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Mitchell JJ, Hamer M, Blodgett JM, Wannamethee GS, Jefferis BJ. Associations between sporting physical activity and cognition in mid and later-life: Evidence from two cohorts. Scand J Med Sci Sports 2023; 33:1570-1575. [PMID: 37254468 PMCID: PMC10947539 DOI: 10.1111/sms.14412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 04/15/2023] [Accepted: 05/15/2023] [Indexed: 06/01/2023]
Abstract
Evidence has linked sporting leisure time physical activity (sporting-LTPA) to healthy cognition throughout adulthood. This may be due to the physiological effects of physical activity (PA), or to other, psychosocial facets of sport. We examined associations between sporting-LTPA and cognition while adjusting for device-measured PA volume devoid of context, both in midlife (N = 4041) participants from the 1970 British Cohort Study and later-life (N = 957) participants from the British Regional Heart Study. Independent of device-measured PA, we identified positive associations between sporting-LTPA and cognition. Sports with team/partner elements were strongly positively associated with cognition, suggesting LTPA context may be critical to this relationship.
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Affiliation(s)
- J. J. Mitchell
- Department of Primary Care and Population HealthUpper Third Floor UCL Medical School (Royal Free Campus)LondonUK
- Division of Surgery and Interventional Sciences, Faculty Medical Sciences, Institute of Sport Exercise & HealthUniversity College LondonLondonUK
| | - M. Hamer
- Division of Surgery and Interventional Sciences, Faculty Medical Sciences, Institute of Sport Exercise & HealthUniversity College LondonLondonUK
| | - J. M. Blodgett
- Division of Surgery and Interventional Sciences, Faculty Medical Sciences, Institute of Sport Exercise & HealthUniversity College LondonLondonUK
| | - G. S. Wannamethee
- Department of Primary Care and Population HealthUpper Third Floor UCL Medical School (Royal Free Campus)LondonUK
| | - B. J. Jefferis
- Department of Primary Care and Population HealthUpper Third Floor UCL Medical School (Royal Free Campus)LondonUK
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Schmidt AF, Hingorani AD, Jefferis BJ, White J, Groenwold R, Dudbridge F. Comparison of variance estimators for meta-analysis of instrumental variable estimates. Int J Epidemiol 2018; 45:1975-1986. [PMID: 27591262 PMCID: PMC5654757 DOI: 10.1093/ije/dyw123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2016] [Indexed: 12/16/2022] Open
Abstract
Background: Mendelian randomization studies perform instrumental variable (IV) analysis using genetic IVs. Results of individual Mendelian randomization studies can be pooled through meta-analysis. We explored how different variance estimators influence the meta-analysed IV estimate. Methods: Two versions of the delta method (IV before or after pooling), four bootstrap estimators, a jack-knife estimator and a heteroscedasticity-consistent (HC) variance estimator were compared using simulation. Two types of meta-analyses were compared, a two-stage meta-analysis pooling results, and a one-stage meta-analysis pooling datasets. Results: Using a two-stage meta-analysis, coverage of the point estimate using bootstrapped estimators deviated from nominal levels at weak instrument settings and/or outcome probabilities ≤ 0.10. The jack-knife estimator was the least biased resampling method, the HC estimator often failed at outcome probabilities ≤ 0.50 and overall the delta method estimators were the least biased. In the presence of between-study heterogeneity, the delta method before meta-analysis performed best. Using a one-stage meta-analysis all methods performed equally well and better than two-stage meta-analysis of greater or equal size. Conclusions: In the presence of between-study heterogeneity, two-stage meta-analyses should preferentially use the delta method before meta-analysis. Weak instrument bias can be reduced by performing a one-stage meta-analysis.
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Affiliation(s)
| | | | - B J Jefferis
- Department of Primary Care and Population Health
| | - J White
- UCL Genetics Institute, University College London, London, UK
| | - Rhh Groenwold
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - F Dudbridge
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Anokye N, Anagnostou A, Lord J, Taylor S, Vali Y, Foster C, Whincup P, Jefferis BJ, Fox-Rushby J. A ′microsimulation′ model for assessing the cost effectiveness of physical activity interventions. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw164.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N Anokye
- Health Economics Research Group (HERG), Brunel University London, London, UK
| | - A Anagnostou
- Department of Computer Science, Brunel University London, London, UK
| | - J Lord
- Southampton Health Technology Assessment Centres, University of Southampton, Southhampton, UK
| | - S Taylor
- Department of Computer Science, Brunel University London, London, UK
| | - Y Vali
- Health Economics Research Group (HERG), Brunel University London, London, UK
| | - C Foster
- Nuffield Department of Population Health, Oxford University, Osford, UK
| | - P Whincup
- Population Health Research Institute, St George’s University of London, London, UK
| | - BJ Jefferis
- Institute of Epidemiology & Health, University College London, London, UK
| | - J Fox-Rushby
- Health Economics Research Group (HERG), Brunel University London, London, UK
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Sartini C, Barry SJE, Whincup PH, Wannamethee SG, Lowe GDO, Jefferis BJ, Lennon L, Welsh P, Ford I, Morris RW. P33 Associations of outdoor temperature and cardiovascular disease risk factors in the elderly: evidence from two Northern European prospective studies. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Aggio DA, Sartini C, Papacosta O, Lennon LT, Ash S, Whincup PH, Wannamethee SG, Jefferis BJ. P135 Association of objectively measured physical activity and sedentary time with sarcopenia, severe sarcopenia and sarcopenic obesity in older men. Br J Soc Med 2016. [DOI: 10.1136/jech-2016-208064.231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Sartini C, Wannamethee SG, Iliffe S, Morris RW, Ash S, Lennon L, Whincup PH, Jefferis BJ. OP93 Objectively measured physical activity and sedentary behaviour in older men: diurnal patterns and their determinants. Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.92] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Parsons TJ, Sartini C, Ellins EA, Halcox JPJ, Smith K, Lennon LT, Ash S, Wannamethee SG, Whincup PH, Jefferis BJ. OP94 Physical activity and carotid intima thickness in older men: cross sectional analysis from the british regional heart study. Br J Soc Med 2015. [DOI: 10.1136/jech-2015-206256.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Jefferis BJ, Iliffe S, Kerse N, Kendrick D, Trost S, Lennon LT, Ash S, Wannamethee SG, Morris R, Whincup PH. OP16 How is Objectively Measured Physical Activity Associated with Falls and fear of Falling in Older Community Dwelling Men? Br J Soc Med 2012. [DOI: 10.1136/jech-2012-201753.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Jefferis BJ, Whincup PH, Welsh P, Wannamethee SG, Rumley A, Lawlor DA, Ebrahim S, Lowe GDO. Prospective study of circulating soluble CD40 ligand concentrations and the incidence of cardiovascular disease in a nested prospective case-control study of older men and women. J Thromb Haemost 2012. [PMID: 21696538 DOI: 10.1111/j.1538-7836.2011.04415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND CD40 ligand(CD40L) is implicated in atherosclerotic plaque formation. OBJECTIVES We investigated prospective associations between circulating soluble CD40L and myocardial infraction (MI) or stroke in an older general population cohort, accounting for established and novel cardiovascular risk factors. METHODS Baseline serum CD40L (sCD40L) was measured in incident MI (n = 368) and stroke (n = 304) cases and two controls per case, 'nested' in prospective UK studies of 4252 men and 4286 women aged 60-79 years, sampled from general practices in Britain in 1998-2000, with 7-year follow-up for fatal and non-fatal MI and stroke. RESULTS sCD40L was higher in smokers and negatively associated with lung function and positively associated with total cholesterol and markers of inflammation, but not with other established cardiovascular disease (CVD) risk factors. Geometric mean sCD40L levels did not differ between MI cases and controls (5.94 ng mL(-1) vs. 5.82 ng mL(-1); P = 0.5) or between stroke cases and controls (5.61 ng mL(-1) vs. 5.28 ng mL(-1), P = 0.1). There was no strong evidence for elevated risk of MI or stroke in multivariable models comparing participants in the top to those in the bottom third of sCD40L. Age-adjusted odds ratios (ORs) were 1.39 [95% confidence interval (CI) 0.98, 1.96] for MI and 1.16 (0.78, 1.73) for stroke. These attenuated to 1.24 (95% CI 0.86, 1.79) and 1.18 (0.78, 1.78), respectively, after adjustment for established and novel CVD risk factors. CONCLUSIONS sCD40L is associated with other inflammatory markers but is not itself a strong independent risk marker for either stroke or MI.
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Affiliation(s)
- B J Jefferis
- Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London, UK.
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Jefferis BJ, Whincup PH, Welsh P, Wannamethee SG, Rumley A, Lawlor DA, Ebrahim S, Lowe GDO. Prospective study of circulating soluble CD40 ligand concentrations and the incidence of cardiovascular disease in a nested prospective case-control study of older men and women. J Thromb Haemost 2011; 9:1452-9. [PMID: 21696538 DOI: 10.1111/j.1538-7836.2011.04415.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND CD40 ligand(CD40L) is implicated in atherosclerotic plaque formation. OBJECTIVES We investigated prospective associations between circulating soluble CD40L and myocardial infraction (MI) or stroke in an older general population cohort, accounting for established and novel cardiovascular risk factors. METHODS Baseline serum CD40L (sCD40L) was measured in incident MI (n = 368) and stroke (n = 304) cases and two controls per case, 'nested' in prospective UK studies of 4252 men and 4286 women aged 60-79 years, sampled from general practices in Britain in 1998-2000, with 7-year follow-up for fatal and non-fatal MI and stroke. RESULTS sCD40L was higher in smokers and negatively associated with lung function and positively associated with total cholesterol and markers of inflammation, but not with other established cardiovascular disease (CVD) risk factors. Geometric mean sCD40L levels did not differ between MI cases and controls (5.94 ng mL(-1) vs. 5.82 ng mL(-1); P = 0.5) or between stroke cases and controls (5.61 ng mL(-1) vs. 5.28 ng mL(-1), P = 0.1). There was no strong evidence for elevated risk of MI or stroke in multivariable models comparing participants in the top to those in the bottom third of sCD40L. Age-adjusted odds ratios (ORs) were 1.39 [95% confidence interval (CI) 0.98, 1.96] for MI and 1.16 (0.78, 1.73) for stroke. These attenuated to 1.24 (95% CI 0.86, 1.79) and 1.18 (0.78, 1.78), respectively, after adjustment for established and novel CVD risk factors. CONCLUSIONS sCD40L is associated with other inflammatory markers but is not itself a strong independent risk marker for either stroke or MI.
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Affiliation(s)
- B J Jefferis
- Department of Primary Care and Population Health, UCL Medical School, Rowland Hill Street, London, UK.
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Jefferis BJ, Lawlor DA, Ebrahim S, Wannamethee SG, Feyerabend C, Doig M, McMeekin L, Cook DG, Whincup PH. Cotinine-assessed second-hand smoke exposure and risk of cardiovascular disease in older adults. Heart 2010; 96:854-9. [PMID: 20478864 PMCID: PMC2921288 DOI: 10.1136/hrt.2009.191148] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Objectives To examine whether second-hand smoke (SHS) exposure measured by serum cotinine is associated with increased coronary heart disease (CHD) and stroke risk among contemporary older British adults. Design Prospective population-based study with self-reported medical history and health behaviours. Fasting blood samples were analysed for serum cotinine and cardiovascular disease (CVD) risk markers. Setting Primary care centres in 25 British towns in 1998–2001. Patients 8512 60–79-year-old men and women selected from primary care registers. Main outcome measures Fatal and non-fatal myocardial infarction (MI; n=445) and stroke (n=386) during median 7.8-year follow-up. Main exposure Observational study of serum cotinine assayed from fasting blood sample using liquid chromatography tandem mass spectrometry method, and self-reported smoking history. Results Among 5374 non-smokers without pre-existing CVD, geometric mean cotinine was 0.15 ng/ml (IQR 0.05–0.30). Compared with non-smokers with cotinine ≤0.05 ng/ml, higher cotinine levels (0.06–0.19, 0.2–0.7 and 0.71–15.0 ng/ml) showed little association with MI; adjusted HRs were 0.92 (95% CI 0.63 to 1.35), 1.07 (0.73 to 1.55) and 1.09 (0.69 to 1.72), p(trend)=0.69. Equivalent HRs for stroke were 0.82 (0.55 to 1.23), 0.74 (0.48 to 1.13) and 0.69 (0.41 to 1.17), p(trend)=0.065. The adjustment for sociodemographic, behavioural and CVD risk factors had little effect on the results. The HR of MI for smokers (1–9 cigarettes/day) compared with non-smokers with cotinine ≤0.05 ng/ml was 2.14 (1.39 to 3.52) and 1.03 (0.52 to 2.04) for stroke. Conclusions In contemporary older men and women, SHS exposure (predominantly at low levels) was not related to CHD or stroke risks, but we cannot rule out the possibility of modest effects at higher exposure levels.
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Affiliation(s)
- B J Jefferis
- UCL Department of Primary Care and Population Health, UCL Medical School, London, UK.
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Jefferis BJ, Nazareth I, Marston L, King M. 024 Prospective cohort study of unemployment and clinical depression in Europe and Chile: the Predict Study. Br J Soc Med 2010. [DOI: 10.1136/jech.2010.120956.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Jefferis BJ, Lowe GDO, Welsh P, Lawlor DA, Ebrahim S, Wannamethee SG, Cook DG, Whincup PH. Secondhand smoke exposure assessed using serum cotinine: associations with myocardial infarction, stroke and cardiovascular risk factors in adult men and women. Br J Soc Med 2009. [DOI: 10.1136/jech.2009.096735n] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Jefferis BJ, Lowe GDO, Welsh P, Rumley A, Lawlor DA, Ebrahim S, Carson C, Doig M, Feyerabend C, McMeekin L, Wannamethee SG, Cook DG, Whincup PH. Secondhand smoke (SHS) exposure is associated with circulating markers of inflammation and endothelial function in adult men and women. Atherosclerosis 2009; 208:550-6. [PMID: 19700161 PMCID: PMC2822956 DOI: 10.1016/j.atherosclerosis.2009.07.044] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2009] [Revised: 07/02/2009] [Accepted: 07/21/2009] [Indexed: 01/18/2023]
Abstract
AIMS Secondhand smoke (SHS) exposure is associated with elevated CHD risks. Yet the pathways through which this may operate have not been investigated in epidemiologic studies with objective SHS exposure measures and a wide range of CHD risk factors associated with active smoking. Therefore we investigate associations between SHS exposure and CHD risk factors, to clarify how SHS exposure may raise risk of CHD. METHODS Cross-sectional population-based study of 5029 men and women aged 59-80 years from primary care practices in Great Britain. Smoking, behavioural and demographic information was reported in questionnaires; nurses made physical measurements and took blood samples for analysis of serum cotinine and markers of inflammation, hemostasis and endothelial dysfunction. RESULTS Active cigarette smokers had lower albumin and higher triglycerides, CRP, IL-6, white cell count, fibrinogen, blood viscosity, factor VIII, VWF and t-PA than non-smokers. Among non-smokers, serum cotinine levels were independently positively associated with CRP, fibrinogen, factor VIII, VWF and t-PA and inversely associated with albumin, after adjustment for age, gender, social and behavioural factors. The differences in CRP, fibrinogen and albumin between cotinine < or =0.05 and >0.7 ng/ml were one-third to one half the size of differences between cotinine < or =0.05 ng/ml and current smokers, but were of similar magnitude for VWF and t-PA. CONCLUSIONS Endothelial, inflammatory and haemostatic markers related to CHD risk showed independent associations with SHS exposure in the same direction as those for active smoking. Results aid understanding of the associations between SHS exposure and elevated CHD risks.
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Affiliation(s)
- B J Jefferis
- Department Primary Care & Population Health, UCL Medical School, Rowland Hill St, NW3 2PF, London, UK.
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