1.
Abe, Takafumi, et al.
(författare)
Assessing the impact of a hilly environment on depressive symptoms among community-dwelling older adults in japan : A cross-sectional study
2021
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:9
Tidskriftsartikel (refereegranskat) abstract
Although some neighborhood environmental factors have been found to affect depressive symptoms, few studies have focused on the impact of living in a hilly environment, i.e., land slope, on depressive symptoms among rural older adults. This cross-sectional study aimed to investigate whether a land slope is associated with depressive symptoms among older adults living in rural areas. Data were collected from 935 participants, aged 65 years and older, who lived in Shimane prefecture, Japan. Depressive symptoms were assessed using the Zung Self-Rating Depression Scale (SDS) and defined on the basis of an SDS score ≥ 40. Land slopes within a 400 m network buffer were assessed using geographic information systems. Odds ratios (ORs) with 95% confidence intervals (CIs) of depressive symptoms were estimated using logistic regression. A total of 215 (23.0%) participants reported depressive symptoms. The land slope was positively associated with depressive symptoms (OR = 1.04; 95% CI = 1.01–1.08) after adjusting for all confounders. In a rural setting, living in a hillier environment was associated with depressive symptoms among community-dwelling older adults in Japan.
2.
Ahrén, Jonatan, et al.
(författare)
A hypothesis - generating Swedish extended national cross-sectional family study of multimorbidity severity and venous thromboembolism
2023
Ingår i: BMJ Open. - 2044-6055. ; 13:6, s. 1-8
Tidskriftsartikel (refereegranskat) abstract
OBJECTIVES: Venous thromboembolism (VTE) is a common worldwide disease. The burden of multimorbidity, that is, two or more chronic diseases, has increased. Whether multimorbidity is associated with VTE risk remains to be studied. Our aim was to determine any association between multimorbidity and VTE and any possible shared familial susceptibility.DESIGN: A nationwide extended cross-sectional hypothesis - generating family study between 1997 and 2015.SETTING: The Swedish Multigeneration Register, the National Patient Register, the Total Population Register and the Swedish cause of death register were linked.PARTICIPANTS: 2 694 442 unique individuals were analysed for VTE and multimorbidity.MAIN OUTCOMES AND MEASURES: Multimorbidity was determined by a counting method using 45 non-communicable diseases. Multimorbidity was defined by the occurrence of ≥2 diseases. A multimorbidity score was constructed defined by 0, 1, 2, 3, 4 or 5 or more diseases.RESULTS: Sixteen percent (n=440 742) of the study population was multimorbid. Of the multimorbid patients, 58% were females. There was an association between multimorbidity and VTE. The adjusted odds ratio (OR) for VTE in individuals with multimorbidity (2 ≥ diagnoses) was 3.16 (95% CI: 3.06 to 3.27) compared with individuals without multimorbidity. There was an association between number of diseases and VTE. The adjusted OR was 1.94 (95% CI: 1.86 to 2.02) for one disease, 2.93 (95% CI: 2.80 to 3.08) for two diseases, 4.07 (95% CI: 3.85 to 4.31) for three diseases, 5.46 (95% CI: 5.10 to 5.85) for four diseases and 9.08 (95% CI: 8.56 to 9.64) for 5 ≥ diseases. The association between multimorbidity and VTE was stronger in males OR 3.45 (3.29 to 3.62) than in females OR 2.91 (2.77 to 3.04). There were significant but mostly weak familial associations between multimorbidity in relatives and VTE.CONCLUSIONS: Increasing multimorbidity exhibits a strong and increasing association with VTE. Familial associations suggest a weak shared familial susceptibility. The association between multimorbidity and VTE suggests that future cohort studies where multimorbidity is used to predict VTE might be worthwhile.
3.
4.
Ali Khan, Uzair, et al.
(författare)
Personal History of Diabetes as Important as Family History of Colorectal Cancer for Risk of Colorectal Cancer : A Nationwide Cohort Study
2020
Ingår i: The American journal of gastroenterology. - : Ovid Technologies (Wolters Kluwer Health). - 1572-0241 .- 0002-9270. ; 115:7, s. 1103-1109
Tidskriftsartikel (refereegranskat) abstract
INTRODUCTION: Diabetes mellitus (DM) and colorectal cancer (CRC) share some risk factors, including lifestyle and metabolic disturbances. We aimed to provide in-depth information on the association of CRC risk, especially early-onset CRC, with DM, family history of CRC, and age at DM diagnosis. METHODS: A nationwide cohort study was conducted using Swedish family cancer data sets, inpatient, and outpatient registers (follow-up: 1964-2015), including all individuals born after 1931 and their parents (12,614,256 individuals; 559,375 diabetic patients; 162,226 CRC patients). RESULTS: DM diagnosis before the age of 50 years was associated with a 1.9-fold increased risk of CRC before the age of 50 years (95% CI for standardized incidence ratio: 1.6-2.3) vs 1.3-fold risk of CRC at/after the age of 50 years (1.2-1.4). DM diagnosis before the age of 50 years in those with a family history of CRC was associated with 6.9-fold risk of CRC before the age of 50 years (4.1-12) and 1.9-fold risk of CRC at/after the age of 50 years (1.4-2.5). Diabetic patients had a similar lifetime risk of CRC before the age of 50 years (0.4%, 95% CI: 0.3%-0.4%) to those with only a family history of CRC (0.5%, 0.5%-0.5%), double that of the population (0.2%, 0.2%-0.2%). DISCUSSION: Our large cohort with valid information on DM and family history of cancer showed that DM is associated with increased risk of CRC in a magnitude close to having family history of CRC. Associations of DM and CRC family history with increased CRC risk were most prominent in young adults. These findings warrant further studies on harms, benefits, and cost-effectiveness of CRC screening in patients with diabetes, especially type 2, at earlier ages than in the general population.
5.
Amstadter, Ananda B., et al.
(författare)
Testing Phenotypic Models of Posttraumatic Stress Disorder and Alcohol Use Disorder Comorbidity Using Longitudinal Registry Data
2023
Ingår i: Journal of Studies on Alcohol and Drugs. - : Alcohol Research Documentation, Inc.. - 1937-1888 .- 1938-4114. ; 84:3, s. 378-388
Tidskriftsartikel (refereegranskat) abstract
Objective: Two predominant phenotypic models of causality exist to explain the high co-occurrence of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD): the self-medication and susceptibility models. Population-based longitudinal studies that simultaneously examine both models are needed. Thus, the goal of the pres-ent study is to test these models using the Swedish National Registries. Method: Registries were used to conduct longitudinal Cox proportional hazard models (n ≈ 1.5 million) and cross-lagged panel models (N ≈ 3.8 million) with follow-up periods of ~23 years. Results: Covarying for cohort and socioeconomic status, Cox proportional hazards model results found strong support for the self-medication model. Results showed that PTSD predicted increased risk for AUD among both men (HR = 4.58 [4.42, 4.74]) and women (HR = 4.14 [3.99, 4.30]), significantly more so for men (interaction HR = 1.11 [1.05, 1.16]). Support was also found for the susceptibility model, although the effects were lower in magnitude than those for the self-medication model. AUD increased risk for PTSD among men (HR = 2.53 [2.47, 2.60]) and women (HR = 2.06 [2.01, 2.12]), and significantly more so for men (interaction term HR = 1.23 [1.18, 1.28]). Cross-lagged model results of simultaneously testing both models found support for bidirectionality. The PTSD-to-AUD paths and the AUD-to-PTSD paths were of modest effect for men and women. Conclusions: The results from both complementary statistical approaches demonstrate that the models of comorbidity are not mutually exclusive. Although the Cox model results evidenced more support for the self-medication pathway, the cross-lagged model results suggest that the prospective relationships between these disorders are nuanced across development. (J. Stud. Alcohol Drugs, 84, 378–388, 2023).
6.
Andell, Pontus, et al.
(författare)
Neighborhood socioeconomic status and aortic stenosis : A Swedish study based on nationwide registries and an echocardiographic screening cohort
2020
Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 318, s. 153-159
Tidskriftsartikel (refereegranskat) abstract
Background: Aortic stenosis (AS) is the most common valvular heart disease in developed countries, confers high mortality in advanced cases, but can effectively be reversed using endovascular or open-heart surgery. We evaluated the association between AS and neighborhood socioeconomic status (NSES). Methods: We used Swedish population-based nationwide registers and an echocardiography screening cohort during the study period 1997–2014. NSES was determined by an established neighborhood deprivation index composed of education, income, unemployment, and receipt of social welfare. Multilevel adjusted logistic regression models determined the association between NSES and incident AS (according to ICD-10 diagnostic codes). Results: The study population of men and women (n=6,641,905) was divided into individuals living in high (n = 1,608,815 [24%]), moderate (n = 3,857,367 [58%]) and low (n = 1,175,723 [18%]) SES neighborhoods. There were 63,227 AS cases in total. Low NSES (versus high) was associated with a slightly increased risk of AS (OR 1.06 [95% CI 1.03–1.08]) in the nationwide study population. In the echocardiography screening cohort (n = 1586), the association between low NSES and AS was markedly stronger (OR: 2.73 [1.05–7.12]). There were more previously undiagnosed AS cases in low compared to high SES neighborhoods (3.1% versus 1.0%). Conclusions: In this nationwide Swedish register study, low NSES was associated with a slightly increased risk of incident AS. However, the association was markedly stronger in the echocardiography screening cohort, which revealed an almost three-fold increase of AS among individuals living in low SES neighborhoods, possibly indicating an underdiagnosis of AS among these individuals.
7.
Arvidsson, Daniel, et al.
(författare)
Cross-cultural validation of a simple self-report instrument of physical activity in immigrants from the Middle East and native Swedes.
2014
Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 42:3, s. 255-262
Tidskriftsartikel (refereegranskat) abstract
AIM: To investigate cross-cultural validity of a simple self-report instrument of physical activity intended to be used in Swedish health care. Methods: A validation study performed in 599 Iraqis (58% men) and 553 Swedes (53% men) aged 30-75 years living in the city of Malmö, Sweden. The self-report instrument by the Swedish National Board of Health and Welfare was compared to corresponding measures assessed from accelerometry as reference. Results: The agreement between the methods in assessing the participants as sufficiently/insufficiently physically active (cut-point 150 min/week) was 65% in the Iraqis and 52% in the Swedes (p<0.001). The proportion disagreement where the self-reported physical activity was sufficient but insufficient according to the accelerometry was 26% and 45% in Iraqis and Swedes, respectively. Physical activity time (min/week) was overestimated by self-report compared to accelerometry by 71% in the Iraqis and 115% in the Swedes (p<0.001). The smallest and largest overestimation was seen in Iraqi (57%) and Swedish (139%) women, respectively. The deviation of the self-report instrument compared to accelerometry was related to the physical activity level, as the overestimation mainly occurred at lower physical activity. Conclusions: The self-report instrument proposed by the Swedish National Board of Health and Welfare may overestimate the proportion sufficiently physically active, but to an extent depending on cultural background and gender.
8.
Arvidsson, Daniel, et al.
(författare)
Neighborhood Walkability, Income, and Hour-by-Hour Physical Activity Patterns.
2013
Ingår i: Medicine & Science in Sports & Exercise. - 1530-0315. ; 45:4, s. 698-705
Tidskriftsartikel (refereegranskat) abstract
PURPOSE: To investigate both the mean daily physical activity and the hour by hour physical activity pattern across the day using accelerometry, and how they are associated with neighborhood walkability and individual income. METHODS: Moderate physical activity (MPA) was assessed by accelerometry in 2,252 adults in the City of Stockholm, Sweden. Neighborhood walkability (residential density, street connectivity, land use mix) was objectively assessed within 1,000m network buffers around the participants´ residence and individual income was self-reported. RESULTS: Living in a high walkability neighborhood was associated with more mean daily MPA compared with living in a low walkability neighborhood on weekdays and weekend days. Hour by hour analyses showed that this association appeared mainly in the afternoon/early evening during weekdays, while it appeared across the middle of the day during weekend days. Individual income was associated with mean daily MPA on weekend days. On weekdays, the hour by hour analyses showed that high income was associated with more MPA around noon and in late afternoon/early evening, while low income was associated with more MPA at the hours before noon and in the early afternoon. During the weekend, high income was more consistently associated with higher MPA. CONCLUSIONS: Hour by hour accelerometry physical activity patterns provides a more comprehensive picture of the associations between neighborhood walkability and individual income and physical activity and the variability of these associations across the day.
9.
Arvidsson, Daniel, et al.
(författare)
Physical Activity and Concordance between Objective and Perceived Walkability.
2012
Ingår i: Medicine & Science in Sports & Exercise. - 1530-0315. ; 44, s. 280-287
Tidskriftsartikel (refereegranskat) abstract
PURPOSE:: To investigate concordance between objective and perceived neighborhood walkability, their associations with self-reported walking and objective physical activity, and sociodemographic characteristics of individuals in neighborhoods with objectively assessed high walkability who misperceive it as low. METHODS:: In 1,925 individuals aged 20-66 years, recruited from administrative areas in the city of Stockholm, Sweden, of both high and low neighborhood walkability, objective neighborhood walkability was assessed within a 1,000m radius of each individual's residential address using Geographic Information Systems (GIS). Perceived walkability was based on the Neighborhood Environment Walkability Scale (NEWS). Walking was assessed using the International Physical Activity Questionnaire (IPAQ), and total physical activity and moderate-to-vigorous physical activity (MVPA) by an accelerometer (ActiGraph). Sociodemographic characteristics were self-reported. RESULTS:: Objective and perceived neighborhood walkability agreed in 67.0% of the individuals, with kappa=0.34 (95% CI: 0.30-0.38). One-third of the individuals in neighborhoods with objectively assessed high walkability misperceived it as low. This non-concordance was more common among older and married/cohabiting individuals. After adjustment for sociodemographic characteristics, high objective neighborhood walkability was associated with 35.0 (95% CI: 14.6-64.6) and 10.5 (95% CI: -5.2-28.5) more minutes/week of walking for transportation and leisure, respectively, and 2.8 (95% CI: 0.9-5.0) more minutes/day of MVPA. High perceived neighborhood walkability was associated with 41.5 (95% CI: 15.8-62.9) and 21.8 (95% CI: 2.8-40.0) more minutes/week of walking for transportation and leisure, respectively, and 1.7 (95% CI: -0.3-3.7) more minutes/day of MVPA. CONCLUSIONS:: Objective and perceived neighborhood walkability both contribute to the amount of walking and objective physical activity. Both measures of neighborhood walkability may be important factors to target in interventions aiming at increasing physical activity.
10.
Aturinde, Augustus, et al.
(författare)
Analysis of spatial co-occurrence between cancer and cardiovascular disease mortality and its spatial variation among the Swedish elderly (2010–2015)
2020
Ingår i: Applied Geography. - : Elsevier BV. - 0143-6228. ; 125
Tidskriftsartikel (refereegranskat) abstract
CVD and cancer are the two leading causes of death worldwide. Improvement in cancer early detection and treatment has resulted in an increased number of cancer survivors. However, many of the survivors tend to develop CVD often leading to their demise. Conversely, people with pre-existing CVD conditions, especially the elderly, have increased chances of developing cancer and dying from the same. The World Health Organization, consequently, recommends joint management of both diseases. However, in Sweden, as with many other countries, few studies have explored the nature of the associations between the two disease mortalities and their spatial variation at a population level. This study uses correlation, global Moran's index and global bivariate Moran's index to investigate national trends of cancer and CVD crude mortality rates in the Swedish elderly. Spatial scan statistics, spatial overlay and local entropy maps were used to analyse for spatial co-occurrence, local joint spatial clustering and associations in the 2010–2015 cancer and CVD crude mortality rates for the Swedish elderly (65+ years). Mortality data were obtained from the Swedish Healthcare Registry. Our results showed that throughout the years of study, the correlation between cancer and CVD crude mortality rates was averagely positive. Spatial correlation analysis (univariate and bivariate) showed that the contribution of the neighbourhood mortality rates to the observed mortality rates was weak, though significant. From cluster analysis, the cancer and CVD crude mortality rates showed differences in clustering spatial scales with CVD clustering at a smaller scale. Finally, local entropy maps showed that cancer and CVD crude mortality rates were not always related across Sweden, but whenever they were, the relationship was mainly positive and linear. This study contributes to cancer and CVD public health efforts in Sweden by identifying areas where the two causes of death spatially co-occur, and where the two exhibit no spatial overlap. This provides a valuable starting ground for more focused studies to identify local drivers and/or informs coordinated targeted intervention in both causes of death.
