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Batty GD, Zaninotto P, Elovainio MJ, Hakulinen CA. Are a lack of social relationships and cigarette smoking really equally powerful predictors of mortality? Analyses of data from two cohort studies. PUBLIC HEALTH IN PRACTICE 2021; 2:100140. [PMID: 34977831 PMCID: PMC8683741 DOI: 10.1016/j.puhip.2021.100140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 04/08/2021] [Accepted: 05/05/2021] [Indexed: 11/28/2022] Open
Affiliation(s)
- G. David Batty
- Department of Epidemiology and Public Health, University College, London, UK
- School of Biological and Population Health Sciences, Oregon State University, Corvallis, USA
- Corresponding author. Department of Epidemiology & Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
| | - Paola Zaninotto
- Department of Epidemiology and Public Health, University College, London, UK
| | - Marko J. Elovainio
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
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Batty GD, Deary IJ, Shipley MJ. Association of change in cognitive function from early adulthood to middle age with risk of cause-specific mortality: the Vietnam Experience Study. J Epidemiol Community Health 2019; 73:712-716. [PMID: 31152074 DOI: 10.1136/jech-2019-212377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 04/12/2019] [Accepted: 04/24/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Studies with single baseline measurements of cognitive function consistently reveal inverse relationships with mortality risk. The relation of change in functioning, particularly from early in the life course, which may offer additional insights into causality, has not, to the best of our knowledge, been tested. AIMS To examine the association of change in cognition between late adolescence and middle age with cause-specific mortality using data from a prospective cohort study. METHODS The analytical sample consisted of 4289 former US male military personnel who were administered the Army General Technical Test in early adulthood (mean age 20.4 years) and again in middle age (mean age 38.3 years). RESULTS A 15-year period of mortality surveillance subsequent to the second phase of cognitive testing gave rise to 237 deaths. Following adjustment for age, a 10-unit increase in cognitive function was related to a reduced risk of death from all causes (HR 0.84; 95% CI 0.75 to 0.93) and cardiovascular disease (HR 0.78; 95% CI 0.64 to 0.95) but not from all cancers (HR 1.14; 95% CI 0.88 to 1.47) nor injury (HR 1.02; 95% CI 0.81 to 1.29). Adjustment for markers of socioeconomic status in middle age resulted in marked attenuation in the magnitude of these associations and statistical significance at conventional levels was lost in all analyses. CONCLUSIONS In the present study, the apparent link between increased cognition and mortality was mediated by socioeconomic status.
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Affiliation(s)
- G David Batty
- Department of Epidemiology and Public Health, University College London, London, UK .,School of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon, USA
| | - Ian J Deary
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Martin J Shipley
- Department of Epidemiology and Public Health, University College London, London, UK
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Der G, Deary IJ. Reaction times match IQ for major causes of mortality: Evidence from a population based prospective cohort study. INTELLIGENCE 2018; 69:134-145. [PMID: 30100646 PMCID: PMC6075944 DOI: 10.1016/j.intell.2018.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Introduction The association of premorbid cognitive ability with all-cause mortality is now well established. However, since all-cause mortality is relatively uninformative about aetiology, evidence has been sought, and is beginning to accumulate, for associations with specific causes of mortality. Likewise, the underlying causal pathways may be illuminated by considering associations with different measures of cognitive ability. For example, critics of IQ type measures point to possible cultural or social biases and there is, consequently, a need for more culturally neutral measures such as reaction times. We examine the associations of cognitive ability with major causes of mortality, including: cardiovascular disease, cancer and respiratory disease and compare the results for a standard IQ test, the Alice Heim 4 (AH4), with those for simple and four-choice reaction times. Methods Data were derived from the oldest cohort of the West of Scotland Twenty-07 Study. Participants were randomly sampled from the Central Clydeside Conurbation, a mainly urban area centred on Glasgow city. At baseline, aged 56, they were interviewed in their homes by trained interviewers; the AH4 was administered and reaction times measured using a portable electronic device. Vital status was ascertained via linkage to the NHS central register. Cox regression was used in SAS 9.4 for the main analyses. Adjustments were made for sex, smoking status and social class. Results Full data on AH4, RT and covariates were available for 1350 out of 1551. During 29 years of follow-up, there were 833 deaths: 279 cardiovascular disease (CVD) (168 CHD; 68 stroke); 291 cancer; 97 respiratory disease; 42 digestive disease; and 39 dementia. The 85 remaining deaths were a heterogeneous mixture with no cause accounting for more than 14. AH4 scores were associated with most major causes. Digestive disease and dementia had similar effect sizes but were not significant. Within cardiovascular disease, there was an association with coronary heart disease but not stroke. The association with cancer was primarily due to those cancers related to smoking. RT measures were mostly associated with the same causes of death. Where significant, effects were in the same directions and of similar magnitude. That is, lower AH4 scores, longer reaction times, and more variable reaction times were all associated with increased mortality risk from the major causes of death. A summary measure of RT outperformed the AH4 for most causes. Conclusion The association between intelligence with mortality from the major causes is also seen with reaction times. That effect sizes are of similar magnitude is suggestive of a common cause. It also implies that the association of cognitive ability with mortality is unlikely to be due to any social, cultural or educational biases that are sometimes ascribed to intelligence measures. Intelligence and reaction times are both associated with most major causes of mortality Effect sizes are of similar magnitude A summary RT measure provides the more parsimonious explanation for most causes
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Affiliation(s)
- Geoff Der
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, UK.,Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, UK
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, UK
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Bitsios P, Karademas E, Mouzaki A, Manolitsis G, Kapellaki O, Diacatou A, Archontaki A, Mamalakis G, Giovazolias T. The Student Counselling Centre at the University of Crete, Greece. BJPsych Int 2017; 14:90-92. [PMID: 29093959 PMCID: PMC5663022 DOI: 10.1192/s2056474000002099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
This report describes the Student Counselling Centre (SCC) at the University of Crete. The SCS was established in 2003. Its main areas of activity are individual and group psychological support, crisis intervention, research, prevention, volunteering and awareness. Emphasis is also put on the support provided to students with special needs, which is now the second core service of the SCC.
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Affiliation(s)
- Panos Bitsios
- Professor of Psychiatry, Medical School, University of Crete, Greece, email
| | - Evangelos Karademas
- Professor of Clinical Health Psychology, Department of Psychology, University of Crete, Greece
| | - Angeliki Mouzaki
- Assistant Professor of Learning Disabilities, Department of Primary Education, University of Crete, Greece
| | - George Manolitsis
- Associate Professor of Psychopedagogy, Department of Preschool Education, University of Crete, Greece
| | - Ourania Kapellaki
- Psychologist, Student Counselling Centre, University of Crete, Greece
| | | | - Arianna Archontaki
- Special Education Counsellor, Student Counselling Centre, University of Crete, Greece
| | - George Mamalakis
- Psychologist, Student Counselling Centre, University of Crete, Greece
| | - Theodoros Giovazolias
- Associate Professor of Counselling Psychology, Department of Psychology, University of Crete, Greece
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Calvin CM, Batty GD, Der G, Brett CE, Taylor A, Pattie A, Čukić I, Deary IJ. Childhood intelligence in relation to major causes of death in 68 year follow-up: prospective population study. BMJ 2017; 357:j2708. [PMID: 28659274 PMCID: PMC5485432 DOI: 10.1136/bmj.j2708] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2017] [Indexed: 01/02/2023]
Abstract
Objectives To examine the association between intelligence measured in childhood and leading causes of death in men and women over the life course.Design Prospective cohort study based on a whole population of participants born in Scotland in 1936 and linked to mortality data across 68 years of follow-up.Setting Scotland.Participants 33 536 men and 32 229 women who were participants in the Scottish Mental Survey of 1947 (SMS1947) and who could be linked to cause of death data up to December 2015.Main outcome measures Cause specific mortality, including from coronary heart disease, stroke, specific cancer types, respiratory disease, digestive disease, external causes, and dementia.Results Childhood intelligence was inversely associated with all major causes of death. The age and sex adjusted hazard ratios (and 95% confidence intervals) per 1 SD (about 15 points) advantage in intelligence test score were strongest for respiratory disease (0.72, 0.70 to 0.74), coronary heart disease (0.75, 0.73 to 0.77), and stroke (0.76, 0.73 to 0.79). Other notable associations (all P<0.001) were observed for deaths from injury (0.81, 0.75 to 0.86), smoking related cancers (0.82, 0.80 to 0.84), digestive disease (0.82, 0.79 to 0.86), and dementia (0.84, 0.78 to 0.90). Weak associations were apparent for suicide (0.87, 0.74 to 1.02) and deaths from cancer not related to smoking (0.96, 0.93 to 1.00), and their confidence intervals included unity. There was a suggestion that childhood intelligence was somewhat more strongly related to coronary heart disease, smoking related cancers, respiratory disease, and dementia in women than men (P value for interactions <0.001, 0.02, <0.001, and 0.02, respectively).Childhood intelligence was related to selected cancer presentations, including lung (0.75, 0.72 to 0.77), stomach (0.77, 0.69 to 0.85), bladder (0.81, 0.71 to 0.91), oesophageal (0.85, 0.78 to 0.94), liver (0.85, 0.74 to 0.97), colorectal (0.89, 0.83 to 0.95), and haematopoietic (0.91, 0.83 to 0.98). Sensitivity analyses on a representative subsample of the cohort observed only small attenuation of the estimated effect of intelligence (by 10-26%) after adjustment for potential confounders, including three indicators of childhood socioeconomic status. In a replication sample from Scotland, in a similar birth year cohort and follow-up period, smoking and adult socioeconomic status partially attenuated (by 16-58%) the association of intelligence with outcome rates.Conclusions In a whole national population year of birth cohort followed over the life course from age 11 to age 79, higher scores on a well validated childhood intelligence test were associated with lower risk of mortality ascribed to coronary heart disease and stroke, cancers related to smoking (particularly lung and stomach), respiratory diseases, digestive diseases, injury, and dementia.
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Affiliation(s)
- Catherine M Calvin
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK
| | - G David Batty
- Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Department of Epidemiology and Public Health, University College London
| | - Geoff Der
- Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow G2 3QB
| | - Caroline E Brett
- Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Natural Sciences and Psychology, Liverpool John Moores University, Tom Reilly Building, Liverpool, L3 3AF, UK
| | - Adele Taylor
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Alison Pattie
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Iva Čukić
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Ian J Deary
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology (CCACE), Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
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Bratsberg B, Rogeberg O. Childhood socioeconomic status does not explain the IQ-mortality gradient. INTELLIGENCE 2017. [DOI: 10.1016/j.intell.2017.04.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Aichele S, Rabbitt P, Ghisletta P. Think Fast, Feel Fine, Live Long: A 29-Year Study of Cognition, Health, and Survival in Middle-Aged and Older Adults. Psychol Sci 2016; 27:518-29. [PMID: 26917212 DOI: 10.1177/0956797615626906] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 12/21/2015] [Indexed: 11/15/2022] Open
Abstract
In a 29-year study of 6,203 individuals ranging in age from 41 to 96 years at initial assessment, we evaluated the relative and combined influence of 65 mortality risk factors, which included sociodemographic variables, lifestyle attributes, medical indices, and multiple cognitive abilities. Reductions in mortality risk were most associated with higher self-rated health, female gender, fewer years as a smoker, and smaller decrements in processing speed with age. Thus, two psychological variables-subjective health status and processing speed-were among the top predictors of survival. We suggest that these psychological attributes, unlike risk factors that are more narrowly defined, reflect (and are influenced by) a broad range of health-related behaviors and characteristics. Information about these attributes can be obtained with relatively little effort or cost and-given the tractability of these measures in different cultural contexts-may prove expedient for prevention, diagnosis, and treatment of conditions related to increased mortality risk in diverse human populations.
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Affiliation(s)
- Stephen Aichele
- Faculty of Psychology and Educational Sciences, University of Geneva
| | | | - Paolo Ghisletta
- Faculty of Psychology and Educational Sciences, University of Geneva Distance Learning University, Switzerland
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Brignardello-Petersen R, Carrasco-Labra A, Jadad AR, Johnston BC, Tomlinson G. Diverse criteria and methods are used to compare treatment effect estimates: a scoping review. J Clin Epidemiol 2016; 75:29-39. [PMID: 26891950 DOI: 10.1016/j.jclinepi.2016.02.001] [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: 07/16/2015] [Revised: 01/16/2016] [Accepted: 02/04/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To determine what criteria researchers use to assess whether the estimates of effect of an intervention on a dichotomous outcome are different when obtained using different study designs. STUDY DESIGN AND SETTING Scoping review of the literature. We included studies of dichotomous outcomes in which authors compared the estimates of effects from different study designs. We performed searches in electronic databases and in the list of references of relevant studies. Two reviewers independently selected studies and abstracted data. We created a list of the criteria used to compare estimates of effects between study designs, described their main features, and classified them using a clinical perspective. RESULTS We included 26 studies, from which we identified 24 criteria. Most of the studies focused on comparing estimates from observational studies and randomized controlled trials (n = 19). The most common criteria aimed to determine whether there was a difference or not (n = 18), provided guidance for such a judgment (n = 16), and were based on the point estimates (n = 11). We judged 14 criteria to be appropriate and classified them as either statistically related or clinically related. CONCLUSION We found that diverse criteria are used to compare effect estimates between study designs. Familiarity with these would aid in the interpretation of results from different studies regarding the same question.
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Affiliation(s)
- Romina Brignardello-Petersen
- Evidence-Based Dentistry Unit, Faculty of Dentistry, University of Chile, Sergio Livingstone 943, Independencia, Santiago 8380492, Chile; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M6, Canada.
| | - Alonso Carrasco-Labra
- Evidence-Based Dentistry Unit, Faculty of Dentistry, University of Chile, Sergio Livingstone 943, Independencia, Santiago 8380492, Chile
| | - Alejandro R Jadad
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M6, Canada; Institute for Global Health Equity and Innovation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M6, Canada; Centre for Global eHealth Innovation, R Fraser Elliot Building, 190 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
| | - Bradley C Johnston
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M6, Canada; Child Health Evaluative Sciences, Hospital for Sick Children Research Institute, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Room 11.9859, West Toronto, Ontario M5G 0A4, Canada; Department of Anesthesia and Pain Medicine, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8, Canada
| | - George Tomlinson
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M6, Canada; Department of Medicine, University Health Network and Mt Sinai Hospital, Toronto, Eaton North, 13th Floor, Room 238, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
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9
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Abstract
Background The link between intelligence in youth and all-cause mortality in later-life is well established. To better understand this relationship, the current study examines the links between pre-morbid intelligence and a number of specific health outcomes at age 50 using the NLSY-1979 cohort. Methods Participants were the 5793 participants in the NLSY-79 who responded to questions about health outcomes at age 50. Sixteen health outcomes were examined: two were summary measures (physical health and functional limitation), 9 were diagnosed illness conditions, 4 were self-reported conditions, and one was a measure of general health status. Linear and logistic regressions were used, as appropriate, to examine the relationship between intelligence in youth and the health outcomes. Age, sex and both childhood and adult SES, and its sub-components – income, education, & occupational prestige – are all adjusted for separately. Results & conclusion Higher pre-morbid intelligence is linked with better physical health at age 50, and a lower risk for a number of chronic health conditions. For example, a 1 SD higher score in IQ was significantly associated with increased odds of having good, very good, or excellent health, with an odds ratio of 1.70 (C.I. 1.55–1.86). Thirteen of the illness outcomes were significantly and negatively associated with IQ in youth; the odds ratios ranged from 0.85 for diabetes/high blood sugar to 0.65 for stroke, per one standard deviation higher score in IQ. Adjustment for childhood SES led to little attenuation but adult SES partially mediated the relationship for a number of conditions. Mediation by adult SES was not consistently explained by any one of its components—income, education, and occupation status. The current findings contribute to our understanding of lower intelligence as a risk factor for poor health and how this may contribute to health inequalities. We examined links between intelligence in youth and health at age 50 in NLSY-1979. Higher intelligence in youth is linked with better physical health at age 50. Higher intelligence in youth is linked with lower risk for chronic illnesses. Adult but not childhood SES partially mediated the intelligence–health relationship.
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Affiliation(s)
- Christina Wraw
- Center for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, Scotland EH8 9JZ, United Kingdom
- Corresponding author.
| | - Ian J. Deary
- Center for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, Scotland EH8 9JZ, United Kingdom
| | - Catharine R. Gale
- Center for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, Scotland EH8 9JZ, United Kingdom
- MRC Life Course Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, SO16 6YD, United Kingdom
| | - Geoff Der
- MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3QB, United Kingdom
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Trampush JW, Lencz T, Knowles E, Davies G, Guha S, Pe’er I, Liewald DC, Starr JM, Djurovic S, Melle I, Sundet K, Christoforou A, Reinvang I, Mukherjee S, DeRosse P, Lundervold A, Steen VM, John M, Espeseth T, Räikkönen K, Widen E, Palotie A, Eriksson JG, Giegling I, Konte B, Ikeda M, Roussos P, Giakoumaki S, Burdick KE, Payton A, Ollier W, Horan M, Scult M, Dickinson D, Straub RE, Donohoe G, Morris D, Corvin A, Gill M, Hariri A, Weinberger DR, Pendleton N, Iwata N, Darvasi A, Bitsios P, Rujescu D, Lahti J, Le Hellard S, Keller MC, Andreassen OA, Deary IJ, Glahn DC, Malhotra AK. Independent evidence for an association between general cognitive ability and a genetic locus for educational attainment. Am J Med Genet B Neuropsychiatr Genet 2015; 168B:363-73. [PMID: 25951819 PMCID: PMC4500051 DOI: 10.1002/ajmg.b.32319] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 04/15/2015] [Indexed: 11/08/2022]
Abstract
Cognitive deficits and reduced educational achievement are common in psychiatric illness; understanding the genetic basis of cognitive and educational deficits may be informative about the etiology of psychiatric disorders. A recent, large genome-wide association study (GWAS) reported a genome-wide significant locus for years of education, which subsequently demonstrated association to general cognitive ability ("g") in overlapping cohorts. The current study was designed to test whether GWAS hits for educational attainment are involved in general cognitive ability in an independent, large-scale collection of cohorts. Using cohorts in the Cognitive Genomics Consortium (COGENT; up to 20,495 healthy individuals), we examined the relationship between g and variants associated with educational attainment. We next conducted meta-analyses with 24,189 individuals with neurocognitive data from the educational attainment studies, and then with 53,188 largely independent individuals from a recent GWAS of cognition. A SNP (rs1906252) located at chromosome 6q16.1, previously associated with years of schooling, was significantly associated with g (P = 1.47 × 10(-4) ) in COGENT. The first joint analysis of 43,381 non-overlapping individuals for this a priori-designated locus was strongly significant (P = 4.94 × 10(-7) ), and the second joint analysis of 68,159 non-overlapping individuals was even more robust (P = 1.65 × 10(-9) ). These results provide independent replication, in a large-scale dataset, of a genetic locus associated with cognitive function and education. As sample sizes grow, cognitive GWAS will identify increasing numbers of associated loci, as has been accomplished in other polygenic quantitative traits, which may be relevant to psychiatric illness.
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Affiliation(s)
- Joey W. Trampush
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York,Hofstra North Shore – LIJ School of Medicine, Department of Psychiatry, Hempstead, New York,Correspondence: Joey W. Trampush, Zucker Hillside Hospital, Division of Psychiatry Research, 75-59 263 Street, Glen Oaks, NY, 11004, USA,
| | - Todd Lencz
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York,Hofstra North Shore – LIJ School of Medicine, Department of Psychiatry, Hempstead, New York
| | - Emma Knowles
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Gail Davies
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom,Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - Saurav Guha
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York
| | - Itsik Pe’er
- Department of Computer Science, Columbia University, New York, New York,Center for Computational Biology and Bioinformatics, Columbia University, New York, New York
| | - David C. Liewald
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
| | - John M. Starr
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom,Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, United Kingdom
| | - Srdjan Djurovic
- NorMent, KG Jebsen Centre, Oslo, Norway,Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- NorMent, KG Jebsen Centre, Oslo, Norway,Oslo University Hospital, Oslo, Norway,University of Oslo, Oslo, Norway
| | - Kjetil Sundet
- NorMent, KG Jebsen Centre, Oslo, Norway,University of Oslo, Oslo, Norway
| | - Andrea Christoforou
- K.G. Jebsen Centre for Psychosis Research, Dr. Einar Martens Research Group for Biological Psychiatry, Department of Clinical Medicine, University of Bergen, Bergen, Norway,Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - Ivar Reinvang
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Semanti Mukherjee
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Pamela DeRosse
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Astri Lundervold
- K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Norway,Department of Biological and Medical Psychology, University of Bergen, Norway,Kavli Research Centre for Aging and Dementia, Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Vidar M. Steen
- K.G. Jebsen Centre for Psychosis Research, Dr. Einar Martens Research Group for Biological Psychiatry, Department of Clinical Medicine, University of Bergen, Bergen, Norway,Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - Majnu John
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Thomas Espeseth
- Department of Psychology, University of Oslo, Oslo, Norway,K.G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Katri Räikkönen
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland
| | - Elisabeth Widen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Finland,Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Cambridge, United Kingdom,Department of Medical Genetics, University of Helsinki and University Central Hospital, Helsinki, Finland
| | - Johan G. Eriksson
- National Institute for Health and Welfare, Finland,Department of General Practice and Primary Health Care, University of Helsinki, Finland,Helsinki University Central Hospital, Unit of General Practice, Helsinki, Finland,Folkh€alsan Research Centre, Helsinki, Finland,Vasa Central Hospital, Vasa, Finland
| | - Ina Giegling
- Department of Psychiatry, University of Halle, Halle, Germany
| | - Bettina Konte
- Department of Psychiatry, University of Halle, Halle, Germany
| | - Masashi Ikeda
- Department of Psychiatry, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Panos Roussos
- Department of Psychiatry, The Mount Sinai School of Medicine, New York, New York
| | - Stella Giakoumaki
- Department of Psychology, School of Social Sciences, University of Crete, Greece
| | - Katherine E. Burdick
- Department of Psychiatry, The Mount Sinai School of Medicine, New York, New York
| | - Antony Payton
- Centre for Integrated Genomic Medical Research, University of Manchester, Manchester, United Kingdom
| | - William Ollier
- Centre for Integrated Genomic Medical Research, University of Manchester, Manchester, United Kingdom
| | - Mike Horan
- School of Community-Based Medicine, Neurodegeneration Research Group, University of Manchester, Manchester, United Kingdom
| | - Matthew Scult
- Laboratory of NeuroGenetics, Department of Psychology & Neuroscience, Duke University, Durham, North Carolina
| | - Dwight Dickinson
- Clinical Brain Disorders Brain and Genes, Cognition and Psychosis Program, Intramural Research Program, National Institute of Mental Health, National Institute of Health, Bethesda, Maryland
| | - Richard E. Straub
- Clinical Brain Disorders Brain and Genes, Cognition and Psychosis Program, Intramural Research Program, National Institute of Mental Health, National Institute of Health, Bethesda, Maryland,Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, Maryland
| | - Gary Donohoe
- Neuropsychiatric Genetics Research Group, Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Derek Morris
- Neuropsychiatric Genetics Research Group, Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Aiden Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Michael Gill
- Neuropsychiatric Genetics Research Group, Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Ahmad Hariri
- Laboratory of NeuroGenetics, Department of Psychology & Neuroscience, Duke University, Durham, North Carolina
| | - Daniel R. Weinberger
- Clinical Brain Disorders Brain and Genes, Cognition and Psychosis Program, Intramural Research Program, National Institute of Mental Health, National Institute of Health, Bethesda, Maryland,Lieber Institute for Brain Development, Johns Hopkins University Medical Campus, Baltimore, Maryland
| | - Neil Pendleton
- Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, United Kingdom
| | - Nakao Iwata
- Department of Psychiatry, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan
| | - Ariel Darvasi
- Department of Genetics, The Institute of Life Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Panos Bitsios
- Department of Psychiatry and Behavioral Sciences, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Dan Rujescu
- Department of Psychiatry, University of Halle, Halle, Germany
| | - Jari Lahti
- Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland,Institute of Genetics, Folkhälsan Research Centre, Helsinki, Finland
| | - Stephanie Le Hellard
- K.G. Jebsen Centre for Psychosis Research, Dr. Einar Martens Research Group for Biological Psychiatry, Department of Clinical Medicine, University of Bergen, Bergen, Norway,Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - Matthew C. Keller
- Institute for Behavioral Genetics, University of Colorado, Boulder, Colorado
| | - Ole A. Andreassen
- NorMent, KG Jebsen Centre, Oslo, Norway,Oslo University Hospital, Oslo, Norway,University of Oslo, Oslo, Norway
| | - Ian J. Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom,Department of Psychology, University of Edinburgh, Edinburgh, United Kingdom
| | - David C. Glahn
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Anil K. Malhotra
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York,Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York,Hofstra North Shore – LIJ School of Medicine, Department of Psychiatry, Hempstead, New York
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11
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Schaefer JD, Caspi A, Belsky DW, Harrington H, Houts R, Israel S, Levine ME, Sugden K, Williams B, Poulton R, Moffitt TE. Early-Life Intelligence Predicts Midlife Biological Age. J Gerontol B Psychol Sci Soc Sci 2015; 71:968-977. [PMID: 26014827 DOI: 10.1093/geronb/gbv035] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 04/13/2015] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Early-life intelligence has been shown to predict multiple causes of death in populations around the world. This finding suggests that intelligence might influence mortality through its effects on a general process of physiological deterioration (i.e., individual variation in "biological age"). We examined whether intelligence could predict measures of aging at midlife before the onset of most age-related disease. METHODS We tested whether intelligence assessed in early childhood, middle childhood, and midlife predicted midlife biological age in members of the Dunedin Study, a population-representative birth cohort. RESULTS Lower intelligence predicted more advanced biological age at midlife as captured by perceived facial age, a 10-biomarker algorithm based on data from the National Health and Nutrition Examination Survey (NHANES), and Framingham heart age (r = 0.1-0.2). Correlations between intelligence and telomere length were less consistent. The associations between intelligence and biological age were not explained by differences in childhood health or parental socioeconomic status, and intelligence remained a significant predictor of biological age even when intelligence was assessed before Study members began their formal schooling. DISCUSSION These results suggest that accelerated aging may serve as one of the factors linking low early-life intelligence to increased rates of morbidity and mortality.
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Affiliation(s)
- Jonathan D Schaefer
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina.
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina.,Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, UK
| | - Daniel W Belsky
- Social Science Research Institute, Duke University, Durham, North Carolina.,Department of Medicine, Duke University School of Medicine, Durham, North Carolina
| | - Honalee Harrington
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Renate Houts
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
| | - Salomon Israel
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina.,Department of Psychology, Hebrew University, Jerusalem, Israel
| | - Morgan E Levine
- Department of Human Genetics, University of California, Los Angeles, California
| | - Karen Sugden
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina.,Center for Genomic and Computational Biology, Duke University, Durham, North Carolina
| | - Benjamin Williams
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina.,Center for Genomic and Computational Biology, Duke University, Durham, North Carolina
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Terrie E Moffitt
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, UK.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina
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12
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Maenner MJ, Greenberg JS, Mailick MR. Association Between Low IQ Scores and Early Mortality in Men and Women: Evidence From a Population-Based Cohort Study. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2015; 120:244-257. [PMID: 25928436 PMCID: PMC4795820 DOI: 10.1352/1944-7558-120.3.244] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Lower (versus higher) IQ scores have been shown to increase the risk of early mortality, however, the underlying mechanisms are poorly understood and previous studies underrepresent individuals with intellectual disability (ID) and women. This study followed one third of all senior-year students (approximately aged 17) attending public high school in Wisconsin, U.S. in 1957 (n = 10,317) until 2011. Men and women with the lowest IQ test scores (i.e., IQ scores ≤ 85) had increased rates of mortality compared to people with the highest IQ test scores, particularly for cardiovascular disease. Importantly, when educational attainment was held constant, people with lower IQ test scores did not have higher mortality by age 70 than people with higher IQ test scores. Individuals with lower IQ test scores likely experience multiple disadvantages throughout life that contribute to increased risk of early mortality.
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13
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The smarter, the stronger: intelligence level correlates with brain resilience to systematic insults. Cortex 2014; 64:293-309. [PMID: 25569764 DOI: 10.1016/j.cortex.2014.11.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Revised: 09/14/2014] [Accepted: 11/11/2014] [Indexed: 12/28/2022]
Abstract
Neuroimaging evidences posit human intelligence as tightly coupled with several structural and functional brain properties, also suggesting its potential protective role against aging and neurodegenerative conditions. However, whether higher order cognition might in fact lead to a more resilient brain has not been quantitatively demonstrated yet. Here we document a relationship between individual intelligence quotient (IQ) and brain resilience to targeted and random attacks, as measured through resting-state fMRI graph-theoretical analysis in 102 healthy individuals. In this modeling context, enhanced brain robustness to targeted attacks (TA) in individuals with higher IQ is supported by an increased distributed processing capacity despite the systematic loss of the most important node(s) of the system. Moreover, brain resilience in individuals with higher IQ is supported by a set of neocortical regions mainly belonging to language and memory processing network(s), whereas regions related to emotional processing are mostly responsible for lower IQ individuals. Results suggest intelligence level among the predictors of post-lesional or neurodegenerative recovery, also promoting the evolutionary role of higher order cognition, and simultaneously suggesting a new framework for brain stimulation interventions aimed at counteract brain deterioration over time.
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14
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Flensborg-Madsen T, Mortensen EL. Infant SES as a predictor of personality--is the association mediated by intelligence? PLoS One 2014; 9:e103846. [PMID: 25078408 PMCID: PMC4117594 DOI: 10.1371/journal.pone.0103846] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 07/02/2014] [Indexed: 12/16/2022] Open
Abstract
Background Although research into the continuity and change of personality traits during a lifespan has been fairly extensive, little research has been conducted on childhood predictors of adult personality. Purpose We aimed to investigate the association between infant socioeconomic status (SES), and Eysenck personality traits in adulthood. An additional aim was to investigate whether intelligence and education may mediate this association. Methods SES of 9125 children in the Copenhagen Perinatal Cohort was recorded at a 1-year examination. A subsample of this cohort, comprising 1182 individuals, participated in a follow-up at 20–34 years and was administered the Eysenck Personality Questionnaire (EPQ) which includes measures of neuroticism, extraversion, psychoticism and the so-called lie-scale. Associations of SES with each of the four personality traits were analysed by bivariate and partial correlations, and the mediating effects of intelligence and years of education were analysed. Results Higher SES in infancy was associated with lower neuroticism (r = −0.06; p = 0.05), lower lie-scale scores (r = −0.11; p = 0.0002), and higher psychoticism (r = 0.09; p = 0.003). However, analyses of mediation revealed no direct effect of infant SES on any of the adult personality traits, but only indirect effects mediated by intelligence and years of education, with intelligence being the main mediating factor. Conclusion Only weak associations were observed between infant SES and personality in young adulthood, and the observed associations were mediated by adult intelligence and educational level. Thus, factors associated with infant SES or family background appears to have weak direct effects on personality development.
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Affiliation(s)
- Trine Flensborg-Madsen
- Unit of Medical Psychology, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | - Erik Lykke Mortensen
- Unit of Medical Psychology, Institute of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, The Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
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15
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Hagger-Johnson G, Deary IJ, Davies CA, Weiss A, Batty GD. Reaction time and mortality from the major causes of death: the NHANES-III study. PLoS One 2014; 9:e82959. [PMID: 24489645 PMCID: PMC3906008 DOI: 10.1371/journal.pone.0082959] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 10/30/2013] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Studies examining the relation of information processing speed, as measured by reaction time, with mortality are scarce. We explored these associations in a representative sample of the US population. METHODS Participants were 5,134 adults (2,342 men) aged 20-59 years from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-94). RESULTS Adjusted for age, sex, and ethnic minority status, a 1 SD slower reaction time was associated with a raised risk of mortality from all-causes (HR = 1.25, 95% CI 1.12, 1.39) and cardiovascular disease (CVD) (HR = 1.36, 95% CI 1.17, 1.58). Having 1 SD more variable reaction time was also associated with greater risk of all-cause (HR = 1.36, 95% CI 1.19, 1.55) and CVD (HR = 1.50, 95% CI 1.33, 1.70) mortality. No associations were observed for cancer mortality. The magnitude of the relationships was comparable in size to established risk factors in this dataset, such as smoking. INTERPRETATION Alongside better-established risk factors, reaction time is associated with increased risk of premature death and cardiovascular disease. It is a candidate risk factor for all-cause and cause-specific mortality.
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Affiliation(s)
- Gareth Hagger-Johnson
- Department of Epidemiology and Public Health, University College London (UCL), London, United Kingdom
| | - Ian J. Deary
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
| | - Carolyn A. Davies
- Medical Research Council (MRC)/Chief Scientist Office (CSO) Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Alexander Weiss
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
| | - G. David Batty
- Department of Epidemiology and Public Health, University College London (UCL), London, United Kingdom
- Department of Psychology, Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, United Kingdom
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Kajantie E, Räikkönen K, Henriksson M, Leskinen JT, Forsén T, Heinonen K, Pesonen AK, Osmond C, Barker DJP, Eriksson JG. Stroke is predicted by low visuospatial in relation to other intellectual abilities and coronary heart disease by low general intelligence. PLoS One 2012; 7:e46841. [PMID: 23144789 PMCID: PMC3492363 DOI: 10.1371/journal.pone.0046841] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2010] [Accepted: 09/09/2012] [Indexed: 11/18/2022] Open
Abstract
Background Low intellectual ability is associated with an increased risk of coronary heart disease and stroke. Most studies have used a general intelligence score. We studied whether three different subscores of intellectual ability predict these disorders. Methods We studied 2,786 men, born between 1934 and 1944 in Helsinki, Finland, who as conscripts at age 20 underwent an intellectual ability test comprising verbal, visuospatial (analogous to Raven's progressive matrices) and arithmetic reasoning subtests. We ascertained the later occurrence of coronary heart disease and stroke from validated national hospital discharge and death registers. Results 281 men (10.1%) had experienced a coronary heart disease event and 131 (4.7%) a stroke event. Coronary heart disease was predicted by low scores in all subtests, hazard ratios for each standard deviation (SD) lower score ranging from 1.21 to 1.30 (confidence intervals 1.08 to 1.46). Stroke was predicted by a low visuospatial reasoning score, the corresponding hazard ratio being 1.23 (95% confidence interval 1.04 to 1.46), adjusted for year and age at testing. Adjusted in addition for the two other scores, the hazard ratio was 1.40 (1.10 to 1.79). This hazard ratio was little affected by adjustment for socioeconomic status in childhood and adult life, whereas the same adjustments attenuated the associations between intellectual ability and coronary heart disease. The associations with stroke were also unchanged when adjusted for systolic blood pressure at 20 years and reimbursement for adult antihypertensive medication. Conclusions Stroke is predicted by low visuospatial reasoning scores in relation to scores in the two other subtests. This association may be mediated by common underlying causes such as impaired brain development, rather than by mechanisms associated with risk factors shared by stroke and coronary heart disease, such as socio-economic status, hypertension and atherosclerosis.
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Affiliation(s)
- Eero Kajantie
- National Institute for Health and Welfare, Helsinki, Finland.
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Goldfarb-Rumyantzev A, Barenbaum A, Rodrigue J, Rout P, Isaacs R, Mukamal K. New social adaptability index predicts overall mortality. Arch Med Sci 2011; 7:720-7. [PMID: 22291811 PMCID: PMC3258768 DOI: 10.5114/aoms.2011.24145] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2010] [Revised: 08/24/2010] [Accepted: 08/27/2010] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Definitions of underprivileged status based on race, gender and geographic location are neither sensitive nor specific; instead we proposed and validated a composite index of social adaptability (SAI). MATERIAL AND METHODS Index of social adaptability was calculated based on employment, education, income, marital status, and substance abuse, each factor contributing from 0 to 3 points. Index of social adaptability was validated in NHANES-3 by association with all-cause and cause-specific mortality. RESULTS Weighted analysis of 19,593 subjects demonstrated mean SAI of 8.29 (95% CI 8.17-8.40). Index of social adaptability was higher in Whites, followed by Mexican-Americans and then the African-American population (ANOVA, p < 0.001). The SAI was higher in subjects living in metropolitan compared to rural areas (T-test, p < 0.001), and was greater in men than in women (T-test, p < 0.001). In Cox models adjusted for age, comorbidity index, BMI, race, sex, geographic location, hemoglobin, serum creatinine, albumin, cholesterol, and glycated hemoglobin levels, SAI was inversely associated with mortality (HR 0.87 per point, 95% CI 0.84-0.90, p < 0.001). This association was confirmed in subgroups. CONCLUSIONS We proposed and validated an indicator of social adaptability with a strong association with mortality, which can be used to identify underprivileged populations at risk of death.
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Park JE, Chiang CE, Munawar M, Pham GK, Sukonthasarn A, Aquino AR, Khoo KL, Chan HWR. Lipid-lowering treatment in hypercholesterolaemic patients: the CEPHEUS Pan-Asian survey. Eur J Prev Cardiol 2011; 19:781-94. [PMID: 21450606 DOI: 10.1177/1741826710397100] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Treatment of hypercholesterolaemia in Asia is rarely evaluated on a large scale, and data on treatment outcome are scarce. The Pan-Asian CEPHEUS study aimed to assess low-density lipoprotein cholesterol (LDL-C) goal attainment among patients on lipid-lowering therapy. METHODS This survey was conducted in eight Asian countries. Hypercholesterolaemic patients aged ≥18 years who had been on lipid-lowering treatment for ≥3 months (stable medication for ≥6 weeks) were recruited, and lipid concentrations were measured. Demographic and other clinically relevant information were collected, and the cardiovascular risk of each patient was determined. Definitions and criteria set by the updated 2004 National Cholesterol Education Program guidelines were applied. RESULTS In this survey, 501 physicians enrolled 8064 patients, of whom 7281 were included in the final analysis. The mean age was 61.0 years, 44.4% were female, and 85.1% were on statin monotherapy. LDL-C goal attainment was reported in 49.1% of patients overall, including 51.2% of primary and 48.7% of secondary prevention patients, and 36.6% of patients with familial hypercholesterolaemia. The LDL-C goal was attained in 75.4% of moderate risk, 55.4% of high risk, and only 34.9% of very high-risk patients. Goal attainment was directly related to age and inversely related to cardiovascular risk and baseline LDL-C. CONCLUSION A large proportion of Asian hypercholesterolaemic patients on lipid-lowering drugs are not at recommended LDL-C levels and remain at risk for cardiovascular disease. Given the proven efficacy of lipid-lowering drugs in the reduction of LDL-C, there is room for further optimization of treatments to maximize benefits and improve outcomes.
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Affiliation(s)
- Jeong Euy Park
- Cardiology, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Kangnam Ku, Seoul, Korea.
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Calvin CM, Deary IJ, Fenton C, Roberts BA, Der G, Leckenby N, Batty GD. Intelligence in youth and all-cause-mortality: systematic review with meta-analysis. Int J Epidemiol 2010; 40:626-44. [PMID: 21037248 DOI: 10.1093/ije/dyq190] [Citation(s) in RCA: 214] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A number of prospective cohort studies have examined the association between intelligence in childhood or youth and life expectancy in adulthood; however, the effect size of this association is yet to be quantified and previous reviews require updating. METHODS The systematic review included an electronic search of EMBASE, MEDLINE and PSYCHINFO databases. This yielded 16 unrelated studies that met inclusion criteria, comprising 22,453 deaths among 1,107,022 participants. Heterogeneity was assessed, and fixed effects models were applied to the aggregate data. Publication bias was evaluated, and sensitivity analyses were conducted. RESULTS A 1-standard deviation (SD) advantage in cognitive test scores was associated with a 24% (95% confidence interval 23-25) lower risk of death, during a 17- to 69-year follow-up. There was little evidence of publication bias (Egger's intercept = 0.10, P = 0.81), and the intelligence-mortality association was similar for men and women. Adjustment for childhood socio-economic status (SES) in the nine studies containing these data had almost no impact on this relationship, suggesting that this is not a confounder of the intelligence-mortality association. Controlling for adult SES in five studies and for education in six studies attenuated the intelligence-mortality hazard ratios by 34 and 54%, respectively. CONCLUSIONS Future investigations should address the extent to which attenuation of the intelligence-mortality link by adult SES indicators is due to mediation, over-adjustment and/or confounding. The explanation(s) for association between higher early-life intelligence and lower risk of adult mortality require further elucidation.
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Affiliation(s)
- Catherine M Calvin
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK
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Deary IJ. Cognitive epidemiology: Its rise, its current issues, and its challenges. PERSONALITY AND INDIVIDUAL DIFFERENCES 2010. [DOI: 10.1016/j.paid.2009.11.012] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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