA, and AMI was constructed using the multinomial machine learning methods based on serum and urinary metabolite signatures.
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Affiliation(s)
- Meijiao Fu
- Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Ruhua He
- Department of Cardiology, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Zhihan Zhang
- Department of Cardiology, Hanzhong Central Hospital, Hanzhong, 723200, Shanxi, China
| | - Fuqing Ma
- Department of Cardiology, The Fifth People's Hospital of Ningxia, Shizuishan, 753000, Ningxia, China
| | - Libo Shen
- Center for Cardiovascular Diseases, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, 750002, Ningxia, China
| | - Yu Zhang
- Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Mingyu Duan
- Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Yameng Zhang
- Department of Cardiology, The Second Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471000, Henan, China
| | - Yifan Wang
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Li Zhu
- Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China.
| | - Jun He
- Department of Cardiology, General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China.
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Mondino A, Khan M, Case B, Fefer G, Panek WK, Gruen ME, Olby NJ. Winning the race with aging: age-related changes in gait speed and its association with cognitive performance in dogs. Front Vet Sci 2023; 10:1150590. [PMID: 37396989 PMCID: PMC10309205 DOI: 10.3389/fvets.2023.1150590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction In humans, gait speed is a crucial component in geriatric evaluation since decreasing speed can be a harbinger of cognitive decline and dementia. Aging companion dogs can suffer from age-related mobility impairment, cognitive decline and dementia known as canine cognitive dysfunction syndrome. We hypothesized that there would be an association between gait speed and cognition in aging dogs. Methods We measured gait speed on and off leash in 46 adult and 49 senior dogs. Cognitive performance in senior dogs was assessed by means of the Canine Dementia Scale and a battery of cognitive tests. Results We demonstrated that dogs' food-motivated gait speed off leash is correlated with fractional lifespan and cognitive performance in dogs, particularly in the domains of attention and working memory. Discussion Food-motivated gait speed off leash represents a relatively easy variable to measure in clinical settings. Moreover, it proves to be a more effective indicator of age-related deterioration and cognitive decline than gait speed on leash.
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Chen Y, Miao M, Wang Z, Ji H, Zhou Y, Liang H, He G, Yuan W. Prenatal bisphenol exposure and intelligence quotient in children at six years of age: A prospective cohort study. CHEMOSPHERE 2023; 334:139023. [PMID: 37230300 DOI: 10.1016/j.chemosphere.2023.139023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 04/27/2023] [Accepted: 05/23/2023] [Indexed: 05/27/2023]
Abstract
The effects of prenatal bisphenol A (BPA) exposure on children's cognitive development have been reported; however, relevant evidence on BPA analogues was limited, with rare evidence of the joint effect of their mixture. Among 424 mother-offspring pairs from the Shanghai-Minhang Birth Cohort Study, maternal urinary concentrations of five bisphenols (BPs) were quantified, and children's cognitive function was assessed by the Wechsler Intelligence Scale at six years of age. We assessed the associations of prenatal exposure to individual BPs with children's intelligence quotient (IQ) and analyzed the joint effect of BPs mixture by the Quantile g-computation model (QGC) and Bayesian kernel machine regression model (BKMR). QGC models showed that higher maternal urinary BPs mixture concentrations were associated with lower scores among boys in a non-linear way; however, no association was observed in girls. For individual effects, BPA and BPF were associated with decreased IQ scores in boys and were identified as important contributors to the joint effect of BPs mixture. However, associations of BPA with increased IQ scores in girls, and TCBPA with increased IQ scores in both sexes were observed. Our findings suggested prenatal exposure to BPs mixture may affect children's cognitive function in a sex-specific pattern and provided evidence of the neurotoxicity of BPA and BPF.
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Affiliation(s)
- Yao Chen
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, No.779, Old Hu Min Road, Shanghai, 200237, China
| | - Maohua Miao
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, No.779, Old Hu Min Road, Shanghai, 200237, China
| | - Ziliang Wang
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, No.779, Old Hu Min Road, Shanghai, 200237, China
| | - Honglei Ji
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, No.779, Old Hu Min Road, Shanghai, 200237, China
| | - Yan Zhou
- Hubei Provincial Key Laboratory of Applied Toxicology, National Reference Laboratory of Dioxin, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Hong Liang
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, No.779, Old Hu Min Road, Shanghai, 200237, China.
| | - Gengsheng He
- Department of Nutrition and Food Hygiene, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, No.130, Dong An Road, Shanghai, 200032, China.
| | - Wei Yuan
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, No.779, Old Hu Min Road, Shanghai, 200237, China
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Gabel LN, Mohamed Ali O, Kotelnikova Y, Tremblay PF, Stanton KJ, Durbin CE, Hayden EP. Predicting children's internalizing symptoms across development from early emotional reactivity. SOCIAL DEVELOPMENT 2023. [DOI: 10.1111/sode.12673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Affiliation(s)
- Lindsay N. Gabel
- Department of Psychology Western University London Ontario Canada
| | - Ola Mohamed Ali
- Department of Psychology Western University London Ontario Canada
| | - Yuliya Kotelnikova
- Faculty of Education, School & Clinical Child Psychology ProgramUniversity of Alberta Edmonton Alberta Canada
| | - Paul F. Tremblay
- Department of Psychology Western University London Ontario Canada
| | - Kasey J. Stanton
- Department of Psychology University of Wyoming Laramie Wyoming USA
| | - C. Emily Durbin
- Department of PsychologyMichigan State University East Lansing Michigan USA
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Chen Y, Zhang X, Wang Z, Yuan Z, Luan M, Yuan W, Liang H, Chen H, Chen D, Yang Y, Miao M. Gestational exposure to organophosphate esters and adiposity measures of children up to 6 years: Effect modification by breastfeeding. Int J Hyg Environ Health 2023; 248:114089. [PMID: 36481744 DOI: 10.1016/j.ijheh.2022.114089] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/06/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
Organophosphate esters (OPEs) are synthetic chemicals used in various commercial products. Accumulating evidence has shown that they may act as metabolic disruptors. However, no study has investigated the long-term effects of gestational OPEs exposure on childhood adiposity. Breast milk represents the optimal nutritional form of feeding for infants and may protect against the adverse effects of gestational OPEs exposure on offspring development. Using data from the Shanghai-Minhang birth cohort study, we investigated the associations of gestational OPEs exposure with adiposity measures in children up to 6 years of age, and whether breastfeeding could modify these associations. A total of 733 mother-child pairs with available data on OPE concentrations and child anthropometry were included. Eight OPE metabolites were assessed in maternal urine samples collected at 12-16 weeks of pregnancy. Information on children's weight, height, arm circumference, and waist circumference was collected at birth and 0.5, 1, 4, and 6 years of age. Weight-for-age and body mass index-for-age z scores were calculated. The duration of children's breastfeeding was categorized as ≤4 months or >4 months. The generalized estimate equation and Bayesian Kernel Machine Regression models were used to examine the associations of OPEs exposure with children's adiposity measures. Selected OPEs exposure was associated with higher children's adiposity measures. Particularly, we found stronger associations of bis(1-chloro-2-propyl) phosphate (BCIPP), bis(2-chloroethyl) phosphate (BCEP), bis(1,3-dichloro-2-propyl) phosphate (BDCPP), and di-o-cresyl phosphate and di-p-cresyl phosphate (DCP) with higher adiposity measures in children breastfed for ≤4 months, while little evidence of associations was found among those breastfed for >4 months. Our study suggested that gestational OPEs exposure could alter children's adiposity measures, but the potential effects were attenuated if children were breastfed for >4 months.
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Affiliation(s)
- Yafei Chen
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), School of Public Health, Fudan University, Shanghai, China
| | - Xiaohua Zhang
- Minhang Maternal and Child Health Hospital, Shanghai, China
| | - Ziliang Wang
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), School of Public Health, Fudan University, Shanghai, China
| | - Zhengwei Yuan
- Key Lab. of Health Ministry for Congenital Malformation, Shengjing Hospital, China Medical Hospital, Shenyang, Liaoning, China
| | - Min Luan
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), School of Public Health, Fudan University, Shanghai, China
| | - Wei Yuan
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), School of Public Health, Fudan University, Shanghai, China
| | - Hong Liang
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), School of Public Health, Fudan University, Shanghai, China
| | - Hexia Chen
- School of Environment, Guangdong Key Laboratory of Environment Pollution and Health, Jinan University, Guangzhou, China
| | - Da Chen
- School of Environment, Guangdong Key Laboratory of Environment Pollution and Health, Jinan University, Guangzhou, China
| | - Yan Yang
- School of Environmental Science and Engineering, Institute of Environmental Health and Pollution Control, Guangdong University of Technology, Guangzhou, China; Chemistry and Chemical Engineering Guangdong Laboratory, Shantou, Guangdong, China; Synergy Innovation Institute of GDUT, Shantou, China.
| | - Maohua Miao
- NHC Key Lab. of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), School of Public Health, Fudan University, Shanghai, China.
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Chen Y, Liang H, Ji H, Sun X, He G, Wang Y, Dai W, Miao M, Yuan W. Associations between maternal urinary isoflavone concentrations and anogenital distance of offspring throughout infancy: a prospective cohort study. Hum Reprod 2023; 38:277-292. [PMID: 36331496 DOI: 10.1093/humrep/deac234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 09/25/2022] [Indexed: 11/06/2022] Open
Abstract
STUDY QUESTION Are maternal urinary isoflavone (ISO) concentrations during pregnancy associated with anogenital distance (AGD) in infants at birth, and at 6 and 12 months of age? SUMMARY ANSWER Higher maternal urinary ISO concentrations during pregnancy were associated with longer AGD in infants of both sexes, and equol (EQU) and daidzein (DAD) were identified as the important ISO mixture components in the observed associations. WHAT IS KNOWN ALREADY Evidence of the association of prenatal exposure to ISO with offspring's AGD is mainly derived from animal studies, which used different study designs and had inconsistent results. Only one human study has been reported and it found null associations between maternal ISO exposure during pregnancy and AGD among boys at birth, with a small sample size and a wide range of exposure windows. No human study on girls was found. STUDY DESIGN, SIZE, DURATION Prospective cohort study (Shanghai-Minhang Birth Cohort Study), with pregnant women recruited at 12-16 weeks of gestation in Shanghai, China between April and December 2012. One thousand two hundred and twenty-five live singletons were left in the cohort at delivery of which 480 mother-infant pairs had data on both maternal urinary ISO concentrations and at least one AGD measurement and were included in the present study. Anopenile distance (AGDAP) and anoscrotal distance (AGDAS) of boys and anoclitoral distance (AGDAC) and anofourchette distance (AGDAF) of girls were measured at birth and at 6 and 12 months of age. PARTICIPANTS/MATERIALS, SETTING, METHODS Multiple linear regression models were used to examine the associations between maternal ISO concentrations and AGD. Bayesian kernel machine regression (BKMR) was implemented to examine both the overall effects of ISO mixture and the single effect of each ISO and identify important components of ISO mixture. MAIN RESULTS AND THE ROLE OF CHANCE A general profile of higher concentrations of maternal ISO associated with longer AGD in infants of both sexes was observed, when maternal education, parity, BMI before pregnancy (BMI, categorical variable), passive smoking during early pregnancy, age at delivery, gestational weeks and infant body size were adjusted for. Among boys, EQU was associated with increased AGDAS at birth and at 6 and 12 months, and DAD was associated with increased AGDAP at birth. Among girls, the associations of EQU and DAD with increased AGDAC and AGDAF at birth were found. When gestational weight gain and feeding patterns of infants in the first 6 months were additionally adjusted for, and maternal BMI was adjusted for as a continuous variable, more pronounced associations were observed, especially for associations of genistein (GEN), DAD and glycitein (GLY) with increased AGDAP and AGDAS at 6 months in boys. However, these associations were not always observed in the highest tertile group, and no consistent dose-response relationships were found. Similar results were observed in BKMR models, showing positive correlations of concentration of ISO mixture with increased AGDAS at both 6 and 12 months among boys, and increased AGDAC and AGDAF at birth among girls. Statistically significant increments of 4.96 mm (95% credible interval (CrI): 1.40, 8.52) and 1.07 mm (95% CrI: 0.02, 2.13) in AGDAS at 6 months among boys and AGDAC at birth among girls, respectively, were observed at the 75th percentile of ISO mixture, compared with 25th percentile. EQU and DAD were identified as the important components among ISO-AGD associations. LIMITATIONS, REASONS FOR CAUTION First, due to the short half-lives of ISO, the accuracy of a single spot urine sample reflecting ISO exposure during pregnancy may be limited, and thus may cause non-differential misclassification. Second, despite the adjustments for several important covariates in the study, unmeasured and residual confounding factors may remain a concern. Third, false discovery due to multiple testing may remain. Finally, the reduced sample sizes attributed to the loss of follow-up and missing data of confounders may limit our ability to detect an association, if any existed. WIDER IMPLICATIONS OF THE FINDINGS Prenatal ISO exposure may affect the reproductive development of offspring. As ISO can be widely detected in pregnant women, especially in Eastern countries, more studies are warranted to provide evidence of the effects of prenatal ISO exposure on long-term reproductive outcomes. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by grants from the National Key Research and Development Program of China (2021YFC2701003), the National Natural Science Foundation of China (22076123), the Science and Technology Commission of Shanghai Municipality (21ZR1454700 and 20ZR1448000), the Shanghai Municipal Health Commission (20194Y0160) and Innovation-oriented Science and Technology Grant from NHC Key Laboratory of Reproduction Regulation (CX2022-04). The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Yao Chen
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Hong Liang
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Honglei Ji
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Xiaowei Sun
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Gengsheng He
- Department of Nutrition and Food Hygiene, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai, China
| | - Yan Wang
- School of Pharmacy, Shanghai Jiaotong University, Shanghai, China
| | - Wentao Dai
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Maohua Miao
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
| | - Wei Yuan
- NHC Key Laboratory of Reproduction Regulation (Shanghai Institute for Biomedical and Pharmaceutical Technologies), Fudan University, Shanghai, China
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Chang CT, Chou MC. Comparison of Non-Uniform Image Quality Caused by Anode Heel Effect between Two Digital Radiographic Systems Using a Circular Step-Wedge Phantom and Mutual Information. ENTROPY (BASEL, SWITZERLAND) 2022; 24:1781. [PMID: 36554186 PMCID: PMC9778271 DOI: 10.3390/e24121781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/29/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
The purpose of this study was to compare non-uniform image quality caused by the anode heel effect between two radiographic systems using a circular step-wedge (CSW) phantom and the normalized mutual information (nMI) metric. Ten repeated radiographic images of the CSW and contrast-detail resolution (CDR) phantoms were acquired from two digital radiographic systems with 16- and 12-degree anode angles, respectively, using various kVp and mAs. To compare non-uniform image quality, the CDR phantom was physically rotated at different orientations, and the directional nMI metrics were calculated from the CSW images. The directional visible ratio (VR) metrics were calculated from the CDR images. Analysis of variance (ANOVA) was performed to understand whether the nMI metric significantly changed with kVp, mAs, and orientations with Bonferroni correction. Mann-Whitney's U test was performed to compare the metrics between the two systems. Contrary to the VR metrics, the nMI metrics significantly changed with orientations in both radiographic systems. In addition, the system with the 12-degree anode angle exhibited less uniform image quality compared to the system with the 16-degree anode angle. A CSW phantom using the directional nMI metric can be significantly helpful to compare non-uniform image quality between two digital radiographic systems.
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Affiliation(s)
- Ching-Ting Chang
- Department of Medical Imaging, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
- Department of Radiology, Kaohsiung Medical University Gangshan Hospital, Kaohsiung 82060, Taiwan
- Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Ming-Chung Chou
- Department of Medical Imaging and Radiological Sciences, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Center for Big Data Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
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Carvalho F, Magalhaes C, Fernandez-Llimos F, Mendes J, Gonçalves J. Skin temperature response to thermal stimulus in patients with hyperhidrosis: A comparative study. J Therm Biol 2022; 109:103322. [DOI: 10.1016/j.jtherbio.2022.103322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 06/07/2022] [Accepted: 08/30/2022] [Indexed: 11/28/2022]
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Robbins SM, Wolfe R, Chang YY, Lavoie M, Preston E, Hazel EM. Inter-segmental coordination amplitude and variability differences during gait in patients with Ehlers-Danlos syndrome and healthy adults. Clin Biomech (Bristol, Avon) 2022; 94:105515. [PMID: 34736750 DOI: 10.1016/j.clinbiomech.2021.105515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 10/18/2021] [Accepted: 10/25/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is limited research examining gait and inter-segmental coordination in patients with Ehlers-Danlos syndrome. The objective was to compare lower extremity inter-segmental coordination amplitude and variability during gait between patients with Ehlers-Danlos syndrome and healthy adults. METHODS This cross-sectional study included participants with Ehlers-Danlos syndrome (n = 13) and healthy adults (n = 14). Gait data were acquired using a motion capture system and force plates. Participants ambulated at self-selected speeds for five trials. Inter-segmental coordination was quantified using continuous relative phase, which examined the dynamic interaction between the thigh-shank and shank-foot paired segments (i.e. phase space relation). A 2-way mixed analysis of variance examined the effects of groups (Ehlers-Danlos and healthy) and gait phases (stance and swing phase) on inter-segmental coordination amplitude and between-trial variability. Effect sizes were calculated using Cohen's d. FINDINGS The Ehlers-Danlos group had greater inter-segmental coordination variability compared to the healthy group for foot-shank and shank-thigh segment pairs in the sagittal plane over stance and swing phases (P = 0.04; small to large effect sizes). The Ehlers-Danlos group also had greater variability in the frontal plane at the foot-shank segment pair during stance phase (P = 0.03; large effect). There were no differences in inter-segmental coordination amplitude between groups (P = 0.06 to 0.85). INTERPRETATION Patients with Ehlers-Danlos syndrome have more variability between gait trials in lower limb motor coordination than healthy adults. This may be related to the impaired proprioception, reduced strength, pain, or slower gait speed seen in this population.
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Affiliation(s)
- Shawn M Robbins
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada; Centre for Interdisciplinary Research in Rehabilitation, Lethbridge-Layton-MacKay Rehabilitation Centre, Montreal, Quebec, Canada.
| | - Russell Wolfe
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Yu-Yao Chang
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
| | - Mathilde Lavoie
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
| | - Emma Preston
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
| | - Elizabeth M Hazel
- McGill University Health Centre, Montreal General Hospital, Montreal, Quebec, Canada
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Cui R, Gujral S, Galfalvy H, Szanto K. The Role of Perceived and Objective Social Connectedness on Risk for Suicidal Thoughts and Behavior in Late-Life and Their Moderating Effect on Cognitive Deficits. Am J Geriatr Psychiatry 2022; 30:527-532. [PMID: 34600819 PMCID: PMC8898978 DOI: 10.1016/j.jagp.2021.08.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/06/2021] [Accepted: 08/23/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Impaired cognition increases suicide risk while social connectedness protects against suicide risk in late life. We examined the independent and interactive effects of social connectedness and cognition on suicide risk in late life. METHODS Participants included 570 individuals aged 50+ from a late-life suicide study. The Interpersonal Support Evaluation List and Social Network Index were used to assess perceived and objective social connectedness, respectively, while the Mattis Dementia Rating Scale and Executive Interview were used to assess cognition. RESULTS Suicide attempters and ideators reported lower perceived social connectedness and exhibited worse executive function than non-suicidal depressed and healthy comparison participants, while only attempters had worse objective social connectedness relative to the other groups. Executive dysfunction was linked to low objective social connectedness in attempters but higher objective social connectedness in healthy comparisons. CONCLUSION Interventions targeting suicide risk may consider bolstering social connectedness, particularly in those with low cognitive health.
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Affiliation(s)
| | | | - Hanga Galfalvy
- Columbia University Medical Center, Departments of Psychiatry and Biostatistics, NY, NY
| | - Katalin Szanto
- University of Pittsburgh School of Medicine (RC, SG, KS), Department of Psychiatry, Pittsburgh, PA.
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Sjöholm H, Hägg S, Nyberg L, Lind J, Kammerlind AS. Exploring possible risk factors for time to first fall and 6-month fall incidence in persons with acute stroke. SAGE Open Med 2022; 10:20503121221088093. [PMID: 35387151 PMCID: PMC8977710 DOI: 10.1177/20503121221088093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 02/25/2022] [Indexed: 11/15/2022] Open
Abstract
Objectives: The aim was to explore how the time to the first fall and 6-month fall incidence relates to rapidly and easily collected data in persons with acute stroke. Methods: Out of consecutively admitted patients with stroke at three stroke units, 284 with at least one follow-up were included in this prospective cohort study. During 6 months following discharge, participants reported falls using a diary and monthly phone calls. Data about participants’ characteristics, functions, and activities were collected during hospital stay and analyzed in relation to time to first fall by Cox regression and fall incidence by negative binomial regression. Results: Use of ⩾9 medications, paresis in arms, paresis in legs (National Institutes of Health Stroke Scale), impaired protective reactions in sitting (Postural Reactions Test), and limitations in self-care (Barthel Index) were decisive risk factors for time to first fall. Limitations in mobility (Step Test, 30-s Chair Stand Test) were decisive risk factors for high fall incidence (p < 0.0005). Conclusion: Several easily collected participant characteristics, functions, and activities were identified as risk factors for falls. The findings emphasize the width of assessments that can be used for the identification of individuals at risk for falls and that the risk factors vary in different strata of the population. These results are important when developing multivariate risk models. The risk factors differed in part when analyzing the time to the first fall and 6-month fall incidence.
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Affiliation(s)
- Hanna Sjöholm
- Rehabilitation Center in Jönköping, Region Jönköping County, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Staffan Hägg
- Futurum, Region Jönköping County, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Lars Nyberg
- Department of Health, Learning and Technology, Luleå University of Technology, Luleå, Sweden
| | - Jonas Lind
- Department of Internal Medicine in Jönköping, Region Jönköping County, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Ann-Sofi Kammerlind
- Futurum, Region Jönköping County, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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