Compulsive buying disorder clustering based on sex, age, onset and personality traits.

PubMed

Granero, Roser; Fernández-Aranda, Fernando; Baño, Marta; Steward, Trevor; Mestre-Bach, Gemma; Del Pino-Gutiérrez, Amparo; Moragas, Laura; Mallorquí-Bagué, Núria; Aymamí, Neus; Goméz-Peña, Mónica; Tárrega, Salomé; Menchón, José M; Jiménez-Murcia, Susana

2016-07-01

In spite of the revived interest in compulsive buying disorder (CBD), its classification into the contemporary nosologic systems continues to be debated, and scarce studies have addressed heterogeneity in the clinical phenotype through methodologies based on a person-centered approach. To identify empirical clusters of CBD employing personality traits, as well as patients' sex, age and the age of CBD onset as indicators. An agglomerative hierarchical clustering method defining a combination of the Schwarz Bayesian Information Criterion and log-likelihood was used. Three clusters were identified in a sample of n=110 patients attending a specialized CBD unit a) "male compulsive buyers" reported the highest prevalence of comorbid gambling disorder and the lowest levels of reward dependence; b) "female low-dysfunctional" mainly included employed women, with the highest level of education, the oldest age of onset, the lowest scores in harm avoidance and the highest levels of persistence, self-directedness and cooperativeness; and c) "female highly-dysfunctional" with the youngest age of onset, the highest levels of comorbid psychopathology and harm avoidance, and the lowest score in self-directedness. Sociodemographic characteristics and personality traits can be used to determine CBD clusters which represent different clinical subtypes. These subtypes should be considered when developing assessment instruments, preventive programs and treatment interventions. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparison of polysomnographic data in age-, sex- and Axis I psychiatric diagnosis matched HIV-seropositive and HIV-seronegative insomnia patients.

PubMed

Low, Yinghui; Goforth, Harold W; Omonuwa, Toma; Preud'homme, Xavier; Edinger, Jack; Krystal, Andrew

2012-12-01

There is a high prevalence of insomnia in HIV-seropositive patients. Insomnia is associated with poorer disease outcomes, cognitive impairment and HIV-associated dementia. However there is limited data characterizing the type of sleep disturbances, and the cause. Previous studies report conflicting results, and observed changes in the distribution of REM and SWS were hypothesized to result from co-morbid mood disorders, although this is not established. We carried out this study to determine if there are differences in polysomnographic (PSG) sleep data in age-, sex- and Axis I diagnoses- matched HIV-seropositive and HIV-seronegative patients. Eighteen HIV-seropositive insomniacs were matched to HIV-seronegative insomniacs based on age, sex and Axis I diagnoses. Participants spent 2 consecutive nights in a sleep lab recording of PSG data. Multivariate analysis revealed an overall significant match-by-variable interaction (p=0.0126). Follow-up analysis show that compared to HIV-seronegative insomnia controls, HIV-seropositive insomniacs have significantly longer SOL, 8% decreased sleep efficiency, and 8-10% decreased time spent in REM sleep (p's<0.05). This study provides preliminary evidence that even after accounting for differences in age, sex and psychiatric diagnoses, HIV-seropositive patients with insomnia have significantly worse sleep than HIV-seronegative patients with insomnia. Unlike what previous authors have proposed, our results do not support the view that comorbid psychiatric disorders like depression are responsible for the observed differences in PSG findings and the greater incidence of insomnia, in HIV-seropositive patients when compared with other groups of insomnia patients. This suggests the presence of other etiologies including neuronal damage, psychosocial stressors, or comorbid medical conditions. Further studies are needed to determine the extent to which these play a role in insomnia in the HIV-seropositive population. Copyright © 2012

Comorbidity, age of onset and suicidality in obsessive-compulsive disorder (OCD): An international collaboration.

PubMed

Brakoulias, V; Starcevic, V; Belloch, A; Brown, C; Ferrao, Y A; Fontenelle, L F; Lochner, C; Marazziti, D; Matsunaga, H; Miguel, E C; Reddy, Y C J; do Rosario, M C; Shavitt, R G; Shyam Sundar, A; Stein, D J; Torres, A R; Viswasam, K

2017-07-01

To collate data from multiple obsessive-compulsive disorder (OCD) treatment centers across seven countries and five continents, and to report findings in relation to OCD comorbidity, age of onset of OCD and comorbid disorders, and suicidality, in a large clinical and ethnically diverse sample, with the aim of investigating cultural variation and the utility of the psychiatric diagnostic classification of obsessive-compulsive and related disorders. Researchers in the field of OCD were invited to contribute summary statistics on current and lifetime psychiatric comorbidity, age of onset of OCD and comorbid disorders and suicidality in their patients with OCD. Data from 3711 adult patients with primary OCD came from Brazil (n=955), India (n=802), Italy (n=750), South Africa (n=565), Japan (n=322), Australia (n=219), and Spain (n=98). The most common current comorbid disorders were major depressive disorder (28.4%; n=1055), obsessive-compulsive personality disorder (24.5%, n=478), generalized anxiety disorder (19.3%, n=716), specific phobia (19.2%, n=714) and social phobia (18.5%, n=686). Major depression was also the most commonly co-occurring lifetime diagnosis, with a rate of 50.5% (n=1874). OCD generally had an age of onset in late adolescence (mean=17.9years, SD=1.9). Social phobia, specific phobia and body dysmorphic disorder also had an early age of onset. Co-occurring major depressive disorder, generalized anxiety disorder and psychotic disorders tended to have a later age of onset than OCD. Suicidal ideation within the last month was reported by 6.4% (n=200) of patients with OCD and 9.0% (n=314) reported a lifetime history of suicide attempt. In this large cross-continental study, comorbidity in OCD was common. The high rates of comorbid major depression and anxiety disorders emphasize the need for clinicians to assess and monitor for these disorders. Earlier ages of onset of OCD, specific phobia and social phobia may indicate some relatedness between these

The challenge of comorbidity in clinical trials for multiple sclerosis.

PubMed

Marrie, Ruth Ann; Miller, Aaron; Sormani, Maria Pia; Thompson, Alan; Waubant, Emmanuelle; Trojano, Maria; O'Connor, Paul; Reingold, Stephen; Cohen, Jeffrey A

2016-04-12

We aimed to provide recommendations for addressing comorbidity in clinical trial design and conduct in multiple sclerosis (MS). We held an international workshop, informed by a systematic review of the incidence and prevalence of comorbidity in MS and an international survey about research priorities for studying comorbidity including their relation to clinical trials in MS. We recommend establishing age- and sex-specific incidence estimates for comorbidities in the MS population, including those that commonly raise concern in clinical trials of immunomodulatory agents; shifting phase III clinical trials of new therapies from explanatory to more pragmatic trials; describing comorbidity status of the enrolled population in publications reporting clinical trials; evaluating treatment response, tolerability, and safety in clinical trials according to comorbidity status; and considering comorbidity status in the design of pharmacovigilance strategies. Our recommendations will help address knowledge gaps regarding comorbidity that interfere with the ability to interpret safety in monitored trials and will enhance the generalizability of findings from clinical trials to "real world" settings where the MS population commonly has comorbid conditions. © 2016 American Academy of Neurology.

The challenge of comorbidity in clinical trials for multiple sclerosis

PubMed Central

Miller, Aaron; Sormani, Maria Pia; Thompson, Alan; Waubant, Emmanuelle; Trojano, Maria; O'Connor, Paul; Reingold, Stephen; Cohen, Jeffrey A.

2016-01-01

Objective: We aimed to provide recommendations for addressing comorbidity in clinical trial design and conduct in multiple sclerosis (MS). Methods: We held an international workshop, informed by a systematic review of the incidence and prevalence of comorbidity in MS and an international survey about research priorities for studying comorbidity including their relation to clinical trials in MS. Results: We recommend establishing age- and sex-specific incidence estimates for comorbidities in the MS population, including those that commonly raise concern in clinical trials of immunomodulatory agents; shifting phase III clinical trials of new therapies from explanatory to more pragmatic trials; describing comorbidity status of the enrolled population in publications reporting clinical trials; evaluating treatment response, tolerability, and safety in clinical trials according to comorbidity status; and considering comorbidity status in the design of pharmacovigilance strategies. Conclusion: Our recommendations will help address knowledge gaps regarding comorbidity that interfere with the ability to interpret safety in monitored trials and will enhance the generalizability of findings from clinical trials to “real world” settings where the MS population commonly has comorbid conditions. PMID:26888986

Shoulder joint impairment among Finns aged 30 years or over: prevalence, risk factors and co-morbidity.

PubMed

Mäkelä, M; Heliövaara, M; Sainio, P; Knekt, P; Impivaara, O; Aromaa, A

1999-07-01

To describe the prevalence, risk factors and consequences of shoulder joint impairment in the population. A representative sample (n = 7217) of the Finnish population aged > or = 30 yr participated in a health examination survey (the Mini-Finland Health Survey). The design of the survey allowed an independent assessment of disability, reported shoulder pain, shoulder joint impairment and major chronic co-morbidity. Shoulder impairment was observed in 8.8%, while pain was reported by 30%. The prevalence of shoulder pain decreased among the elderly, whereas impairments increased up to 20% of those aged 75-80 yr. In addition to age, sex, previous injury to the shoulder joint and a history of physically heavy work, diabetes was associated with shoulder impairment (OR 1.6, 95% CI 1.2-2.1). Shoulder impairment was associated with disability (adjusted OR 2.0, CI 1.6-2.5). Shoulder impairment is an important component of ill health among the elderly, and cannot be reduced to reported pain alone.

What Can ADHD without Comorbidity Teach Us about Comorbidity?

ERIC Educational Resources Information Center

Takeda, Toshinobu; Ambrosini, Paul J.; deBerardinis, Rachel; Elia, Josephine

2012-01-01

Neuropsychiatric comorbidity in ADHD is frequent, impairing and poorly understood. In this report, characteristics of comorbid and comorbid-free ADHD subjects are investigated in an attempt to identify differences that could potentially advance our understanding of risk factors. In a clinically-referred ADHD cohort of 449 youths (ages 6-18), age,…

Relation between age, comorbidity, and complications in patients undergoing major surgery for head and neck cancer.

PubMed

Peters, Thomas T A; van Dijk, Boukje A C; Roodenburg, Jan L N; van der Laan, Bernard F A M; Halmos, Gyorgy B

2014-03-01

Multiple factors have been identified as predictors of complication after head and neck surgery. However, little is known about the exact role of different comorbid conditions in the development of postoperative complications. This question is especially interesting in the elderly population. The aim of this study was to investigate the association between comorbidity and types of postoperative complications with special attention to age differences. A retrospective analysis was performed of 1,201 major surgical interventions for head and neck malignancies in a tertiary referral center between 1995 and 2010. The Adult Comorbidity Evaluation 27 (ACE-27) index was used to analyze severity (mild, moderate, and severe comorbidity) and type (12 different organ systems) of comorbidity. The Clavien-Dindo index was used to evaluate grade and type of complications after treatment. In univariate analysis gender, comorbidity, stage, mandibulectomy, total laryngectomy, neck dissection, and length of surgery significantly predicted grade of complication. In a multivariate analysis, complication was predicted by age, stage, length of surgery, and various comorbidities. After specification of the complications, age was only a predictor of medical complications; tumor stage was a significant factor in surgical complications. Length of surgery was the only significant variable in all types of complications. Specific comorbidities are associated with specific complications; however, age itself seems not to be a contraindication for major head and neck surgery. With careful preoperative assessment and risk analysis, physicians can better individualize treatment recommendations.

Sex differences and sex hormones in anxiety-like behavior of aging rats.

PubMed

Domonkos, Emese; Borbélyová, Veronika; Csongová, Melinda; Bosý, Martin; Kačmárová, Mária; Ostatníková, Daniela; Hodosy, Július; Celec, Peter

2017-07-01

Sex differences in the prevalence of affective disorders might be attributable to different sex hormone milieu. The effects of short-term sex hormone deficiency on behavior, especially on anxiety have been studied in numerous animal experiments, mainly on young adult rats and mice. However, sex differences in aged animals and the effects of long-term hypogonadism are understudied. The aim of our study was to analyze sex differences in anxiety-like behavior in aged rats and to prove whether they can be attributed to endogenous sex hormone production in males. A battery of tests was performed to assess anxiety-like behavior in aged female, male and gonadectomized male rats castrated before puberty. In addition, the aged gonadectomized male rats were treated with a single injection of estradiol or testosterone or supplemented with estradiol for two-weeks. Female rats displayed a less anxious behavior than male rats in most of the conducted behavioral tests except the light-dark box. Long-term androgen deficiency decreased the sex difference in anxiety either partially (open field, PhenoTyper cage) or completely (elevated plus maze). Neither single injection of sex hormones, nor two-week supplementation of estradiol in gonadectomized aged male rats significantly affected their anxiety-like behavior in the elevated plus maze. In conclusion, our results confirm sex differences in anxiety in aged rats likely mediated by endogenous testosterone production in males. Whether long-term supplementation with exogenous sex hormones could affect anxiety-like behavior in elderly individuals remains to be elucidated. Copyright © 2017 Elsevier Inc. All rights reserved.

Cardiovascular comorbidities of pediatric psoriasis among hospitalized children in the United States.

PubMed

Kwa, Lauren; Kwa, Michael C; Silverberg, Jonathan I

2017-12-01

Psoriasis has been shown to be associated with cardiovascular disease in adults. Little is known about cardiovascular risk in pediatric psoriasis. To determine if there is an association between pediatric psoriasis and cardiovascular comorbidities. Data were analyzed from the 2002-2012 Nationwide Inpatient Sample, which included 4,884,448 hospitalized children aged 0-17 years. Bivariate and multivariate survey logistic regression models were created to calculate the odds of psoriasis on cardiovascular comorbidities. In multivariate survey logistic regression models adjusting for age, sex, and race/ethnicity, pediatric psoriasis was significantly associated with 5 of 10 cardiovascular comorbidities (adjusted odds ratio [95% confidence interval]), including obesity (3.15 [2.46-4.05]), hypertension (2.63 [1.93-3.59]), diabetes (2.90 [1.90-4.42]), arrhythmia (1.39 [1.02-1.88]), and valvular heart disease (1.90 [1.07-3.37]). The highest odds of cardiovascular risk factors occurred in blacks and Hispanics and children ages 0-9 years, but there were no sex differences. The study was limited to hospitalized children. We were unable to assess the impact of psoriasis treatment or family history on cardiovascular risk. Pediatric psoriasis is associated with higher odds of multiple cardiovascular comorbidities among hospitalized patients. Strategies for mitigating excess cardiovascular risk in pediatric psoriasis need to be determined. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

The Association of Age With Clinical Presentation and Comorbidities of Pyoderma Gangrenosum.

PubMed

Ashchyan, Hovik J; Butler, Daniel C; Nelson, Caroline A; Noe, Megan H; Tsiaras, William G; Lockwood, Stephen J; James, William D; Micheletti, Robert G; Rosenbach, Misha; Mostaghimi, Arash

2018-04-01

Pyoderma gangrenosum is an inflammatory neutrophilic dermatosis. Current knowledge of this rare disease is limited owing to a lack of validated diagnostic criteria and large population studies. To evaluate the association of age with the clinical presentation and comorbidities of pyoderma gangrenosum. This was a multicenter retrospective cohort study performed at tertiary academic referral centers in urban settings. Adults (≥18 years) who were evaluated and diagnosed as having pyoderma gangrenosum at the Brigham and Women's and Massachusetts General Hospitals from 2000 to 2015 and the University of Pennsylvania Health System from 2006 to 2016 were included. Patient demographics, clinical features, medical comorbidities, and treatment. Of the 356 validated cases of pyoderma gangrenosum included in the study, 267 (75%) were women and 284 (84.8%) were white. The mean (SD) age at presentation was 51.6 (17.7) years. Pathergy was recorded in 100 patients (28.1%). A total of 238 patients (66.9%) had associated medical comorbidities: inflammatory bowel disease in 146 patients (41.0%); inflammatory arthritis in 73 patients (20.5%); solid organ malignant neoplasms in 23 patients (6.5%); hematologic malignant neoplasms in 21 patients (5.9%); and hematologic disorders, specifically monoclonal gammopathy of undetermined significance, myelodysplastic syndrome, and polycythemia vera in 17 patients (4.8%). When stratified by age, pathergy was more common in patients 65 years or older (36.3% vs 24.3%; P = .02). Inflammatory bowel disease was the only medical comorbidity that was more common in patients younger than 65 years (47.7% vs 26.6%; P < .001), while a number of medical comorbidities were more common in those 65 years or older, including rheumatoid arthritis (13.3% vs 6.2%; P = .03), ankylosing spondylitis (1.8% vs 0%; P = .04), solid organ malignant neoplasms (13.3% vs 3.3%; P < .001), hematologic malignant neoplasms (9.7% vs 4.1%; P = .04), and

Sex-Based Differences in Asthma among Preschool and School-Aged Children in Korea.

PubMed

Jang, Yeonsoo; Shin, Anna

2015-01-01

The purpose of this study was to explore risk factors related to asthma prevalence among preschool and school-aged children using a representative national dataset from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2009-2011. We evaluated the demographic information, health status, household environment, socioeconomic status, and parents' health status of 3,542 children aged 4-12 years. A sex-stratified multivariate logistic regression was used to obtain adjusted prevalence odds ratios (ORs) and 95% confidence intervals after accounting for primary sample units, stratification, and sample weights. The sex-specific asthma prevalence in the 4- to 12-year-old children was 7.39% in boys and 6.27% in girls. Boys and girls with comorbid atopic dermatitis were more likely to have asthma than those without atopic dermatitis (boys: OR = 2.20, p = 0.0071; girls: OR = 2.33, p = 0.0031). Boys and girls with ≥1 asthmatic parent were more likely to have asthma than those without asthmatic parents (boys: OR = 3.90, p = 0.0006; girls: OR = 3.65, p = 0.0138). As girls got older, the prevalence of asthma decreased (OR = 0.90, p = 0.0408). Girls residing in rural areas were 60% less likely to have asthma than those residing in urban areas (p = 0.0309). Boys with ≥5 family members were more likely to have asthma than those with ≤3 family members (OR = 2.45, p = 0.0323). The factors related to asthma prevalence may differ depending on sex in preschool and school-aged children. By understanding the characteristics of sex-based differences in asthma, individualized asthma management plans may be established clinically.

Associations between AUDIT-C and mortality vary by age and sex.

PubMed

Harris, Alex H S; Bradley, Katharine A; Bowe, Thomas; Henderson, Patricia; Moos, Rudolf

2010-10-01

We sought to determine the sex- and age-specific risk of mortality associated with scores on the 3-item Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) questionnaire using data from a national sample of Veterans Health Administration (VHA) patients. Men (N = 215,924) and women (N = 9168) who completed the AUDIT-C in a patient survey were followed for 24 months. AUDIT-C categories (0, 1-4, 5-8, 9-12) were evaluated as predictors of mortality in logistic regression models, adjusted for age, race, education, marital status, smoking, depression, and comorbidities. For women, AUDIT-C scores of 9-12 were associated with a significantly increased risk of death compared to the AUDIT-C 1-4 group (odds ratio [OR] 7.09; 95% confidence interval [CI] = 2.67, 18.82). For men overall, AUDIT-C scores of 5-8 and 9-12 were associated with increased risk of death compared to the AUDIT-C 1-4 group (OR 1.13, 95% CI = 1.05, 1.21, and OR 1.63, 95% CI = 1.45, 1.84, respectively) but these associations varied by age. These results provide sex- and age-tailored risk information that clinicians can use in evidence-based conversations with patients about the health-related risks of their alcohol consumption. This study adds to the growing literature establishing the AUDIT-C as a scaled marker of alcohol-related risk or "vital sign" that might facilitate the detection and management of alcohol-related risks and problems.

Determining age and sex of American coots

USGS Publications Warehouse

Eddleman, William R.; Knopf, Fritz L.

1985-01-01

Reliable techniques for age and sex determination of migrating and wintering American Coots (Fulica americana) have not been available. Breeding coots can be ages through age 3 by tarsal color (birds 4 years and older were placed in a 4+ age class) (Crawford 1978), and males and females have sex-specific behaviors and calls while on breeding territories (Gullion 1950, 1952). Externally, juvenile coots differ from adults in having gray (as opposed to white) bills and brown (as opposed to red) eyes to an age of 75 days (Gullion 1954-394). Bill color changes to white by about 120 days. No quantitative data have been available, however, on the proportion of juveniles retaining these traits throughout fall and early winter. Nonbreeding coots can be ages as juvenile or adult by internal examination of the thickness of the wall of the bursa of Fabricius, although bursal depth does not predictably decline with age (Fredrickson 1968). Attempts to sex coots by single external measurements of combinations of measurements have met with mixed success. Eight-five percent of 101 fall migrants in Wisconsin could be sexed by the length of the metatarsus-midtoe including claw by using 139.5 mm as a cutoff point (Burton 1959), whereas 88% of 67 coots in California were correctly sexed by the length of the metatarsus-midtoe without claw using 127.5 mm as the cutoff point (Gullion 1952). Two-hundred-thirty-two of 291 coots collected in Iowa, however, were in the zone of overlap between the sexes for this measurement (Fredrickson 1968). Previous studies attempting to develop aging and sexing techniques for American Coots have been limited to a few study sites or to 1 season or year, often failing to take geographical, annual, and seasonal morphological variation into account (e.g., Visser 1976, Fjeldsa 1977). We designed the present study to refine and quantify external and internal age and sex criteria for postbreeding coots, with the objective of defining techniques applicable for all

Measuring trends in age at first sex and age at marriage in Manicaland, Zimbabwe.

PubMed

Cremin, I; Mushati, P; Hallett, T; Mupambireyi, Z; Nyamukapa, C; Garnett, G P; Gregson, S

2009-04-01

To identify reporting biases and to determine the influence of inconsistent reporting on observed trends in the timing of age at first sex and age at marriage. Longitudinal data from three rounds of a population-based cohort in eastern Zimbabwe were analysed. Reports of age at first sex and age at marriage from 6837 individuals attending multiple rounds were classified according to consistency. Survival analysis was used to identify trends in the timing of first sex and marriage. In this population, women initiate sex and enter marriage at younger ages than men but spend much less time between first sex and marriage. Among those surveyed between 1998 and 2005, median ages at first sex and first marriage were 18.5 years and 21.4 years for men and 18.2 years and 18.5 years, respectively, for women aged 15-54 years. High levels of reports of both age at first sex and age at marriage among those attending multiple surveys were found to be unreliable. Excluding reports identified as unreliable from these analyses did not alter the observed trends in either age at first sex or age at marriage. Tracing birth cohorts as they aged revealed reporting biases, particularly among the youngest cohorts. Comparisons by birth cohorts, which span a period of >40 years, indicate that median age at first sex has remained constant over time for women but has declined gradually for men. Although many reports of age at first sex and age at marriage were found to be unreliable, inclusion of such reports did not result in artificial generation or suppression of trends.

Prevalence of hypovitaminosis D and its association with comorbidities of childhood obesity.

PubMed

Williams, Ronald; Novick, Marsha; Lehman, Erik

2014-01-01

Our study sought to further delineate the prevalence of hypovitaminosis D and its relationship to comorbidities of childhood obesity. We conducted a retrospective chart review from 155 obese children aged 5 to 19 years who attended the Penn State Children’s Hospital Pediatric Multidisciplinary Weight Loss Program from November 2009 through November 2010. We determined the incidence of hypovitaminosis D and examined its association with comorbidities including elevated blood pressure, diabetes, acanthosis nigricans, depression, hyperlipidemia, hyperinsulinemia, and abnormal liver function test results, as well as age, sex, and geographic location. Under the latest Institute of Medicine definitions, vitamin D deficiency (< 20 ng/mL) and insufficiency (20-29 ng/mL) was present in 40% and 38% of children, respectively. The prevalence of vitamin D deficiency was 27.8% in children aged 5 to 9 years, 35.4% in children aged 10 to 14 years, and 50.9% of children aged 15 years or older. Older age, African-American race, winter/spring season, higher insulin level, total number of comorbidities, and polycystic ovary syndrome (in girls) were significantly associated with vitamin D deficiency. African-American race, winter/spring season, hyperinsulinemia, elevated systolic blood pressure, urban location, and total numbers of comorbidities were significantly associated with hypovitaminosis D (< 30 ng/mL). Hypovitaminosis D is associated with several medical comorbidities in obese children. Given the large percentage of children, even in our youngest age group, who are vitamin D deficient, obese children should be considered for routine vitamin D screening.

The Prevalence, Comorbidity, and Age of Onset of Social Anxiety Disorder among U.S. Latinos

PubMed Central

Polo, Antonio; Alegría, Margarita; Chen, Chih-Nan; Blanco, Carlos

2013-01-01

Objective Social Anxiety Disorder (SAD) is increasingly being recognized as a prevalent, unremitting, and highly comorbid disorder1 yet studies focusing on this disorder among U.S. Latinos and immigrant populations are not available. This article evaluates ethnic differences in the prevalence, comorbidity, and age of onset of SAD. Cultural and contextual factors associated with risk of SAD are also examined within the Latino population. Method Data are analyzed using the National Latino and Asian American Study (NLAAS) and the National Comorbidity Survey-Replication (NCS-R). Both studies utilized the World Mental Health – Composite International Diagnostic Interview, which estimates the prevalence of lifetime and 12-month psychiatric disorders according to DSM-IV criteria. Results Latinos (LAT) reported lower lifetime and 12-month SAD prevalence and a later age of onset than U.S.-born non-Latino Whites (NLW). On the other hand, LAT diagnosed with 12-month SAD reported higher impairment across home, work, and relationship domains than their NLW counterparts. Overall, high SAD comorbidity was found with depressive, anxiety, and substance-related disorders among both ethnic groups. However, relative to NLW, LAT who entered the U.S. after the age of 21 were less likely to have lifetime SAD comorbidity with drug abuse and dependence and more likely to report lifetime SAD comorbidity with agoraphobia. Conclusion Varied trajectories of SAD risk are present across ethnicity and nativity groups. Clinicians must consider how culture and ethnicity shape these different presentations and determine treatment options accordingly. Outreach efforts are needed to reach immigrant Latinos, and those with comorbid SAD and Agoraphobia in particular. PMID:21899817

Comorbid autoimmune diseases in patients with sarcoidosis: A nationwide case-control study in Taiwan.

PubMed

Wu, Chi-Hung; Chung, Pei-I; Wu, Chen-Yi; Chen, Yen-Ta; Chiu, Yun-Wen; Chang, Yun-Ting; Liu, Han-Nan

2017-04-01

The association between sarcoidosis and autoimmune comorbidities has been reported, however, it has seldom been confirmed by a large nationwide study. Our study aimed to clarify the association between sarcoidosis and autoimmune comorbidities in the Taiwanese. A total of 1237 patients with sarcoidosis and 4948 age- and sex-matched control subjects were selected from the National Health Insurance Research Database of Taiwan from 1997 to 2010. Multiple logistic regressions were performed to calculate the odds of comorbidities between the two groups. The prevalence of sarcoidosis was 2.17/100 000 individuals in Taiwan. Sarcoidosis patients tended to run a higher risk of autoimmune comorbidities than the control group (17.6% vs 9.4%, P < 0.05). Autoimmune thyroid disease (adjusted odd ratio [aOR], 1.32; 95% confidence interval [CI], 1.05-1.64), Sjögren's syndrome (aOR, 11.6; 95% CI, 4.36-31.0) and ankylosing spondylitis (aOR, 3.80; 95% CI, 2.42-5.97) were significantly associated with sarcoidosis. The sex-stratified analyses were carried out to demonstrate a significant association of sarcoidosis with ankylosing spondylitis in both sexes, but with autoimmune thyroid disease in male patients and with Sjögren's syndrome female patients, respectively. Besides, the diagnosis of the autoimmune comorbidities strongly associated with sarcoidosis tended to be established after that of sarcoidosis. This study demonstrated that patients with sarcoidosis tended to have autoimmune thyroid disease, Sjögren's syndrome and ankylosing spondylitis, and the diagnosis of sarcoidosis usually preceded that of associated comorbidities. Clinicians should be alert to autoimmune comorbidities in patients with sarcoidosis. © 2016 Japanese Dermatological Association.

Taking it one day at a time: African American women aging with HIV and co-morbidities.

PubMed

Warren-Jeanpiere, Lari; Dillaway, Heather; Hamilton, Pilar; Young, Mary; Goparaju, Lakshmi

2014-07-01

Self-managing HIV/AIDS presents challenges for anyone infected. These challenges may be further complicated for older HIV-infected African American women who acquired the disease at younger ages and now have co-morbidities. Little is known regarding how women's age identity, social responsibilities, co-morbidities, and romantic relationship status influence their HIV self-management. Five focus groups were conducted in Washington DC, with HIV-positive African American women aged 52-65. Topics included HIV and co-morbidity self-management, social support needs, medication adherence, and future plans for old age. A constant comparison approach was applied during data analysis. Co-morbidities, including diabetes and hypertension, were perceived to be more difficult to self-manage than HIV. This difficulty was not attributed to aging but to daily struggles such as lack of income and/or health insurance, an inflexible work schedule, and loneliness. Social responsibilities, including caring for family, positively impacted participants' ability to self-manage HIV by serving as motivation to stay healthy in order to continue to help family members. In contrast, inflexible work schedules negatively impacted women's ability to sustain medication adherence. Overall, this study demonstrates that HIV and co-morbidity self-management are inextricably linked. We can no longer afford to view engagement in HIV care as a single-disease issue and hope to attain optimal health and well-being in our HIV-affected populations. Optimal HIV self-management must be framed within a larger context that simultaneously addresses HIV and co-morbidities, while considering how social and cultural factors uniquely intersect to influence older African American women's self-management strategies.

Sex Differences in Cannabis Use Disorder Diagnosis Involved Hospitalizations in the United States

PubMed Central

Zhu, He; Wu, Li-Tzy

2017-01-01

Objectives: The study examined sex differences in trend and clinical characteristics of cannabis use disorder (CUD) diagnosis involved hospitalizations among adult patients. Methods: We analyzed hospitalization data from the 2007–2011 Nationwide Inpatient Samples for patients aged 18–64 years (N = 15,114,930). Descriptive statistics were used to characterize demographic variables and to compare the proportions of CUD diagnosis and comorbid patterns between male and female hospitalizations. Logistic regressions were performed to examine the association of sex and other demographic variables with CUD diagnosis. Results: During the study period, 3.3% of male and 1.5% of female hospitalizations had any-listed CUD diagnoses, and both sexes presented an upward trend in the number, rate, and proportion of CUD diagnosis. Among hospitalizations for patients aged 18–25 years, about 1 in 10 males and 1 in 20 females included a CUD diagnosis, and this proportion decreased with age strata. Mental disorders accounted for the highest proportion of CUD involved inpatient hospitalizations, and female CUD involved hospitalizations included a higher proportion of mental disorders that required hospitalized care compared with male hospitalizations (41% vs 36%). In each sex group, younger age, black race, lower household income, large metropolitan residence, non-private insurance, substance use diagnosis, and mental disorders were associated with elevated odds of having CUD diagnosis. Conclusion: The large sample of clinical hospitalization data suggest an increased trend in CUD diagnosis and sex differences in several comorbidities with CUD-involved hospital admissions. Prevention and treatment for CUD should consider sex differences in clinical comorbidities. PMID:28700366

Shared Genetic Influences on Negative Emotionality and Major Depression/Conduct Disorder Comorbidity

ERIC Educational Resources Information Center

Tackett, Jennifer L.; Waldman, Irwin D.; Van Hulle, Carol A.; Lahey, Benjamin B.

2011-01-01

Objective: To investigate whether genetic contributions to major depressive disorder and conduct disorder comorbidity are shared with genetic influences on negative emotionality. Method: Primary caregivers of 2,022 same- and opposite-sex twin pairs 6 to 18 years of age comprised a population-based sample. Participants were randomly selected across…

Impact of age, comorbidity and symptoms on physical function in long-term breast cancer survivors (CALGB 70803)

PubMed Central

Cohen, Harvey Jay; Lan, Lan; Archer, Laura; Kornblith, Alice B.

2012-01-01

Purpose The purpose of this study was to assess the impact of aging, comorbidities and symptoms on physical function in patients surviving 20 years since adjuvant treatment for breast cancer. Patients & Methods Patients were originally treated on CALGB 7581 (from 1975–1980), a randomized trial of three adjuvant therapies and reassessed (153 of 193 eligible survivors) 20 years from the onset of therapy for physical function and symptoms by the EORTC QLQ-C30 and comorbidities by the OARS questionnaire. Results The average age at reassessment was 64.5 years. 66% of patients had at least two comorbidities and 22% had four or more, but relatively little interference with activities. Older patients had greater multimorbidity. Physical function was generally high and comparable to matched population norms. Older patients had greater difficulty with strenuous activities. For every increase in number of comorbidities, physical function score decreased by 5.1 (p<.001). Symptoms were also frequent (80%) and correlated strongly with decreases in function (0–100u scale) (p <.001), to an even greater degree than comorbidities. Conclusion Very long-term cancer survivors have changes in physical function and symptoms largely consistent with their aging suggesting that the impact of cancer and its treatment is attenuated over time and largely replaced by the impact of age-related comorbidities and functional decline. PMID:22707996

Multiple Comorbid Conditions among Middle-Aged and Elderly Hemophilia Patients: Prevalence Estimates and Implications for Future Care

PubMed Central

Khleif, Aroub A.; Rodriguez, Nidra; Brown, Deborah; Escobar, Miguel A.

2011-01-01

Introduction. Advances in hemophilia care and treatment have led to increases in the life expectancy among hemophiliacs. As a result, persons with hemophilia are reaching an older age and experiencing various age-related health conditions never seen before in this population. Aim. To determine the prevalence of comorbidities among middle-aged and elderly hemophilia A and hemophilia B patients. Methods. Retrospective chart review among all hemophilia patients, who attended the Gulf States Hemophilia and Thrombophilia Center. Results. All patients had at least one comorbid condition other than hemophilia, and the majority had between 3 and 6 comorbidities. The most common conditions identified were chronic hepatitis C, hypertension, HIV, chronic arthropathy, and overweight/obesity. Conclusions. Since persons with comorbidities are more likely to have poorer health outcomes and require greater care in managing their health needs, caring for aging hemophiliacs is likely to pose various social and economic challenges for both patients and providers. PMID:21912745

Associations Between AUDIT-C and Mortality Vary by Age and Sex

PubMed Central

Bradley, Katharine A.; Bowe, Thomas; Henderson, Patricia; Moos, Rudolf

2010-01-01

Abstract We sought to determine the sex- and age-specific risk of mortality associated with scores on the 3-item Alcohol Use Disorder Identification Test–Consumption (AUDIT-C) questionnaire using data from a national sample of Veterans Health Administration (VHA) patients. Men (N = 215,924) and women (N = 9168) who completed the AUDIT-C in a patient survey were followed for 24 months. AUDIT-C categories (0, 1–4, 5–8, 9–12) were evaluated as predictors of mortality in logistic regression models, adjusted for age, race, education, marital status, smoking, depression, and comorbidities. For women, AUDIT-C scores of 9–12 were associated with a significantly increased risk of death compared to the AUDIT-C 1-4 group (odds ratio [OR] 7.09; 95% confidence interval [CI] = 2.67, 18.82). For men overall, AUDIT-C scores of 5–8 and 9–12 were associated with increased risk of death compared to the AUDIT-C 1-4 group (OR 1.13, 95% CI = 1.05, 1.21, and OR 1.63, 95% CI = 1.45, 1.84, respectively) but these associations varied by age. These results provide sex- and age-tailored risk information that clinicians can use in evidence-based conversations with patients about the health-related risks of their alcohol consumption. This study adds to the growing literature establishing the AUDIT-C as a scaled marker of alcohol-related risk or “vital sign” that might facilitate the detection and management of alcohol-related risks and problems. (Population Health Management 2010;13:263–268) PMID:20879907

Anxiety Disorders in Old Age: Psychiatric Comorbidities, Quality of Life, and Prevalence According to Age, Gender, and Country.

PubMed

Canuto, Alessandra; Weber, Kerstin; Baertschi, Marc; Andreas, Sylke; Volkert, Jana; Dehoust, Maria Christina; Sehner, Susanne; Suling, Anna; Wegscheider, Karl; Ausín, Berta; Crawford, Mike J; Da Ronch, Chiara; Grassi, Luigi; Hershkovitz, Yael; Muñoz, Manuel; Quirk, Alan; Rotenstein, Ora; Santos-Olmo, Ana Belén; Shalev, Arieh; Strehle, Jens; Wittchen, Hans-Ulrich; Schulz, Holger; Härter, Martin

2018-02-01

Previous estimates of the prevalence of anxiety disorders in late life vary greatly due to the lack of reliable diagnostic tools. This MentDis_ICF65+ study assessed 12-month prevalence rates of anxiety disorders and age- and gender-related differences in comorbidities, as well as impact on quality of life. The study used a cross-sectional multicenter survey. The study sample comprised 3,142 men and women aged 65 to 84 years, living in five European countries and Israel. Anxiety disorders were assessed using computer-assisted face-to-face interviews with an age-appropriate diagnostic interview (CIDI65+). The prevalence of anxiety disorders was 17.2%. Agoraphobia was the most frequent disorder (4.9%), followed by panic disorder (3.8%), animal phobia (3.5%), general anxiety disorder (3.1%), post-traumatic stress disorder (1.4%), social phobia (1.3%), and obsessive-compulsive disorder (0.8%). The prevalence rate of any anxiety disorder dropped by 40% to 47% in adults aged 75-84 years compared with those aged 65-74 years. Women were twice as likely to present with agoraphobia or general anxiety disorder as men. Only panic disorder and phobia were associated with comorbid major depression. The negative relationship with quality of life was limited to agoraphobia and generalized anxiety disorder. The age-appropriate CIDI65+ led to higher prevalence rates of anxiety disorders in the elderly, yet to weaker associations with comorbidities and impaired quality of life compared with previous studies. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Psychiatric comorbidity in adult eczema.

PubMed

Schmitt, J; Romanos, M; Pfennig, A; Leopold, K; Meurer, M

2009-10-01

Atopic eczema (AE) is a common dermatological condition that causes significant problems in everyday life and high levels of illness-related stress in substantial proportions of patients. The extent to which adult AE is associated with clinically relevant psychiatric morbidity is unclear. To investigate the association between adult AE and major psychiatric/psychosomatic disorders. Case-control study utilizing the GKV database Saxony, an interdisciplinary administrative outpatient database from Germany. All patients documented as having AE at least twice within the study period (2003-2004) (n = 3769, mean age 44 years) were individually matched by age and sex to 3769 controls without AE. Logistic regression models were fitted to investigate the relationship of AE with affective, stress-related, behaviour and schizophrenic disorders, considering sociodemographic characteristics, consulting behaviour and allergic comorbidities as potential confounding factors. Eczema was independently associated with affective [adjusted odds ratio (OR) 1.42, 95% confidence interval (CI) 1.13-1.79], stress-related (OR 1.55, 95% CI 1.35-1.77), behaviour (OR 1.52, 95% CI 1.03-2.23) and schizophrenic disorders (OR 2.12, 95% CI 1.22-3.71). For each psychiatric condition the likelihood of being affected significantly increased with each physician visit due to AE, suggesting that the risk of psychiatric comorbidity increases with the severity of AE. This study indicates psychiatric comorbidity of adults with AE. Collaboration between dermatologists and mental health specialists may optimize medical care for a significant subgroup of patients with AE.

Epidemiology and cardiovascular comorbidities in patients with psoriasis: A Korean nationwide population-based cohort study.

PubMed

Oh, Eui Hyun; Ro, Young Suck; Kim, Jeong Eun

2017-06-01

There is a lack of nationwide studies examining the epidemiology and comorbidities of psoriasis vulgaris (PsV) and psoriatic arthritis (PsA) in Asian populations. The purpose of this study is to determine the demographics of psoriasis in Korea along with the incidence of cerebro-cardiovascular (CV) comorbidities and to compare these risks between populations with PsA and with PsV. This cohort study identified 15 484 patients with psoriasis among 855 003 subjects in the Korean National Health Insurance Database from 2002 through 2010. The cases were further classified into PsA and PsV. We used hazard ratios (HR) and 95% confidence intervals (CI) from the univariate and age-sex adjusted logistic regression model to assess the risk of comorbidities in patients with PsA and PsV. The annual prevalence of psoriasis increased from 313.2 to 453.5/100 000 people from 2002 through 2010; however, the overall incidence rate for psoriasis slightly decreased (252.7-212.6/100 000 population). Of psoriatic patients, 10.8% had PsA, and after adjusting for age and sex, PsA patients had a significantly higher risk of dyslipidemia than PsV patients (adjusted HR, 1.185; 95% CI, 1.049-1.338). When stratified by age group, subjects aged 20-39 years had a higher risk of stroke and many CV risk factors. In conclusion, the prevalence of psoriasis, while within the range of previous reports, tended to increase over time. Patients with PsA had higher burdens of specific comorbid diseases than those with PsV, especially at a comparatively early age. © 2017 Japanese Dermatological Association.

Salt preference: age and sex related variability.

PubMed

Verma, Punam; Mittal, Sunita; Ghildiyal, Archana; Chaudhary, Lalita; Mahajan, K K

2007-01-01

Salt preference was assessed in 60 adults of 18-21 yrs of age (30 males and 30 females) and in 60 children of 7-12 yrs of age (30 boys and 30 girls). Subjects rated the preference on Likert scale for popcorns of five salt concentrations (OM, 1M, 2M, 3M and +3M). Statistical analysis using Two way ANOVA revealed statistically significant effect of age and sex on salt preference (F4,100 = 15.027, P < 0.01) and One Way ANOVA revealed statistically significant sex difference in salt preference of adults (F4,50 = 16.26, P < 0.01) but no statistically significant sex difference in salt preference of children (F4,50 = 4.08, P > 0.05). Dietary experiences during development and more physical activity in children may be responsible for higher salt preference in children while finding no sex variability in children favours the role of sex hormones in salt preference of male and females.

Psychiatric comorbidity among patients with hypochondriasis.

PubMed

Noyes, R; Kathol, R G; Fisher, M M; Phillips, B M; Suelzer, M T; Woodman, C L

1994-03-01

The purpose of this study was to determine the nature and extent of comorbidity among patients with DSM-III-R hypochondriasis and to examine the relationships between this disorder and coexisting psychiatric illness. For this purpose, patients seen in a general medicine clinic were screened using measures of hypochondriacal attitudes and somatic symptoms. Those scoring above an established cutoff were given a structured diagnostic interview. In this manner, 50 patients who met DSM-III-R criteria for hypochondriasis and 50 age- and sex-matched controls were identified. The presence of other psychiatric disorders (current and past) was determined by means of the same diagnostic interview. More hypochondriacal subjects (62.0%) had lifetime comorbidity than did controls (30.0%). Major depression, the most frequent comorbid disturbance, was usually current and most often had an onset after that of hypochondriasis. Panic disorder with agoraphobia, the most frequent anxiety disorder, was also current but often began before or at the same time as hypochondriasis. Few subjects met criteria for somatization disorder but a third qualified for a subsyndromal form of this disorder. The data show that, in medical outpatients with hypochondriasis, mood and anxiety disorders frequently coexist. This comorbidity is subject to varying interpretations including overlap of symptom criteria, treatment-seeking bias, and the possibility that hypochondriasis predisposes to or causes the comorbid disorder, as seems likely in the case of depression. In some instances hypochondriasis may be an associated feature of another illness.

Impact of Age and Comorbidity on Cervical and Breast Cancer Literacy of African Americans, Latina, and Arab Women.

PubMed

Talley, Costellia H; Williams, Karen Patricia

2015-09-01

This study examines the relationship between age, comorbidity, and breast and cervical cancer literacy in a sample of African American, Latina, and Arab women (N = 371) from Detroit, Michigan. The Age-adjusted Charlson Comorbidity Index (ACC) was used characterize the impact of age and comorbidity on breast and cervical cancer literacy. The relationship between ACC and breast and cervical cancer screening, and group differences, were assessed. There was a statistically significant difference between breast cancer literacy scores. ACC had a greater impact on breast cancer literacy for African Americans. Copyright © 2015 Elsevier Inc. All rights reserved.

Disparities experienced by Aboriginal compared to non-Aboriginal metropolitan Western Australians in receiving coronary angiography following acute ischaemic heart disease: the impact of age and comorbidities.

PubMed

Lopez, Derrick; Katzenellenbogen, Judith M; Sanfilippo, Frank M; Woods, John A; Hobbs, Michael S T; Knuiman, Matthew W; Briffa, Tom G; Thompson, Peter L; Thompson, Sandra C

2014-10-21

Aboriginal Australians have a substantially higher frequency of ischaemic heart disease (IHD) events than their non-Aboriginal counterparts, together with a higher prevalence of comorbidities. The pattern of health service provision for IHD suggests inequitable delivery of important diagnostic procedures. Published data on disparities in IHD management among Aboriginal Australians are conflicting, and the role of comorbidities has not been adequately delineated. We compared the profiles of Aboriginal and non-Aboriginal patients in the metropolitan area undergoing emergency IHD admissions at Western Australian metropolitan hospitals, and investigated the determinants of receiving coronary angiography. Person-linked administrative hospital and mortality records were used to identify 28-day survivors of IHD emergency admission events (n =20,816) commencing at metropolitan hospitals in 2005-09. The outcome measure was receipt of angiography. The Aboriginal to non-Aboriginal risk ratio (RR) was estimated from a multivariable Poisson log-linear regression model with allowance for multiple IHD events in individuals. The subgroup of myocardial infarction (MI) events was modelled separately. Compared with their non-Aboriginal counterparts, Aboriginal IHD patients were younger and more likely to have comorbidities. In the age- and sex-adjusted model, Aboriginal patients were less likely than others to receive angiography (RRIHD 0.77, 95% CI 0.72-0.83; RRMI 0.81, 95% CI 0.75-0.87) but in the full multivariable model this disparity was accounted for by comorbidities as well as IHD category and MI subtype, and private health insurance (RRIHD 0.95, 95% CI 0.89-1.01; RRMI 0.94, 95% CI 0.88-1.01). When stratified by age groups, this disparity was not significant in the 25-54 year age group (RRMI 0.95, 95% CI 0.88-1.02) but was significant in the 55-84 year age group (RRMI 0.88, 95% CI 0.77-0.99). The disproportionate under-management of older Aboriginal IHD patients is of

Hyperostosis frontalis interna: criteria for sexing and aging a skeleton.

PubMed

May, Hila; Peled, Nathan; Dar, Gali; Cohen, Haim; Abbas, Janan; Medlej, Bahaa; Hershkovitz, Israel

2011-09-01

Estimation of sex and age in skeletons is essential in anthropological and forensic medicine investigations. The aim of the current study was to examine the potential of hyperostosis frontalis interna (HFI) as a criterion for determining sex and age in forensic cases. Macroscopic examination of the inner aspect of the frontal bone of 768 skulls (326 males and 442 females) aged 1 to 103, which had undergone a head computerized tomography scan, was carried out using the volume rendering technique. HFI was divided into two categories: minor and major. HFI is a sex- and age-dependent phenomena, with females manifesting significantly higher prevalence than males (p<0.01). In both females and males, prevalence of HFI increases as age increases (p<0.01). We present herein the probabilities of designating an unknown skull to a specific sex and age cohort according to the presence of HFI (standardized to age distribution in an Israeli population). Moreover, we present the probability of an individual belonging to a specific sex or age cohort according to age or sex (respectively) and severity of HFI. We suggest a valid, reliable, and easy method for sex and age identification of unknown skulls.

Increased risk of comorbid rheumatic disorders in vitiligo patients: A nationwide population-based study.

PubMed

Choi, Chong Won; Eun, Sung Hye; Choi, Kwang Hyun; Bae, Jung Min

2017-08-01

Vitiligo is a common acquired depigmentation disorder. Previous studies have shown that vitiligo is associated with a variety of autoimmune disorders. However, a large-scale epidemiological study focused on comorbid rheumatic disorders has not been undertaken. To clarify the associations between vitiligo and various rheumatic disorders, we performed a cross-sectional study using data from the Korean National Health Insurance claims database. Between 2009 and 2013, totals of 86 210 patients with vitiligo and 172 420 age- and sex-matched controls without vitiligo were enrolled in this study. Vitiligo patients were found to be at increased risk of systemic lupus erythematosus, systemic sclerosis, Sjögren's syndrome and rheumatoid arthritis, but no significant association was found between vitiligo and dermatomyositis/polymyositis, Behçet's disease or ankylosing spondylitis. Subgroup analysis showed an increased risk of dermatomyositis/polymyositis in male and ankylosing spondylitis in female vitiligo patients. The risks of dermatomyositis/polymyositis or ankylosing spondylitis were higher in young vitiligo patients. Our study confirms a significant association between vitiligo and rheumatic disorders. Differences in comorbid rheumatic disorders by age group and sex suggest the need for patient-specific approaches. Careful consideration of rheumatic disorders is required for the proper management of comorbidities in vitiligo patients. © 2017 Japanese Dermatological Association.

The effect of age and medical comorbidities on in vitro myoblast expansion in women with and without pelvic organ prolapse.

PubMed

Price, Danielle Markle; Lane, Felicia L; Craig, Jocelyn B; Nistor, Gabriel; Motakef, Saba; Pham, Quynh-Ahn; Keirstead, Hans

2014-01-01

This is an observational study is designed to assess the influence of age, prolapse and medical co-morbidities on myogenic stem cells growth in-vitro. A biopsy of the rectus abdominus muscle was obtained during surgery in patients with and without pelvic organ prolapse (POP). Nuclei number and fiber count were correlated with patient's age, presence of POP, and medical comorbidities. Efficiency of expansion of myogenic stem cells in vitro was calculated. The percentage of Pax7-, MyoD-, and desmin-positive cells was correlated with age, POP status, and medical comorbidities. A total of 17 specimens were obtained; 13 specimens were available for histologic analysis. There was no correlation between patient's age, POP status or medical comorbidities and nuclei or fiber count, growth rate, or the percentage of Pax7- and MyoD-positive cells. Patients with 2 to 4 medical comorbidities were noted to have a significantly lower percentage of desmin-positive cells. Specimens with a higher nuclear count had significantly better cellular expansion. Data were analyzed using Kruskal-Wallis or Wilcoxon rank sum statistics. Multiple medical comorbidities but not patient's age or POP status influenced in vitro myogenic stem cell growth. These data suggest that patients with advancing age or POP may be acceptable autologous donors if treatment of urinary or anal incontinence requires myoblast transplantation.

Compulsive Buying Behavior: Characteristics of Comorbidity with Gambling Disorder.

PubMed

Granero, Roser; Fernández-Aranda, Fernando; Steward, Trevor; Mestre-Bach, Gemma; Baño, Marta; Del Pino-Gutiérrez, Amparo; Moragas, Laura; Aymamí, Neus; Gómez-Peña, Mónica; Mallorquí-Bagué, Núria; Tárrega, Salomé; Menchón, José M; Jiménez-Murcia, Susana

2016-01-01

Compulsive buying behavior (CBB) has begun to be recognized as a condition worthy of attention by clinicians and researchers. Studies on the commonalities between CBB and other behavioral addictions such as gambling disorder (GD) exist in the literature, but additional research is needed to assess the frequency and clinical relevance of the comorbidity of CBB and GD. The aim of the study was to estimate the point-prevalence of CBB+GD in a clinical setting. Data corresponded to n = 3221 treatment-seeking patients who met criteria for CBB or GD at a public hospital unit specialized in treating behavioral addictions. Three groups were compared: only-CBB (n = 127), only-GD (n = 3118) and comorbid CBB+GD (n = 24). Prevalence for the co-occurrence of CBB+GD was 0.75%. In the stratum of patients with GD, GD+CBB comorbidity obtained relatively low point prevalence (0.77%), while in the subsample of CBB patients the estimated prevalence of comorbid GD was relatively high (18.9%). CBB+GD comorbidity was characterized by lower prevalence of single patients, higher risk of other behavioral addictions (sex, gaming or internet), older age and age of onset. CBB+GD registered a higher proportion of women compared to only-GD (37.5 vs. 10.0%) but a higher proportion of men compared to only-CBB (62.5 vs. 24.4%). Compared to only-GD patients, the simultaneous presence of CBB+GD was associated with increased psychopathology and dysfunctional levels of harm avoidance. This study provides empirical evidence to better understand CBB, GD and their co-occurrence. Future research should help delineate the processes through which people acquire and develop this comorbidity.

Compulsive Buying Behavior: Characteristics of Comorbidity with Gambling Disorder

PubMed Central

Granero, Roser; Fernández-Aranda, Fernando; Steward, Trevor; Mestre-Bach, Gemma; Baño, Marta; del Pino-Gutiérrez, Amparo; Moragas, Laura; Aymamí, Neus; Gómez-Peña, Mónica; Mallorquí-Bagué, Núria; Tárrega, Salomé; Menchón, José M.; Jiménez-Murcia, Susana

2016-01-01

Compulsive buying behavior (CBB) has begun to be recognized as a condition worthy of attention by clinicians and researchers. Studies on the commonalities between CBB and other behavioral addictions such as gambling disorder (GD) exist in the literature, but additional research is needed to assess the frequency and clinical relevance of the comorbidity of CBB and GD. The aim of the study was to estimate the point-prevalence of CBB+GD in a clinical setting. Data corresponded to n = 3221 treatment-seeking patients who met criteria for CBB or GD at a public hospital unit specialized in treating behavioral addictions. Three groups were compared: only-CBB (n = 127), only-GD (n = 3118) and comorbid CBB+GD (n = 24). Prevalence for the co-occurrence of CBB+GD was 0.75%. In the stratum of patients with GD, GD+CBB comorbidity obtained relatively low point prevalence (0.77%), while in the subsample of CBB patients the estimated prevalence of comorbid GD was relatively high (18.9%). CBB+GD comorbidity was characterized by lower prevalence of single patients, higher risk of other behavioral addictions (sex, gaming or internet), older age and age of onset. CBB+GD registered a higher proportion of women compared to only-GD (37.5 vs. 10.0%) but a higher proportion of men compared to only-CBB (62.5 vs. 24.4%). Compared to only-GD patients, the simultaneous presence of CBB+GD was associated with increased psychopathology and dysfunctional levels of harm avoidance. This study provides empirical evidence to better understand CBB, GD and their co-occurrence. Future research should help delineate the processes through which people acquire and develop this comorbidity. PMID:27199853

Health resource utilization varies by comorbidities in children with epilepsy.

PubMed

Puka, Klajdi; Smith, Mary Lou; Moineddin, Rahim; Snead, O Carter; Widjaja, Elysa

2016-04-01

Comorbidities in adults with epilepsy have been shown to significantly increase health resource utilization (HRU). The current study aimed to determine whether a similar association exists among children with epilepsy in a universal health insurance system. Health administrative databases in Ontario, Canada were used to evaluate the frequency of neurologist visits, emergency department (ED) visits, and hospitalizations. We evaluated the association between HRU and comorbidities, including depression, anxiety, learning disability, attention deficit hyperactivity disorder (ADHD), and autistic spectrum disorder (ASD), adjusting for age, sex, residence, and socio-economic status. The frequency of neurology visits was increased by comorbid depression, ASD, and learning disability (adjusted relative risk [aRR]=1.29-2.07; p<.01). The frequency of ED visits was increased by all comorbidities (aRR=1.26-2.83; p<.0001). The frequency of hospitalizations was increased by comorbid depression, anxiety, ASD, and learning disability (aRR=1.77-7.20; p<.0001). Learning disability had the largest impact on HRU. For each additional comorbidity, the frequency of neurology visits, ED visits, and hospitalizations increased by 1.64 to 3.16 times (p<.0001). Among children with epilepsy, mental health and developmental comorbidities were associated with increased HRU, and different comorbidities influenced different types of HRU. In addition, we highlight the importance of identifying and managing these comorbidities, as they increased the risks of costly HRU such as ED visits and hospitalizations. Copyright © 2016 Elsevier Inc. All rights reserved.

Age of onset in social anxiety disorder: Relation to clinical variables and major depression comorbidity.

PubMed

Koyuncu, Ahmet; Ertekin, Erhan; Deveci, Erdem; Ertekin, Banu Aslanta; Yüksel, Çagrı; Çelebi, Fahri; Binbay, Zerrin; Demir, Esra Yancar; Tükel, Rasit

2015-05-01

The aim of this study was to determine the rates of early- and late-onset social anxiety disorder (SAD) and to investigate the effects of onset time on clinical characteristics and the course of SAD. A total of 377 patients with SAD were assessed using a sociodemographic data form, the Liebowitz Social Anxiety Scale (LSAS), Beck Depression Inventory (BDI), and the Global Assessment of Functioning (GAF). Three hundred patients with SAD onset before age 18 were classified as members of the early-onset group, whereas 77 patients with SAD onset at age ≥ 18 comprised the late-onset group. The 2 groups were compared in terms of sociodemographic and clinical characteristics, comorbidity, and scale scores. The rate of SAD onset before age 18 was 79.6%. Compared with the late-onset group, the early-onset group had a younger age at first depressive episode, higher rate of atypical depression, higher LSAS and BDI scores, and lower GAF scores. In cases of early onset of SAD, symptom severity of both SAD and comorbid depression increased and functionality decreased. It is important to assess and treat SAD patients at a younger age because early-onset SAD may be associated with a more severe course and higher rate of major depression comorbidity.

[Comorbidities of COPD].

PubMed

Brinchault, G; Diot, P; Dixmier, A; Goupil, F; Guillais, P; Gut-Gobert, C; Leroyer, C; Marchand-Adam, S; Meurice, J-C; Morel, H; Person, C; Cavaillès, A

2015-12-01

COPD is a slowly progressive chronic respiratory disease causing an irreversible decrease in air flow. The main cause is smoking, which provokes inflammatory phenomena in the respiratory tract. COPD is a serious public health issue, causing high morbidity, mortality and disability. Related comorbidities are linked to ageing, common risk factors and genetic predispositions. A combination of comorbidities increases healthcare costs. For instance, patients with more than two comorbidities represent a quarter of all COPD sufferers but account for half the related health costs. Our review describes different comorbidities and their impact on the COPD prognosis. The comorbidities include: cardiovascular diseases, osteoporosis, denutrition, obesity, ageing, anemia, sleeping disorders, diabetes, metabolic syndrome, anxiety-depression and lung cancer. The prognosis worsens with one or more comorbidities. Clinicians are faced with the challenge of finding practical and appropriate ways of treating these comorbidities, and there is increasing interest in developing a global, multidisciplinary approach to management. Managing this chronic disease should be based on a holistic, patient-centred approach and smoking cessation remains the key factor in the care of COPD patients. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Sex differences in perceived stress and early recovery in young and middle-aged patients with acute myocardial infarction.

PubMed

Xu, Xiao; Bao, Haikun; Strait, Kelly; Spertus, John A; Lichtman, Judith H; D'Onofrio, Gail; Spatz, Erica; Bucholz, Emily M; Geda, Mary; Lorenze, Nancy P; Bueno, Héctor; Beltrame, John F; Krumholz, Harlan M

2015-02-17

Younger age and female sex are both associated with greater mental stress in the general population, but limited data exist on the status of perceived stress in young and middle-aged patients presenting with acute myocardial infarction. We examined sex difference in stress, contributing factors to this difference, and whether this difference helps explain sex-based disparities in 1-month recovery using data from 3572 patients with acute myocardial infarction (2397 women and 1175 men) 18 to 55 years of age. The average score of the 14-item Perceived Stress Scale at baseline was 23.4 for men and 27.0 for women (P<0.001). Higher stress in women was explained largely by sex differences in comorbidities, physical and mental health status, intrafamily conflict, caregiving demands, and financial hardship. After adjustment for demographic and clinical characteristics, women had worse recovery than men at 1 month after acute myocardial infarction, with mean differences in improvement score between women and men ranging from -0.04 for EuroQol utility index to -3.96 for angina-related quality of life (P<0.05 for all). Further adjustment for baseline stress reduced these sex-based differences in recovery to -0.03 to -3.63, which, however, remained statistically significant (P<0.05 for all). High stress at baseline was associated with significantly worse recovery in angina-specific and overall quality of life, as well as mental health status. The effect of baseline stress on recovery did not vary between men and women. Among young and middle-aged patients, higher stress at baseline is associated with worse recovery in multiple health outcomes after acute myocardial infarction. Women perceive greater psychological stress than men at baseline, which partially explains women's worse recovery. © 2015 American Heart Association, Inc.

Effects of comorbidity and early age of onset in young people with Bipolar Disorder on self harming behaviour and suicide attempts.

PubMed

Moor, Stephanie; Crowe, Marie; Luty, Sue; Carter, Janet; Joyce, Peter R

2012-02-01

The age of the first episode of illness in Bipolar Disorder has been shown to be an important predictor of outcome with early onset, particularly onset before puberty, associated with greater comorbidity, a poorer quality of life and greatest impairment in functioning. Baseline data from a psychotherapy study was used to examine the prevalence of other comorbid psychiatric conditions and the impact of onset at an early age on both self harming behaviour and suicide attempts in young people with Bipolar Disorder. This study of 100 adolescents and young adults (aged 15-36 years) with Bipolar Disorder showed that comorbid conditions were very common, even at the start of their bipolar illness. Comorbidity increased as the age of onset decreased with very early onset (<13 years) patients bearing the greatest burden of disease. Greater comorbidity also significantly increased the risk of having self harmed and attempted suicide with high lethal intent. Self harming behaviour was predicted by having a lifetime diagnoses of Borderline Personality Disorder and Panic Disorder along with an early age of onset of Bipolar Disorder. In contrast, previous suicide attempts were predicted by greater comorbidity and not by very early (<13 years) age of onset. Copyright © 2011 Elsevier B.V. All rights reserved.

How do health and biological age influence chronological age and sex differences in cognitive aging: moderating, mediating, or both?

PubMed

Wahlin, Ake; MacDonald, Stuart W S; deFrias, Cindy M; Nilsson, Lars-Göran; Dixon, Roger A

2006-06-01

Much research on cognitive competence in normal older adults has documented age and sex differences. The authors used new cross-sectional data from the Victoria Longitudinal Study (VLS) (n=386; age 61 to 95 years) to examine how health and biological age influence age and sex differences in cognitive aging. The authors found evidence for both moderating and mediating influences. Age differences were moderated by health status, such that the negative effects of age were most pronounced among participants of relatively better health. Sex differences were moderated by health and were more pronounced among participants reporting comparatively poorer health. Although health mediated a notable amount of age-related cognitive variation, BioAge mediated considerably more variance, even after statistical control for differences in health. A complex pattern emerged for the mediation of sex differences: Although BioAge accounted for sex-related variation in cognitive performance, health operated to suppress these differences. Overall, both health and BioAge predicted cognitive variation independently of chronological age. Copyright (c) 2006 APA, all rights reserved.

Treatment response to sildenafil in men with erectile dysfunction relative to concomitant comorbidities and age.

PubMed

Goldstein, Irwin; Stecher, Vera; Carlsson, Martin

2017-03-01

To evaluate treatment response in men with erectile dysfunction (ED) and concomitant comorbidities. Data were pooled from 42 placebo-controlled, flexible-dose sildenafil trials. In most trials, the sildenafil dose was 50 mg, taken ~1 hour before sexual activity but not more than once daily, with adjustment to 100 or 25 mg as needed. The overall population (N=9413) was stratified by age (<45, 46-64, ≥65 years). Treatment response was defined as a minimal clinically important difference (MCID) from baseline in the International Index of Erectile Function-Erectile Function (IIEF-EF) domain score of >2, >5 and >7 for men with mild, moderate and severe ED at baseline, respectively, or an IIEF-EF domain score ≥26 (no ED) at end-point. In the overall population, treatment response using the IIEF-EF MCID definition was significantly greater (P<.0001) with sildenafil vs placebo in men with no comorbidity (77% vs 33%), cardiovascular disease/hypertension only (71% vs 27%), diabetes only (63% vs 24%) or depression only (78% vs 29%). Using an IIEF-EF score ≥26, treatment response was significantly greater (P<.0001) with sildenafil vs placebo in men with no comorbidity (49% vs 17%), cardiovascular disease/hypertension only (48% vs 12%), diabetes only (40% vs 12%) or depression only (60% vs 17%). With each definition, the treatment response for each age and comorbidity was significantly greater (P≤.0065) with sildenafil vs placebo. The treatment response was significantly greater with sildenafil vs placebo in men with ED and each comorbidity regardless of age. © 2017 John Wiley & Sons Ltd.

Prevalence and outcomes of comorbid illnesses in elderly patients with respiratory diseases.

PubMed

Bahadir, Ayse; Ortakoylu, Mediha Gonenc; Iliaz, Sinem; Kanmaz, Zehra Dilek; Bagci, Belma Akbaba; Iliaz, Raim; Caglar, Emel

2016-07-01

The aim of the present study was to determine the prevalence of comorbidities in very elderly patients hospitalized as a result of acute respiratory diseases and to analyze sex-specific differences, and to examine the effects of these comorbidities on their treatment outcomes. A total of 3316 patients were admitted to our pulmonary inpatient clinic between 2009 and 2011, and 243 of them (aged over 80 years) with acute respiratory disease were included in our study. Data were retrospectively collected, and included demographic features, comorbidities, laboratory findings, length of hospital stay and in-hospital mortality. In total of 243, 144 patients (59.3%) were men and 99 patients (40.7%) were women. The mean age was 84 ± 3 years. The prevalence of comorbidity was 75.7% (n = 184). The most common comorbid disease in patients with chronic obstructive pulmonary disease was congestive heart failure (32.9%), and it was chronic obstructive pulmonary disease (49.4%) in patients with pneumonia. The rate of having one comorbidity was 58.2% (n = 107) and 35.3% (n = 65) had two. Approximately half (52.6%) of the in-hospital deaths occurred within the first 48 hours of hospitalization. The number of comorbidities was higher in the deceased patients compared with the living patients (P = 0.01). The present study showed that the majority of our patients had at least one comorbidity. The first 48 hours of hospitalization was very important, especially for the patients with comorbidities, to determine the need for intensive care unit and prognosis. The coexistence of comorbidities can increase the risk of mortality in the elderly. Geriatr Gerontol Int 2016; 16: 791-796. © 2015 Japan Geriatrics Society.

Sex differences in normal age trajectories of functional brain networks.

PubMed

Scheinost, Dustin; Finn, Emily S; Tokoglu, Fuyuze; Shen, Xilin; Papademetris, Xenophon; Hampson, Michelle; Constable, R Todd

2015-04-01

Resting-state functional magnetic resonance image (rs-fMRI) is increasingly used to study functional brain networks. Nevertheless, variability in these networks due to factors such as sex and aging is not fully understood. This study explored sex differences in normal age trajectories of resting-state networks (RSNs) using a novel voxel-wise measure of functional connectivity, the intrinsic connectivity distribution (ICD). Males and females showed differential patterns of changing connectivity in large-scale RSNs during normal aging from early adulthood to late middle-age. In some networks, such as the default-mode network, males and females both showed decreases in connectivity with age, albeit at different rates. In other networks, such as the fronto-parietal network, males and females showed divergent connectivity trajectories with age. Main effects of sex and age were found in many of the same regions showing sex-related differences in aging. Finally, these sex differences in aging trajectories were robust to choice of preprocessing strategy, such as global signal regression. Our findings resolve some discrepancies in the literature, especially with respect to the trajectory of connectivity in the default mode, which can be explained by our observed interactions between sex and aging. Overall, results indicate that RSNs show different aging trajectories for males and females. Characterizing effects of sex and age on RSNs are critical first steps in understanding the functional organization of the human brain. © 2014 Wiley Periodicals, Inc.

Sex differences in survival after myocardial infarction in Sweden, 1987-2010.

PubMed

Berg, Johanna; Björck, Lena; Nielsen, Susanne; Lappas, Georgios; Rosengren, Annika

2017-10-01

In this nationwide study, we investigated age-specific and sex-specific trends in sex differences in survival after acute myocardial infarction (AMI), including deaths from coronary heart disease (CHD) that occurred outside hospital. Observational study in Sweden of 28-day and 1-year mortality among 658 110 persons (35.7% women) aged 35-84 years with a first-time CHD event 1987-2010 with data retrieved from the national Swedish death and hospital registries. Age-adjusted 28-day case fatality decreased from 23.5% to 8.5% over the period (p<0.05). In hospitalised cases, short-term survival in women aged 35-54 years compared with men of the same age was poorer, not changing appreciably over time (HRs for women relative to men 1.63 (95% CI 1.28 to 2.08) at age 35-54 years and 1.28 (95% CI 1.12 to 1.46) at age 55-64 years in 2005-2010), but after adjustment for comorbidities, differences between men and women were no longer significant (HR 1.25 (95% CI 0.97 to 1.61) and 1.05 (95% CI 0.91 to 1.20)). When CHD deaths outside hospital were included, women had better prognosis regardless of age and period. In patients surviving the first 28 days, age-adjusted 1-year case fatality decreased from 15.3% to 7.7% (p<0.05) for both men and women. After adjustment for comorbidities, no significant sex differences persisted below the age of 75 years in the last period. Female 28-day survivors 75-84 years old had a consistently better prognosis than older men. The worse short-term outcomes in women <55 years of age hospitalised with AMI did not persist after adjustment for comorbidities. When CHD deaths outside hospital were included, women had consistently better short-term prognosis. In 28-day survivors, women did not fare worse than men when differences in comorbidities were considered. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Generalized anxiety and major depressive disorders, their comorbidity and hypertension in middle-aged men.

PubMed

Carroll, Douglas; Phillips, Anna C; Gale, Catharine R; Batty, G David

2010-01-01

To examine the cross-sectional associations between generalized anxiety disorder (GAD) and major depressive disorder (MDD), their comorbidity, and hypertension. Participants (n = 4180) were drawn from a cohort of men who were members of the U.S. army during the Vietnam war era. Occupational, sociodemographic, and health data were collected from military service files, telephone interviews, and medical examinations. Hypertension status was defined by the presence of one of the following: self-reports at interview of either a physician-diagnosis or taking antihypertensive medication; or an average systolic blood pressure > or = 140 mm Hg or an average diastolic blood pressure > or = 90 mm Hg at the medical examination. One-year prevalence of GAD and MDD was determined, using Diagnostic and Statistical Manual of Mental Disorders, Third Edition criteria. In separate regression models adjusting for age and then additionally for place of service, ethnicity, marital status, alcohol consumption, smoking, body mass index, household income, and education grade, both GAD and MDD were related positively to hypertension. In age-adjusted and fully adjusted models comparing comorbid GAD/MDD, GAD alone, MDD alone, and neither condition, comorbidity showed the strongest relationship with hypertension. Depression has been the main focus for research on mental health and physical health outcomes. The present results suggest that future research should pay equal attention to GAD and, in particular, the comorbidity of GAD and MDD.

Medical comorbidity in complicated grief: Results from the HEAL collaborative trial.

PubMed

Robbins-Welty, Gregg; Stahl, Sarah; Zhang, Jun; Anderson, Stewart; Schenker, Yael; Shear, M Katherine; Simon, Naomi M; Zisook, Sidney; Skritskaya, Natalia; Mauro, Christina; Lebowitz, Barry D; Reynolds, Charles F

2018-01-01

To describe medical comorbidity in persons with Complicated Grief (CG) and to test whether medical comorbidity in individuals with CG is associated with the severity and duration of CG, after adjusting for age, sex, race, and current depressive symptoms. In exploratory analyses, we compared data from participants in an NIMH-sponsored multisite clinical trial of CG ("HEAL": "Healing Emotions After Loss") to archival data from participants matched on age, gender, and race/ethnicity, stratified by the presence or absence of current major depression. We used the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) as a measure of medical polymorbidity. We investigated the association between CG and medical comorbidity via multiple linear regression, adjusting for sociodemographic and clinical variables, including severity of depressive symptoms. Chronological age and severity of co-occurring symptoms of major depression correlated with cumulative medical polymorbidity in persons with Complicated Grief. The severity of CG and the time since loss did not correlate with global medical polymorbidity (CIRS-G score). Nor was there an interaction between severity of depressive symptoms and severity of CG symptoms in predicting global CIRS-G score. Cumulative medical comorbidity, as measured by CIRS-G scores, was greater in subjects with current major depression ("DEPRESSED") than in CG subjects, and both DEPRESSED and CG subjects had greater medical morbidity than CONTROLS. Medical comorbidity is prevalent in Complicated Grief, associated with increasing age and co-occurring depressive symptoms but apparently not with chronicity and severity of Complicated Grief per se. This observation suggests that treating depression in the context of CG may be important to managing medical conditions in individuals with Complicated Grief to attenuate or prevent the long-term medical sequelae of CG. Copyright © 2017 Elsevier Ltd. All rights reserved.

Adjusting health spending for the presence of comorbidities: an application to United States national inpatient data.

PubMed

Dieleman, Joseph L; Baral, Ranju; Johnson, Elizabeth; Bulchis, Anne; Birger, Maxwell; Bui, Anthony L; Campbell, Madeline; Chapin, Abigail; Gabert, Rose; Hamavid, Hannah; Horst, Cody; Joseph, Jonathan; Lomsadze, Liya; Squires, Ellen; Tobias, Martin

2017-08-29

One of the major challenges in estimating health care spending spent on each cause of illness is allocating spending for a health care event to a single cause of illness in the presence of comorbidities. Comorbidities, the secondary diagnoses, are common across many causes of illness and often correlate with worse health outcomes and more expensive health care. In this study, we propose a method for measuring the average spending for each cause of illness with and without comorbidities. Our strategy for measuring cause of illness-specific spending and adjusting for the presence of comorbidities uses a regression-based framework to estimate excess spending due to comorbidities. We consider multiple causes simultaneously, allowing causes of illness to appear as either a primary diagnosis or a comorbidity. Our adjustment method distributes excess spending away from primary diagnoses (outflows), exaggerated due to the presence of comorbidities, and allocates that spending towards causes of illness that appear as comorbidities (inflows). We apply this framework for spending adjustment to the National Inpatient Survey data in the United States for years 1996-2012 to generate comorbidity-adjusted health care spending estimates for 154 causes of illness by age and sex. The primary diagnoses with the greatest number of comorbidities in the NIS dataset were acute renal failure, septicemia, and endocarditis. Hypertension, diabetes, and ischemic heart disease were the most common comorbidities across all age groups. After adjusting for comorbidities, chronic kidney diseases, atrial fibrillation and flutter, and chronic obstructive pulmonary disease increased by 74.1%, 40.9%, and 21.0%, respectively, while pancreatitis, lower respiratory infections, and septicemia decreased by 21.3%, 17.2%, and 16.0%. For many diseases, comorbidity adjustments had varying effects on spending for different age groups. Our methodology takes a unified approach to account for excess spending caused

Neurodevelopmental comorbidities and seizure control 24 months after a first unprovoked seizure in children.

PubMed

Jason, Eva Åndell; Tomson, Torbjörn; Carlsson, Sofia; Tedroff, Kristina; Åmark, Per

2018-07-01

To follow children with newly diagnosed unprovoked seizures to determine (1) whether the prevalence of neurodevelopmental comorbidities and cerebral palsy (CP) changed after the initial seizure, and (2) the association between studied comorbidities and seizures 13-24 months after seizure onset or initiation of treatment. Analyses were based on 750 children (28 days-18 years) with a first unprovoked seizure (index) included in a population-based Incidence Registry in Stockholm between 2001 and 2006. The children were followed for two years and their medical records were examined for a priori defined neurodevelopmental/psychiatric comorbidities and CP and seizure frequency. Baseline information was collected from medical records from before, and up to six months after, the index seizure. Odds ratios (OR) of repeated seizures 13-24 months after the first seizure or after initiation of anti-epileptic drug treatment was calculated by logistic regression and adjusted for age and sex. At baseline, 32% of the children had neurodevelopmental/psychiatric comorbidities or CP compared to 35%, 24 months later. Children with such comorbidities more often experienced seizures 13-24 months after the index seizure (OR 2.87, CI 2.07-3.99) with the highest OR in those with CP or attention deficit hyperactivity disorder (ADHD). Children diagnosed at age <1 year exhibited the highest prevalence of comorbidities as well as OR for repeated seizures. A combination of young age and comorbidity was associated with an OR for repeated seizures of 5.12 (CI 3.03-8.65). Among the children without comorbidities 76% were seizure free 13-24 months after the index seizure or after initiation of AED treatment compared to 53% of children with comorbidities. This study indicates that neurodevelopmental comorbidities and CP in children with epilepsy tend to be present already at seizure onset and that such comorbidities are strong indicators of poor outcome regarding seizure control with or without

Validation of the rheumatic disease comorbidity index.

PubMed

England, Bryant R; Sayles, Harlan; Mikuls, Ted R; Johnson, Dannette S; Michaud, Kaleb

2015-05-01

There is no consensus on which comorbidity index is optimal for rheumatic health outcomes research. We compared a new Rheumatic Disease Comorbidity Index (RDCI) with the Charlson-Deyo Index (CDI), Functional Comorbidity Index (FCI), Elixhauser Total Score (ETS), Elixhauser Point System (EPS), and a simple comorbidity count (COUNT) using a US cohort of rheumatoid arthritis (RA) patients. Using administrative diagnostic codes and patient self-reporting, we tested predictive values of the RDCI, CDI, FCI, ETS, EPS, and COUNT for 2 outcomes: all-cause mortality and physical functioning. Indices were compared using 3 models: bare (consisting of age, sex, and race), administrative (bare plus visit frequency, body mass index, and treatments), and clinic (administrative plus erythrocyte sedimentation rate, nodules, rheumatoid factor positivity, and patient activity scale). The ETS and RDCI best predicted death, with FCI performing the worst. The FCI best predicted function, with ETS and RDCI performing nearly as well. CDI predicted function poorly. The order of indices remained relatively unchanged in the different models, though the magnitude of improvement in Akaike's information criterion decreased in the administrative and clinic models. The RDCI and ETS are excellent indices as a means of accounting for comorbid illness when the RA-related outcomes of death and physical functioning are studied using administrative data. The RDCI is a versatile index and appears to perform well with self-report data as well as administrative data. Further studies are warranted to compare these indices using other outcomes in diverse study populations. © 2015, American College of Rheumatology.

Serum aminotransferase changes with significant weight loss: sex and age effects.

PubMed

Suzuki, Ayako; Binks, Martin; Sha, Ronald; Wachholtz, Amy; Eisenson, Howard; Diehl, Anna Mae

2010-02-01

In obese subjects, the liver may be differentially affected by significant weight loss depending on as yet unknown factors. We explored clinical factors associated with serum alanine aminotransferase (ALT) changes during significant weight loss in a residential weight loss program. Clinical data from 362 adults who received a comprehensive weight loss intervention (ie, diets, physical fitness, and behavioral modification) in the program were analyzed. Serum ALT was used as a surrogate marker of liver injury. The ALT changes during the program were calculated to create study outcome categories (improvement, no change, or deterioration of ALT during significant weight loss). Variables of demography, lifestyle, and comorbidities at baseline, and total/rate of weight change during the program were explored for associations with the ALT change categories using multiple logistic regression models. Variation by sex was apparent among predictors of ALT deterioration; men with rapid weight loss and women with higher initial body mass index were more likely to experience ALT deterioration, whereas men with prior alcohol consumption were less likely to experience ALT deterioration even after adjusting for baseline ALT (Ps < .03). Variation by age was apparent among predictors of ALT improvement; younger patients with current smoking and older patients with rapid weight loss, diabetes or impaired fasting glucose, or sleep apnea or who followed a reduced-carbohydrate diet were less likely to experience ALT improvement (Ps < .05). A number of clinical factors influence ALT changes during weight loss in sex- and age-specific manners. The patterns that we detected may have pathophysiologic significance beyond the practical implications of our findings in clinical practice related to underlying changes in fat metabolism. Copyright 2010 Elsevier Inc. All rights reserved.

Efficacy and immunogenicity of high-dose influenza vaccine in older adults by age, comorbidities, and frailty.

PubMed

DiazGranados, Carlos A; Dunning, Andrew J; Robertson, Corwin A; Talbot, H Keipp; Landolfi, Victoria; Greenberg, David P

2015-08-26

A randomized trial demonstrated that a high-dose inactivated influenza vaccine (IIV-HD) was 24.2% more efficacious than a standard-dose vaccine (IIV-SD) against laboratory-confirmed influenza illness in adults ≥65 years. To evaluate the consistency of IIV-HD benefits, supplemental analyses explored efficacy and immunogenicity by baseline characteristics of special interest. Double-blind, randomized, active-controlled, multicenter trial. Adults ≥65 years were randomized 1:1 to receive IIV-HD or IIV-SD and followed for 6-8 months postvaccination for the occurrence of influenza. One third of participants were randomly selected to provide sera for measurement of hemagglutination inhibition antibody (HAI) titers. Efficacy (IIV-HD vs. IIV-SD) against laboratory-confirmed, protocol-defined influenza-like illness (PD-ILI) and HAI geometric mean titer (GMT) ratios (IIV-HD/IIV-SD) were evaluated by age, and number of high-risk comorbid and frailty conditions. Efficacy (95% confidence intervals) of IIV-HD relative to IIV-SD against laboratory-confirmed PD-ILI was 19.7% (0.4%; 35.4%) for participants 65-74 years, 32.4% (8.1%; 50.6%) for those ≥75 years, 22.1% (3.9%; 37.0%) for participants with ≥1 high-risk comorbidity, 23.6% (-3.2%; 43.6%) for those with ≥2 high-risk comorbidities, 27.5% (0.4%; 47.4%) for persons with 1 frailty condition, 23.9% (-9.0%; 47.2%) for those with 2 frailty conditions, and 16.0% (-16.3%; 39.4%) for those with ≥3 frailty conditions. There was no evidence of vaccine efficacy heterogeneity within age, comorbidity, and frailty strata (P-values 0.351, 0.875, and 0.838, respectively). HAI GMT ratios were significantly higher among IIV-HD recipients for all strains and across all subgroups. Estimates of relative efficacy consistently favored IIV-HD over IIV-SD. There was no significant evidence that baseline age, comorbidity, or frailty modified the efficacy of IIV-HD relative to IIV-SD. IIV-HD significantly improved HAI responses for all

Managing comorbidities in COPD

PubMed Central

Hillas, Georgios; Perlikos, Fotis; Tsiligianni, Ioanna; Tzanakis, Nikolaos

2015-01-01

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Age and smoking are common risk factors for COPD and other illnesses, often leading COPD patients to demonstrate multiple coexisting comorbidities. COPD exacerbations and comorbidities contribute to the overall severity in individual patients. Clinical trials investigating the treatment of COPD routinely exclude patients with multiple comorbidities or advanced age. Clinical practice guidelines for a specific disease do not usually address comorbidities in their recommendations. However, the management and the medical intervention in COPD patients with comorbidities need a holistic approach that is not clearly established worldwide. This holistic approach should include the specific burden of each comorbidity in the COPD severity classification scale. Further, the pharmacological and nonpharmacological management should also include optimal interventions and risk factor modifications simultaneously for all diseases. All health care specialists in COPD management need to work together with professionals specialized in the management of the other major chronic diseases in order to provide a multidisciplinary approach to COPD patients with multiple diseases. In this review, we focus on the major comorbidities that affect COPD patients. We present an overview of the problems faced, the reasons and risk factors for the most commonly encountered comorbidities, and the burden on health care costs. We also provide a rationale for approaching the therapeutic options of the COPD patient afflicted by comorbidity. PMID:25609943

Age difference asymmetry and a two-sex perspective.

PubMed

Ni Bhrolchain, M

1992-01-01

Age differences in marriage are examined using data from the Marriage and Divorce Statistics, Series FM2, 1966-87, in England and Wales. Specifically, there is a description of differentials in the spousal age gap by sex and marital status of the partner, trends in the age differences between spouses, the components of change in age differences, i.e., changing age at marriage, and changes in partner's marital status. Data were unavailable to answer whether or not changes in opportunity or constraint (shifts in age/sex distribution) or changing preferences in relation to age differences or both affected the shifts, but plausible interpretations are provided. The difference in ages is evident in the pattern of mean age difference in 1987 for single brides (3.0 years) and the mean gap for bachelors (1.6 years). These figures are still different from the 2.1-year gap in the marriages of 2 single partners or the 2.6-year gap for all marriages. The mean age of 1st marriages is 2.2 for both sexes, 1.6 for men and 3.0 for women. for 2nd and later marriages the pattern is reversed, where divorced women remarry to men averaging 1.7 years older while divorced men remarry a woman 5.3 years younger. The gaps among the widowed are 1.9 years for women and 6.7 years for men. The reasons for the differentials are that not all single men marry single women and the reverse, and that age differences depend on sex, marriage order for both sexes, and marital status of the partner. The longitudinal pattern of age differences being larger in remarriages than in 1st marriages is exhibited for male remarriages only; for women in remarriages the age difference is shortened from 3.0 years to 1.7 years. In comparing time trends, 1) the mean age gap is consistently larger in women's than in men's 1st marriages with a larger gap appearing closer to the present; 2) the age differences have fluctuated over time; 3) the gap in men's and women's marriages were similar up to 1970 and, between 1970

Tuberous sclerosis complex: correlation of magnetic resonance imaging (MRI) findings with comorbidities.

PubMed

Wong, Virginia; Khong, Pek-Lan

2006-02-01

We studied the magnetic resonance imaging (MRI) findings in a cohort of Chinese children with tuberous sclerosis complex to determine the relationship between age, sex, mental retardation, autism, epilepsy, infantile spasm, and early age at onset of seizures and the numbers and locations of tubers detected. We searched our tuberous sclerosis registry, established in 1985 (N = 44), and performed an analysis of children who had MRIs of the brain performed (n = 22). A neuroradiologist blinded to the clinical findings scored the MRIs according to the total number and site of the tubers. The following factors were analyzed: age, sex, presence of autism (n = 7), presence (n = 19) and severity of mental retardation (mild [n = 12], moderate to severe [n = 7]), presence of epilepsy (n = 21) or infantile spasm (n = 8), and age at onset of seizures less than 1 year (n = 10). There was no significant relationship between the number and site of tubers and the following factors: sex, autism, mental retardation, degree of mental retardation, epilepsy, history of infantile spasm, or age at onset of seizures less than 1 year. Only the presence of cortical tubers in the parietal regions had a significant relationship with the history of infantile spasm (P = .012). Using multiple regression analysis of all of the risk factors, only age is related to the number of tubers in the MRI (P = .047), and a history of infantile spasm is related to the presence of tubers in the parietal (P = .009) and occipital (P = .031) lobes. The associated comorbidities in tuberous sclerosis complex might be explained by more complex underlying genetic or pathologic issues rather than purely by the site of the cortical tubers. We suggest that a developmental approach, by analyzing the age at the appearance of tubers in both symptomatic and asymptomatic cases with the development of other neuropsychiatric comorbidities, should be undertaken to assess the causal relationship.

Sex-Role Inconstancy, Biology, and Successful Aging: A Dialectical Model

ERIC Educational Resources Information Center

Sinnott, Jan Dynda

1977-01-01

This paper examines sex-role inconstancy from a life-span point of view. New environmental realities and an increasing life-span may make traditional sex roles less functional in old age. Evidence is presented for more successful aging in persons manifesting convergent sex-role behavior. (Author)

Neurovascular control of blood pressure is influenced by aging, sex, and sex hormones.

PubMed

Baker, Sarah E; Limberg, Jacqueline K; Ranadive, Sushant M; Joyner, Michael J

2016-12-01

In this review, we highlight that the relationship between muscle sympathetic nerve activity (MSNA) and mean arterial pressure is complex, differs by sex, and changes with age. In young men there is an inverse relationship between MSNA and cardiac output where high MSNA is compensated for by low cardiac output. This inverse relationship is not seen in older men. In young women sympathetic vasoconstriction is offset by β-adrenoreceptor mediated vasodilation, limiting the ability of young women to maintain blood pressure in response to orthostatic stress. However, β-mediated dilation in women is attenuated with age, leading to unopposed α-adrenergic vasoconstriction and a rise in the direct transduction of MSNA into increases in blood pressure. We propose that these changes with age and menopausal status are major contributing factors in the increased prevalence of hypertension in older women. In addition to aging, we highlight that changes in sex hormones in young women (across the menstrual cycle, with oral contraceptive use, or with pregnancy) influence MSNA and the transduction of MSNA into increases in blood pressure. It is likely that the β-adrenergic receptors and/or changes in baroreflex sensitivity play a large role in these sex differences and changes with alterations in sex hormones. Copyright © 2016 the American Physiological Society.

Multimorbidity, age-related comorbidities and mortality: association of activation, senescence and inflammation markers in HIV adults.

PubMed

Duffau, Pierre; Ozanne, Alexandra; Bonnet, Fabrice; Lazaro, Estibaliz; Cazanave, Charles; Blanco, Patrick; Rivière, Etienne; Desclaux, Arnaud; Hyernard, Caroline; Gensous, Noemie; Pellegrin, I; Wittkop, L

2018-05-11

The widespread introduction of combination antiretroviral therapy (cART) has increased survival of HIV+ patients. However, the prevalence of age-related comorbidities remains higher than that of the general population, suggesting that individuals with HIV suffer from accelerated aging. Immune activation, -senescence and inflammation could play an important role in this process. The CIADIS (Chronic Immune Activation anD Senescence) sub-study analyzed biomarkers of activation, differentiation, and senescence of T-cells in a cellular-CIADIS weighted score, while biomarkers of inflammation were analyzed in a soluble-CIADIS weighted score using principal component analysis. Adjusted logistic regression and Cox proportional hazard models were used to determine the association between CIADIS weighted scores and 1) the presence of multimorbidity, 2) time to occurrence of the first new age-related comorbidity, and 3) time to death, over a 3-year follow-up period. Of 828 patients with an undetectable viral load, a higher cellular-CIADIS weighted score and higher TNFRI levels were independently associated with the presence of multimorbidity (OR=1.3; 95% CI 1.0-1.6; P=0.02), but the soluble-CIADIS weighted score was not (OR=1.1; 95% CI 0.9-1.3; P=0.33). A higher cellular-CIADIS weighted score (HR=2.2; P < 0.01), higher levels of CD8 activation and a lower CD4/CD8 ratio were associated with a higher risk of age-related comorbidities. Only TNFRI was associated with mortality in a 3-year period. The cellular-CIADIS weighted score was independently associated with both multimorbidity at inclusion and the risk of new age-related comorbidity during a 3- year follow-up. TNFRI was associated a higher risk for mortality.

China's marriage squeeze: A decomposition into age and sex structure.

PubMed

Jiang, Quanbao; Li, Xiaomin; Li, Shuzhuo; Feldman, Marcus W

2016-06-01

Most recent studies of marriage patterns in China have emphasized the male-biased sex ratio but have largely neglected age structure as a factor in China's male marriage squeeze. In this paper we develop an index we call "spousal sex ratio" (SSR) to measure the marriage squeeze, and a method of decomposing the proportion of male surplus into age and sex structure effects within a small spousal age difference interval. We project that China's marriage market will be confronted with a relatively severe male squeeze. For the decomposition of the cohort aged 30, from 2010 to 2020 age structure will be dominant, while from 2020 through 2034 the contribution of age structure will gradually decrease and that of sex structure will increase. From then on, sex structure will be dominant. The index and decomposition, concentrated on a specific female birth cohort, can distinguish spousal competition for single cohorts which may be covered by a summary index for the whole marriage market; these can also be used for consecutive cohorts to reflect the situation of the whole marriage market.

Chinese Registry of rheumatoid arthritis (CREDIT): II. prevalence and risk factors of major comorbidities in Chinese patients with rheumatoid arthritis.

PubMed

Jin, Shangyi; Li, Mengtao; Fang, Yongfei; Li, Qin; Liu, Ju; Duan, Xinwang; Liu, Yi; Wu, Rui; Shi, Xiaofei; Wang, Yongfu; Jiang, Zhenyu; Wang, Yanhong; Yu, Chen; Wang, Qian; Tian, Xinping; Zhao, Yan; Zeng, Xiaofeng

2017-11-15

Rheumatoid arthritis patients are at higher risk of developing comorbidities. The main objective of this study was to evaluate the prevalence of major comorbidities in Chinese rheumatoid arthritis patients. We also aimed to identify factors associated with these comorbidities. Baseline demographic, clinical characteristics and comorbidity data from RA patients enrolled in the Chinese Registry of rhEumatoiD arthrITis (CREDIT) from Nov 2016 to August 2017 were presented and compared with those from five other registries across the world. Possible factors related to three major comorbidities (cardiovascular disease, fragility fracture and malignancy) were identified using multivariate logistic regression analyses. A total of 13,210 RA patients were included (80.6% female, mean age 52.9 years and median RA duration 4.0 years). Baseline prevalence rates of major comorbidities were calculated: CVD, 2.2% (95% CI 2.0-2.5%); fragility fracture, 1.7% (95% CI 1.5-1.9%); malignancy, 0.6% (95% CI 0.5-0.7%); overall major comorbidities, 4.2% (95% CI 3.9-4.6%). Advanced age was associated with all comorbidities. Male gender and disease duration were positively related to CVD. Female sex and longer disease duration were potential risk factors for fragility fractures. Ever use of methotrexate (MTX) was negatively related to baseline comorbidities. Patients with rheumatoid arthritis in China have similar prevalence of comorbidities with other Asian countries. Advanced age and long disease duration are possible risk factors for comorbidities. On the contrary, MTX may protect RA patients from several major comorbidities, supporting its central role in the management of rheumatoid arthritis.

Neuropathologic comorbidity and cognitive impairment in the Nun and Honolulu-Asia Aging Studies

PubMed Central

Edland, Steven D.; Hemmy, Laura S.; Montine, Kathleen S.; Zarow, Chris; Sonnen, Joshua A.; Uyehara-Lock, Jane H.; Gelber, Rebecca P.; Ross, G. Webster; Petrovitch, Helen; Masaki, Kamal H.; Lim, Kelvin O.; Launer, Lenore J.; Montine, Thomas J.

2016-01-01

Objective: To examine frequencies and relationships of 5 common neuropathologic abnormalities identified at autopsy with late-life cognitive impairment and dementia in 2 different autopsy panels. Methods: The Nun Study (NS) and the Honolulu-Asia Aging Study (HAAS) are population-based investigations of brain aging that included repeated cognitive assessments and comprehensive brain autopsies. The neuropathologic abnormalities assessed were Alzheimer disease (AD) neuropathologic changes, neocortical Lewy bodies (LBs), hippocampal sclerosis, microinfarcts, and low brain weight. Associations with screening tests for cognitive impairment were examined. Results: Neuropathologic abnormalities occurred at levels ranging from 9.7% to 43%, and were independently associated with cognitive impairment in both studies. Neocortical LBs and AD changes were more frequent among the predominantly Caucasian NS women, while microinfarcts were more common in the Japanese American HAAS men. Comorbidity was usual and very strongly associated with cognitive impairment. Apparent cognitive resilience (no cognitive impairment despite Braak stage V) was strongly associated with minimal or no comorbid abnormalities, with fewer neocortical AD lesions, and weakly with longer interval between final testing and autopsy. Conclusions: Total burden of comorbid neuropathologic abnormalities, rather than any single lesion type, was the most relevant determinant of cognitive impairment in both cohorts, often despite clinical diagnosis of only AD. These findings emphasize challenges to dementia pathogenesis and intervention research and to accurate diagnoses during life. PMID:26888993

Neuropathologic comorbidity and cognitive impairment in the Nun and Honolulu-Asia Aging Studies.

PubMed

White, Lon R; Edland, Steven D; Hemmy, Laura S; Montine, Kathleen S; Zarow, Chris; Sonnen, Joshua A; Uyehara-Lock, Jane H; Gelber, Rebecca P; Ross, G Webster; Petrovitch, Helen; Masaki, Kamal H; Lim, Kelvin O; Launer, Lenore J; Montine, Thomas J

2016-03-15

To examine frequencies and relationships of 5 common neuropathologic abnormalities identified at autopsy with late-life cognitive impairment and dementia in 2 different autopsy panels. The Nun Study (NS) and the Honolulu-Asia Aging Study (HAAS) are population-based investigations of brain aging that included repeated cognitive assessments and comprehensive brain autopsies. The neuropathologic abnormalities assessed were Alzheimer disease (AD) neuropathologic changes, neocortical Lewy bodies (LBs), hippocampal sclerosis, microinfarcts, and low brain weight. Associations with screening tests for cognitive impairment were examined. Neuropathologic abnormalities occurred at levels ranging from 9.7% to 43%, and were independently associated with cognitive impairment in both studies. Neocortical LBs and AD changes were more frequent among the predominantly Caucasian NS women, while microinfarcts were more common in the Japanese American HAAS men. Comorbidity was usual and very strongly associated with cognitive impairment. Apparent cognitive resilience (no cognitive impairment despite Braak stage V) was strongly associated with minimal or no comorbid abnormalities, with fewer neocortical AD lesions, and weakly with longer interval between final testing and autopsy. Total burden of comorbid neuropathologic abnormalities, rather than any single lesion type, was the most relevant determinant of cognitive impairment in both cohorts, often despite clinical diagnosis of only AD. These findings emphasize challenges to dementia pathogenesis and intervention research and to accurate diagnoses during life. © 2016 American Academy of Neurology.

Contemporary Sex-Based Differences by Age in Presenting Characteristics, Use of an Early Invasive Strategy, and Inhospital Mortality in Patients With Non-ST-Segment-Elevation Myocardial Infarction in the United States.

PubMed

Gupta, Tanush; Kolte, Dhaval; Khera, Sahil; Agarwal, Nayan; Villablanca, Pedro A; Goel, Kashish; Patel, Kavisha; Aronow, Wilbert S; Wiley, Jose; Bortnick, Anna E; Aronow, Herbert D; Abbott, J Dawn; Pyo, Robert T; Panza, Julio A; Menegus, Mark A; Rihal, Charanjit S; Fonarow, Gregg C; Garcia, Mario J; Bhatt, Deepak L

2018-01-01

Prior studies have reported higher inhospital mortality in women versus men with non-ST-segment-elevation myocardial infarction. Whether this is because of worse baseline risk profile compared with men or sex-based disparities in treatment is not completely understood. We queried the 2003 to 2014 National Inpatient Sample databases to identify all hospitalizations in patients aged ≥18 years with the principal diagnosis of non-ST-segment-elevation myocardial infarction. Complex samples multivariable logistic regression models were used to examine sex differences in use of an early invasive strategy and inhospital mortality. Of 4 765 739 patients with non-ST-segment-elevation myocardial infarction, 2 026 285 (42.5%) were women. Women were on average 6 years older than men and had a higher comorbidity burden. Women were less likely to be treated with an early invasive strategy (29.4% versus 39.2%; adjusted odds ratio, 0.92; 95% confidence interval, 0.91-0.94). Women had higher crude inhospital mortality than men (4.7% versus 3.9%; unadjusted odds ratio, 1.22; 95% confidence interval, 1.20-1.25). After adjustment for age (adjusted odds ratio, 0.96; 95% confidence interval, 0.94-0.98) and additionally for comorbidities, other demographics, and hospital characteristics, women had 10% lower odds of inhospital mortality (adjusted odds ratio, 0.90; 95% confidence interval, 0.89-0.92). Further adjustment for differences in the use of an early invasive strategy did not change the association between female sex and lower risk-adjusted inhospital mortality. Although women were less likely to be treated with an early invasive strategy compared with men, the lower use of an early invasive strategy was not responsible for the higher crude inhospital mortality in women, which could be entirely explained by older age and higher comorbidity burden. © 2018 American Heart Association, Inc.

Age and sex influences on running mechanics and coordination variability.

PubMed

Boyer, Katherine A; Freedman Silvernail, Julia; Hamill, Joseph

2017-11-01

The purpose of this study was to examine the impact of age on running mechanics separately for male and female runners and to quantify sex differences in running mechanics and coordination variability for older runners. Kinematics and kinetics were captured for 20 younger (10 male) and 20 older (10 male) adults running overground at 3.5 m · s -1 . A modified vector coding technique was used to calculate segment coordination variability. Lower extremity joint angles, moments and segment coordination variability were compared between age and sex groups. Significant sex-age interaction effects were found for heel-strike hip flexion and ankle in/eversion angles and peak ankle dorsiflexion angle. In older adults, mid-stance knee flexion angle, ankle inversion and abduction moments and hip abduction and external rotation moments differed by sex. Older compared with younger females had reduced coordination variability in the thigh-shank transverse plane couple but greater coordination variability for the shank rotation-foot eversion couple in early stance. These results suggest there may be a non-equivalent aging process in the movement mechanics for males and females. The age and sex differences in running mechanics and coordination variability highlight the need for sex-based analyses for future studies examining injury risk with age.

The association between major depression prevalence and sex becomes weaker with age.

PubMed

Patten, Scott B; Williams, Jeanne V A; Lavorato, Dina H; Wang, Jian Li; Bulloch, Andrew G M; Sajobi, Tolulope

2016-02-01

Women have a higher prevalence of major depressive episodes (MDE) than men, and the annual prevalence of MDE declines with age. Age by sex interactions may occur (a weakening of the sex effect with age), but are easily overlooked since individual studies lack statistical power to detect interactions. The objective of this study was to evaluate age by sex interactions in MDE prevalence. In Canada, a series of 10 national surveys conducted between 1996 and 2013 assessed MDE prevalence in respondents over the age of 14. Treating age as a continuous variable, binomial and linear regression was used to model age by sex interactions in each survey. To increase power, the survey-specific interaction coefficients were then pooled using meta-analytic methods. The estimated interaction terms were homogeneous. In the binomial regression model I (2) was 31.2 % and was not statistically significant (Q statistic = 13.1, df = 9, p = 0.159). The pooled estimate (-0.004) was significant (z = 3.13, p = 0.002), indicating that the effect of sex became weaker with increasing age. This resulted in near disappearance of the sex difference in the 75+ age group. This finding was also supported by an examination of age- and sex-specific estimates pooled across the surveys. The association of MDE prevalence with sex becomes weaker with age. The interaction may reflect biological effect modification. Investigators should test for, and consider inclusion of age by sex interactions in epidemiological analyses of MDE prevalence.

Mallard age and sex determination from wings

USGS Publications Warehouse

Carney, S.M.; Geis, A.D.

1960-01-01

This paper describes characters on the wing plumage of the mallard that indicate age and sex. A key outlines a logical order in which to check age and sex characters on wings. This method was tested and found to be more than 95 percent reliable, although it was found that considerable practice and training with known-age specimens was required to achieve this level of accuracy....The implications of this technique and the sampling procedure it permits are discussed. Wing collections could provide information on production, and, if coupled with a banding program could permit seasonal population estimates to be calculated. In addition, representative samples of wings would provide data to check the reliability of several other waterfowl surveys.

Sex, the aging immune system, and chronic disease.

PubMed

Gubbels Bupp, Melanie R

2015-04-01

The immune systems of men and women differ in significant ways, especially after puberty. In particular, females are generally more prone to autoimmunity, but experience lower rates of infections and chronic inflammatory disease. Sex hormones, genes encoded on the sex chromosomes, and gender-specific behaviors likely contribute to these differences. The aging process is associated with changes in the composition and function of the immune system and these changes may occur at an accelerated rate in men as compared to women. Moreover, after the age of menopause, the incidence of chronic inflammatory disease in women approaches or exceeds that observed in males. At the same time, the incidence of autoimmunity in post-menopausal women is decreased or equivalent to the rates observed in similarly-aged men. Additional studies addressing the influence of sex on the pathogenesis of chronic and autoimmune diseases in the aged are warranted. Copyright © 2015 Elsevier Inc. All rights reserved.

Age and Comorbid Illness Are Associated With Late Rectal Toxicity Following Dose-Escalated Radiation Therapy for Prostate Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hamstra, Daniel A.; Stenmark, Matt H.; Ritter, Tim

2013-04-01

Purpose: To assess the impacts of patient age and comorbid illness on rectal toxicity following external beam radiation therapy (EBRT) for prostate cancer and to assess the Qualitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC) normal tissue complication probability (NTCP) model in this context. Methods and Materials: Rectal toxicity was analyzed in 718 men previously treated for prostate cancer with EBRT (≥75 Gy). Comorbid illness was scored using the Charlson Comorbidity Index (CCMI), and the NTCP was evaluated with the QUANTEC model. The influence of clinical and treatment-related parameters on rectal toxicity was assessed by Kaplan-Meier and Coxmore » proportional hazards models. Results: The cumulative incidence of rectal toxicity grade ≥2 was 9.5% and 11.6% at 3 and 5 years and 3.3% and 3.9% at 3 and 5 years for grade ≥3 toxicity, respectively. Each year of age predicted an increasing relative risk of grade ≥2 (P<.03; hazard ratio [HR], 1.04 [95% confidence interval (CI), 1.01-1.06]) and ≥3 rectal toxicity (P<.0001; HR, 1.14 [95% CI,1.07-1.22]). Increasing CCMI predicted rectal toxicity where a history of either myocardial infarction (MI) (P<.0001; HR, 5.1 [95% CI, 1.9-13.7]) or congestive heart failure (CHF) (P<.0006; HR, 5.4 [95% CI, 0.6-47.5]) predicted grade ≥3 rectal toxicity, with lesser correlation with grade ≥2 toxicity (P<.02 for MI, and P<.09 for CHF). An age comorbidity model to predict rectal toxicity was developed and confirmed in a validation cohort. The use of anticoagulants increased toxicity independent of age and comorbidity. NTCP was prognostic for grade ≥3 (P=.015) but not grade ≥2 (P=.49) toxicity. On multivariate analysis, age, MI, CHF, and an NTCP >20% all correlated with late rectal toxicity. Conclusions: Patient age and a history of MI or CHF significantly impact rectal toxicity following EBRT for the treatment of prostate cancer, even after controlling for NTCP.« less

Sex differences in the effect of aging on dry eye disease.

PubMed

Ahn, Jong Ho; Choi, Yoon-Hyeong; Paik, Hae Jung; Kim, Mee Kum; Wee, Won Ryang; Kim, Dong Hyun

2017-01-01

Aging is a major risk factor in dry eye disease (DED), and understanding sexual differences is very important in biomedical research. However, there is little information about sex differences in the effect of aging on DED. We investigated sex differences in the effect of aging and other risk factors for DED. This study included data of 16,824 adults from the Korea National Health and Nutrition Examination Survey (2010-2012), which is a population-based cross-sectional survey. DED was defined as the presence of frequent ocular dryness or a previous diagnosis by an ophthalmologist. Basic sociodemographic factors and previously known risk factors for DED were included in the analyses. Linear regression modeling and multivariate logistic regression modeling were used to compare the sex differences in the effect of risk factors for DED; we additionally performed tests for interactions between sex and other risk factors for DED in logistic regression models. In our linear regression models, the prevalence of DED symptoms in men increased with age ( R =0.311, P =0.012); however, there was no association between aging and DED in women ( P >0.05). Multivariate logistic regression analyses showed that aging in men was not associated with DED (DED symptoms/diagnosis: odds ratio [OR] =1.01/1.04, each P >0.05), while aging in women was protectively associated with DED (DED symptoms/diagnosis: OR =0.94/0.91, P =0.011/0.003). Previous ocular surgery was significantly associated with DED in both men and women (men/women: OR =2.45/1.77 [DED symptoms] and 3.17/2.05 [DED diagnosis], each P <0.001). Tests for interactions of sex revealed significantly different aging × sex and previous ocular surgery × sex interactions ( P for interaction of sex: DED symptoms/diagnosis - 0.044/0.011 [age] and 0.012/0.006 [previous ocular surgery]). There were distinct sex differences in the effect of aging on DED in the Korean population. DED following ocular surgery also showed sexually different

Survival After MI in a Community Cohort Study Contribution of Comorbidities in NSTEMI

PubMed Central

Foraker, Randi E.; Guha, Avirup; Chang, Henry; O’Brien, Emily C.; Bower, Julie K.; Crouser, Elliott D.; Rosamond, Wayne D.; Raman, Subha V.

2018-01-01

Background Non–ST-segment elevation myocardial infarction (NSTEMI) comprises the majority of MI worldwide, yet mortality remains high. Management of NSTEMI is relatively delayed and heterogeneous compared with the “time is muscle” approach to ST-segment elevation MI, though it is unknown to what extent comorbid conditions drive NSTEMI mortality. Objectives We sought to quantify mortality due to MI versus comorbid conditions in patients with NSTEMI. Methods Participants of the ARIC (Atherosclerosis Risk in Communities) study cohort ages 45 to 64 years, who developed incident NSTEMI were identified and incidence-density matched to participants who did not experience an MI by age group, sex, race, and study community. We estimated hazard ratios for all-cause mortality, comparing those who developed NSTEMI to those who did not experience an MI. Results ARIC participants with incident NSTEMI were more likely at baseline to be smokers, have diabetes and renal dysfunction, and take blood pressure or cholesterol-lowering medications than were participants who did not have an MI. Over one-half of participants experiencing NSTEMI died over a median follow-up of 8.4 years; incident NSTEMI was associated with 30% higher risk of mortality after adjusting for comorbid conditions (hazard ratio: 1.30; 95% confidence interval: 1.11 to 1.53). Conclusions NSTEMI confers a significantly higher mortality hazard beyond what can be attributed to comorbid conditions. More consistent and effective strategies are needed to reduce mortality in NSTEMI amid comorbid conditions. PMID:29409724

Associations between diet quality, health status and diabetic complications in patients with type 2 diabetes and comorbid obesity.

PubMed

Mangou, Apostolis; Grammatikopoulou, Maria G; Mirkopoulou, Daphne; Sailer, Nikolaos; Kotzamanidis, Charalambos; Tsigga, Maria

2012-02-01

Patients with type 2 diabetes (T2DM) demonstrate low dietary adherence and this is further aggravated with comorbid obesity. The aim of the present study was to assess diet quality in patients with T2DM and comorbid obesity compared to patients with T2DM alone and to examine the associations between comorbidities and diet quality. The sample consisted of 59 adult patients with diabesity (T2DM and comorbid obesity) and 94 patients with T2DM alone. All diabetes comorbidities and complications were recorded and diet quality was assessed with the Healthy Eating Index (HEI). Mean raw HEI of the diabese subjects was 81.9±7.1 and the diabetic subjects was 80.2±6.9. When HEI was adjusted to the sex, age and weight status, the diabese demonstrated a higher HEI. Among comorbidities, only renal disease decreased HEI. According to the principal component analysis of the total sample, adequate diet quality was explained by cardiovascular disease, cigarette smoking, alcohol consumption, peptic ulcer, sex, diabesity and diabetic foot syndrome. In the diabese, adequate HEI was explained by diabetic foot syndrome, smoking, drinking alcohol and having a family history of diabetes. Adult patients with T2DM demonstrate adequate diet quality. Different factors are associated with the adoption of a high quality diet between the diabese and the T2DM alone. Copyright © 2011 SEEN. Published by Elsevier Espana. All rights reserved.

Romanticism as a function of age, sex, and ethnicity.

PubMed

Regan, Pamela C; Anguiano, Carlos

2010-12-01

This study examined the association between romanticism (operationalized as mean score on the Romantic Beliefs Scale) and age, sex, and ethnicity in a large community sample (N = 436). Age was negatively correlated with romanticism scores; as age increased, romanticism scores decreased. No sex differences were found; men and women had similar, moderate scores. Although ethnicity largely was unrelated to romanticism, Asian/Pacific Islander participants were significantly more romantic than were African-American participants.

Biological age and sex-related declines in physical activity during adolescence.

PubMed

Cairney, John; Veldhuizen, Scott; Kwan, Matthew; Hay, John; Faught, Brent E

2014-04-01

Sex differences in the rate of decline in physical activity (PA) are most pronounced during adolescence. However, once boys and girls are aligned on biological age, sex differences in the patterns of PA become attenuated. The aim of this study was to test whether biological maturation can account for sex differences in participation in PA over time from late childhood to early adolescence. A prospective cohort of children (N = 2100; 1064 boys) was followed from ages 11 to 14 yr, with repeated assessments of PA and anthropometry. Self-reported participation in organized and free play activities was used to track participation in PA. Biological age was measured using an estimate of years to attainment of peak height velocity. Mixed-effects models were used to test whether controlling for biological age attenuates the effect of chronological age and sex on PA. As expected, the rate of decline in participation in PA was greater for girls than for boys (B = -1.18, P < 0.01). In multivariable analyses, adjusting for biological age completely attenuated the effect of sex and chronological age for participation in free play activities, but not for participation in organized play. Overall, biological age was a stronger predictor of participation than chronological age. The effect of biological age on sex by chronological age differences may be specific to certain types of PA participation. Given the importance of maturation to participation in activity, it is suggested that public health strategies target biological not chronological age to prevent declines in PA during adolescence particularly when promoting habitual or lifestyle activity.

Shared genetic influences on negative emotionality and major depression/conduct disorder comorbidity.

PubMed

Tackett, Jennifer L; Waldman, Irwin D; Van Hulle, Carol A; Lahey, Benjamin B

2011-08-01

To investigate whether genetic contributions to major depressive disorder and conduct disorder comorbidity are shared with genetic influences on negative emotionality. Primary caregivers of 2,022 same- and opposite-sex twin pairs 6 to 18 years of age comprised a population-based sample. Participants were randomly selected across five regions in Tennessee, with stratification by age and geographic location. Face-to-face structured interviews were conducted with the primary caregiver of a representative sample of twins. After accounting for genetic influences on negative emotionality, genetic influences on major depressive disorder/conduct disorder comorbidity were nonsignficant, but only in male twins. Specifically, 19% of the variance in the two disorders was accounted for by genetic factors shared with negative emotionality in male twins. Although the full hypothesis could not be tested in female twins, 10% to 11% of the variance in the two disorders was also accounted for by genetic factors shared with negative emotionality. Common shared environmental and nonshared environmental influences were found for major depressive disorder/conduct disorder comorbidity in male and female twins. Negative emotionality represents an important dispositional trait that may explain genetic influences on major depressive disorder/conduct disorder comorbidity, at least for boys. Models of major depressive disorder/conduct disorder comorbidity must simultaneously measure common and specific genetic and environmental factors for a full understanding of this phenomenon. Gender differences require specific research attention in dispositional factors and developmental progression. Copyright © 2011 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Relationships of comorbidities and old age with postoperative complications of head and neck free flaps: A review.

PubMed

Hwang, Kun; Lee, Jin Pyo; Yoo, Si Yoon; Kim, Hun

2016-12-01

The aim of this study was to determine the relationships between free flap complications and old age or comorbidities. In a PubMed and Scopus search, the search terms (1) free flap OR microvascular anastomosis AND (2) elderly OR old age AND (3) complications OR comorbidity OR co-morbidity were used. Among the 62 full-text articles from 241 abstracts, 31 papers without sufficient content were excluded and 10 mined papers were added. Subsequently, 41 papers were reviewed. Overall complication rates of free flap increased significantly with age (p < 0.001; y = 0.457x + 13.464; 40.9% at 60 years, 45.5% at 70 years, and 50.0% at 80 years). Flap survival rates increased significantly (p < 0.001; y = 0.025x + 93.876). Donor site complication rates also increased significantly with age (p < 0.001; y = 1.238x - 63.700; 10.9% at 60 years, 23.0% at 70 years, and 35.3% at 80 years). The Kaplan-Feinstein index (KFI, OR = 7.944, 9.563), the Adult Comorbidity Evaluation-27 (ACE-27, OR = 5.854), the American Society of Anesthesiologists score (ASA, OR = 4.397), and the Index of Coexistent Diseases score (ICED, OR = 3.584) had statistically significant impacts on flap survival (p < 0.05). Diabetes (OR = 4.562) and chronic obstructive pulmonary disease (OR = 2.300) had statistically significant negative impacts on the flap survival rate (p < 0.05). Elderly patients had significantly higher Charlson Comorbidity Index (CCI) and ASA scores (p < 0.001). Similarly, elderly patients exhibited a significantly higher prevalence of dementia (p < 0.001) and use of aspirin at the time of surgery (p < 0.001). On the basis of these results, we suggest that the incidence of complications is directly related to the preoperative medical condition of an individual patient rather than to age. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Age- and sex-specific thorax finite element model development and simulation.

PubMed

Schoell, Samantha L; Weaver, Ashley A; Vavalle, Nicholas A; Stitzel, Joel D

2015-01-01

The shape, size, bone density, and cortical thickness of the thoracic skeleton vary significantly with age and sex, which can affect the injury tolerance, especially in at-risk populations such as the elderly. Computational modeling has emerged as a powerful and versatile tool to assess injury risk. However, current computational models only represent certain ages and sexes in the population. The purpose of this study was to morph an existing finite element (FE) model of the thorax to depict thorax morphology for males and females of ages 30 and 70 years old (YO) and to investigate the effect on injury risk. Age- and sex-specific FE models were developed using thin-plate spline interpolation. In order to execute the thin-plate spline interpolation, homologous landmarks on the reference, target, and FE model are required. An image segmentation and registration algorithm was used to collect homologous rib and sternum landmark data from males and females aged 0-100 years. The Generalized Procrustes Analysis was applied to the homologous landmark data to quantify age- and sex-specific isolated shape changes in the thorax. The Global Human Body Models Consortium (GHBMC) 50th percentile male occupant model was morphed to create age- and sex-specific thoracic shape change models (scaled to a 50th percentile male size). To evaluate the thoracic response, 2 loading cases (frontal hub impact and lateral impact) were simulated to assess the importance of geometric and material property changes with age and sex. Due to the geometric and material property changes with age and sex, there were observed differences in the response of the thorax in both the frontal and lateral impacts. Material property changes alone had little to no effect on the maximum thoracic force or the maximum percent compression. With age, the thorax becomes stiffer due to superior rotation of the ribs, which can result in increased bone strain that can increase the risk of fracture. For the 70-YO models

China’s marriage squeeze: A decomposition into age and sex structure

PubMed Central

LI, Xiaomin; LI, Shuzhuo; FELDMAN, Marcus W.

2016-01-01

Most recent studies of marriage patterns in China have emphasized the male-biased sex ratio but have largely neglected age structure as a factor in China’s male marriage squeeze. In this paper we develop an index we call “spousal sex ratio” (SSR) to measure the marriage squeeze, and a method of decomposing the proportion of male surplus into age and sex structure effects within a small spousal age difference interval. We project that China’s marriage market will be confronted with a relatively severe male squeeze. For the decomposition of the cohort aged 30, from 2010 to 2020 age structure will be dominant, while from 2020 through 2034 the contribution of age structure will gradually decrease and that of sex structure will increase. From then on, sex structure will be dominant. The index and decomposition, concentrated on a specific female birth cohort, can distinguish spousal competition for single cohorts which may be covered by a summary index for the whole marriage market; these can also be used for consecutive cohorts to reflect the situation of the whole marriage market. PMID:27242390

Aging obviates sex-specific physiological responses to exercise.

PubMed

Deschenes, Michael R; Taylor, Jessica L; Mangis, Katherine A

2013-01-01

Both sex and aging have been shown to affect physiological responses to exercise. The aim of the present investigation was to determine whether aging impacted the sex-specific nature of physiological responses to exercise commonly noted among young adults. Ten aged men (69.0 ± 1.7 years; mean ± SE) and 10 aged women (71.6 ± 1.3 years) reporting similar levels of habitual physical activity performed a 30-min exercise session at 60-65% of their predetermined peak oxygen uptake. Cardiovascular, thermoregulatory, and metabolic variables were assessed before exercise, at the 15th and 30th min of exercise, and at 5 and 15 min into a passive postexercise recovery period. Variables of interest were statistically analyzed via two-way analysis of variance with repeated measures; significance was set at P < 0.05. Significant effects of time (i.e., exercise) for each physiological variable of interest were identified, but not once was a significant effect of group (i.e., sex) detected. Exercise-induced physiological responses to prolonged, moderate intensity exercise were similar among aged men and aged women. This evidence that the sexually dimorphic nature of physiological responses to exercise is obviated with age should be taken into account when prescribing health-related exercise training programs for older individuals. Copyright © 2013 Wiley Periodicals, Inc.

Imaging Follow-up of Low-Risk Incidental Pancreas and Kidney Findings: Effects of Patient Age and Comorbidity on Projected Life Expectancy.

PubMed

Raphel, Tiana J; Weaver, Davis T; Berland, Lincoln L; Herts, Brian R; Megibow, Alec J; Knudsen, Amy B; Pandharipande, Pari V

2018-05-01

Purpose To determine the effects of patient age and comorbidity level on life expectancy (LE) benefits associated with imaging follow-up of Bosniak IIF renal cysts and pancreatic side-branch (SB) intraductal papillary mucinous neoplasms (IPMNs). Materials and Methods A decision-analytic Markov model to evaluate LE benefits was developed. Hypothetical cohorts with varied age (60-80 years) and comorbidities (none, mild, moderate, or severe) were evaluated. For each finding, LE projections from two strategies were compared: imaging follow-up and no imaging follow-up. Under follow-up, it was assumed that cancers associated with the incidental finding were successfully treated before they spread. For patients without follow-up, mortality risks from Bosniak IIF cysts (renal cell carcinoma) and SBIPMNs (pancreatic ductal adenocarcinoma) were incorporated. Model assumptions and parameter uncertainty were evaluated in sensitivity analysis. Results In the youngest, healthiest cohorts (age, 60 years; no comorbidities), projected LE benefits from follow-up were as follows: Bosniak IIF cyst, 6.5 months (women) and 5.8 months (men); SBIPMN, 6.4 months (women) and 5.3 months (men). Follow-up of Bosniak IIF cysts in 60-year-old women with severe comorbidities yielded a LE benefit of 3.9 months; in 80-year-old women with no comorbidities, the benefit was 2.8 months, and with severe comorbidities the benefit was 1.5 months. Similar trends were observed in men and for SBIPMN. Results were sensitive to the performance of follow-up for cancer detection; malignancy risks; and stage at presentation of malignant, unfollowed Bosniak IIF cysts. Conclusion With progression of age and comorbidity level, follow-up of low-risk incidental findings yields increasingly limited benefits for patients. © RSNA, 2018 Online supplemental material is available for this article.

Mental Health and Substance Use Disorder Comorbidity among Methamphetamine-Using Men Who have Sex with Men.

PubMed

Fletcher, Jesse B; Swendeman, Dallas; Reback, Cathy J

2018-04-02

Men who have sex with men (MSM) exhibit elevated rates of mental health and substance use disorder relative to their non-MSM male counterparts. Methamphetamine use in particular has been associated with both neuronal damage and mental health disorders among MSM, and this study reports on the prevalence and comorbidity of DSM-5 mental health and substance use disorders in a sample of methamphetamine-using MSM. From March 2014 through January 2015, 286 methamphetamine-using MSM enrolled in a study to reduce methamphetamine use and sexual risk behaviors. At baseline, participants demonstrated high rates of current major depressive episode (35.8%), antisocial personality disorder (23.9%), suicide risk (23.2%), obsessive-compulsive disorder (23.2%), and social phobia (20.4%), as well as methamphetamine use disorder (89.1%), marijuana use disorder (41.0%), alcohol use disorder (39.6%), cocaine use disorder (30.9%), and inhalants use disorder (15.4%). Analyses revealed significant (p < 0.05) associations between methamphetamine use disorder severity and all listed mental health disorders, as well as between alcohol use disorder and all listed mental health disorders. Mental health disorder prevalence and substance use disorder severity were both elevated, and both methamphetamine and alcohol use disorder severity were associated with increased likelihood of comorbid mental health disorder.

Gender‐specific effects of comorbid depression and anxiety on the propensity to drink in negative emotional states

PubMed Central

Biernacka, Joanna M.; Geske, Jennifer R.; Abulseoud, Osama A.; Brunner, Michael D.; Chauhan, Mohit; Hall‐Flavin, Daniel K.; Lewis, Kriste A.; Loukianova, Larissa L.; Melnyk, George J.; Onsrud, David A.; Proctor, Brian D.; Schneekloth, Terry D.; Skime, Michelle K.; Wittkopp, John E.; Frye, Mark A.; Mrazek, David A.

2016-01-01

Abstract Background and Aims Depression and anxiety are often comorbid with alcoholism and contribute to craving and relapse. We aimed to estimate the prevalence of life‐time diagnoses of major depressive disorder (MDD), substance‐induced depression (SID), anxiety disorder (AnxD) and substance‐induced anxiety (SIA), the effects of these comorbidities on the propensity to drink in negative emotional states (negative craving), and test whether these effects differ by sex. Design Secondary analyses of baseline data collected in a single‐arm study of pharmacogenetic predictors of acamprosate response. Setting Academic medical center and affiliated community‐based treatment programs in the American upper mid‐west. Participants A total of 287 males and 156 females aged 18–80 years, meeting DSM‐IV criteria for alcohol dependence. Measurements The primary outcome measure was ‘propensity to drink in negative emotional situations’ (determined by the Inventory of Drug Taking Situations) and the key predictors/covariates were sex and psychiatric comorbidities, including MDD, SID, AnxD and SIA (determined by Psychiatric Research Interview of Substance and Mood Disorders). Findings The prevalence of the MDD, SID and AnxD was higher in females compared with males (33.1 versus 18.4%, 44.8 versus 26.4% and 42.2 versus 27.4%, respectively; P < 0.01, each), while SIA was rare (3.3%) and did not differ by sex. Increased propensity to drink in negative emotional situations was associated with comorbid MDD (β = 6.6, P = 0.013) and AnxD (β = 4.8, P = 0.042) as well as a SID × sex interaction effect (P = 0.003), indicating that the association of SID with propensity to drink in negative emotional situations differs by sex and is stronger in males (β = 7.9, P = 0.009) compared with females (β = −6.6, P = 0.091). Conclusions There appears to be a higher prevalence of comorbid depression and anxiety disorders as well as propensity to drink in

Insomnia, comorbidity, and risk of injury among insured Americans: results from the America Insomnia Survey.

PubMed

Kessler, Ronald C; Berglund, Patricia A; Coulouvrat, Catherine; Fitzgerald, Timothy; Hajak, Goeran; Roth, Thomas; Shahly, Victoria; Shillington, Alicia C; Stephenson, Judith J; Walsh, James K

2012-06-01

To estimate associations of broadly defined insomnia (i.e., meeting inclusion criteria for International Classification of Diseases, Tenth Revision (ICD-10), Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), or Research Diagnostic Criteria/International Classification of Sleep Disorders, Second Edition (RDC/ICSD-2) diagnosis) with workplace/nonworkplace injuries controlling for comorbid conditions among workers in the America Insomnia Survey (AIS). Cross-sectional telephone survey. National sample of 4,991 employed health plan subscribers (age 18 yr and older). None. Broadly defined insomnia with duration of at least 12 mo was assessed with the Brief Insomnia Questionnaire (BIQ). Injuries in the 12 mo before interview were assessed with a standard self-report measure of injuries causing role impairment or requiring medical attention. Eighteen comorbid condition clusters were assessed with medical/pharmacy claims records and self-reports. Insomnia had significant gross associations (odds ratios, ORs) with both workplace and nonworkplace injuries (OR 2.0 and 1.5, respectively) in logistic regression analyses before controlling for comorbid conditions. The significant population attributable risk proportions (PARPs) of total injuries with insomnia was 4.6% after controlling for comorbid conditions. Only 2 other conditions had PARPs exceeding those of insomnia. The associations of insomnia with injuries did not vary significantly with worker age, sex, or education, but did vary significantly with comorbid conditions. Specifically, insomnia was significantly associated with workplace and nonworkplace injuries (OR 1.8 and 1.5, respectively) among workers having no comorbid conditions, with workplace but not nonworkplace injuries (OR 1.8 and 1.2, respectively) among workers having 1 comorbid condition, and with neither workplace nor nonworkplace injuries (OR 0.9 and 1.0, respectively) among workers having 2 or more comorbid conditions. The

Impact of Age and Comorbidity on Cervical and Breast Cancer Literacy of African Americans, Latina, and Arab women

PubMed Central

Talley, Costellia H.; Williams, Karen Patricia

2015-01-01

Background Appropriate and timely screening can significantly reduce breast and cervical cancer morbidity and mortality. Racial/ethnic minorities and immigrant populations have lower screening rates and delays in follow-up after abnormal tests. Purpose In this study, we examined the relationship between age, comorbidity, breast and cervical cancer literacy in a sample of African American, Latina, and Arab women (N=371) from Detroit, Michigan. Methods Age-adjusted Charlson Comorbidity Index (ACC) was used characterize the impact of age and comorbidity has on breast and cervical cancer literacy; Breast Cancer Literacy Assessment Tool was used to assess breast cancer literacy; Cervical Cancer Literacy Assessment Tool was used to assess cervical cancer literacy. ANOVA was used to assess the relationship between ACC, breast and cervical cancer screening and group differences. Results There was a statistically significant difference between breast cancer literacy (Breast-CLAT total scores) scores (F(2,367)= 17.31, p= < 0.01). ACC had a greater impact on breast cancer literacy for African American F(2,214) =11, p = <0.01. PMID:26333609

Examining the effects of comorbidities on disease-modifying therapy use in multiple sclerosis

PubMed Central

Zhang, Tingting; Tremlett, Helen; Leung, Stella; Zhu, Feng; Kingwell, Elaine; Fisk, John D.; Bhan, Virender; Campbell, Trudy L.; Stadnyk, Karen; Yu, B. Nancy

2016-01-01

Objective: Comorbidities are common in multiple sclerosis (MS) and adversely affect health outcomes. However, the effect of comorbidity on treatment decisions in MS remains unknown. We aimed to examine the effects of comorbidity on initiation of injectable disease-modifying therapies (DMTs) and on the choice of the initial DMT in MS. Methods: We conducted a retrospective observational analysis using population-based health administrative and linked clinical databases in 3 Canadian provinces. MS cases were defined as any individual with ≥3 diagnostic codes for MS. Cohort entry (index date) was the first recorded demyelinating disease-related claim. The outcomes included choice of initial first-line DMTs and time to initiating a DMT. Logistic and Cox regression models were used to examine the association between comorbidity status and study outcomes, adjusting for sex, age, year of index date, and socioeconomic status. Meta-analysis was used to estimate overall effects across the 3 provinces. Results: We identified 10,698 persons with incident MS, half of whom had ≥1 comorbidities. As the total number of comorbidities increased, the likelihood of initiating a DMT decreased. Comorbid anxiety and ischemic heart disease were associated with reduced initiation of a DMT. However, patients with depression were 13% more likely to initiate a DMT compared to those without depression at the index date (adjusted hazard ratio 1.13; 95% confidence interval 1.00–1.27). Conclusions: Comorbidities are associated with treatment decisions regarding DMTs in MS. A better understanding of the effects of comorbidity on effectiveness and safety of DMTs is needed. PMID:26944268

Age differences in the prevalence and comorbidity of DSM-IV major depressive episodes: Results from the WHO World Mental Health Survey Initiative

PubMed Central

Kessler, Ronald C.; Birnbaum, Howard; Shahly, Victoria; Bromet, Evelyn; Hwang, Irving; McLaughlin, Katie A.; Sampson, Nancy; Andrade, Laura Helena; de Girolamo, Giovanni; Demyttenaere, Koen; Haro, Josep Maria; Karam, Aimee N.; Kostyuchenko, Stanislav; Kovess, Viviane; Lara, Carmen; Levinson, Daphna; Matschinger, Herbert; Nakane, Yoshibumi; Browne, Mark Oakley; Ormel, Johan; Posada-Villa, Jose; Sagar, Rajesh; Stein, Dan J.

2011-01-01

Background Although depression appears to decrease in late life, this could be due to misattribution of depressive symptoms to physical disorders that increase in late life. Methods We investigated this issue by studying age differences in comorbidity of DSM-IV major depressive episodes (MDE) with chronic physical conditions in the WHO World Mental Health (WMH) surveys, a series of community epidemiological surveys carried out in 10 developed countries (n = 51,771) and 8 developing countries (n = 37,265). MDE and other mental disorders were assessed with the Composite International Diagnostic Interview (CIDI). Organic exclusion rules were not used to avoid inappropriate exclusion of cases with physical comorbidity. Physical conditions were assessed with a standard chronic conditions checklist. Results Twelve-month DSM-IV/CIDI MDE was significantly less prevalent among respondents ages 65+ than younger respondents in developed but not developing countries. Prevalence of comorbid mental disorders generally either decreased or remained stable with age, while comorbidity of MDE with mental disorders generally increased with age. Prevalence of physical conditions, in comparison, generally increased with age, while comorbidity of MDE with physical conditions generally decreased with age. Depression treatment was lowest among the elderly in developed and developing countries. Conclusions The weakening associations between MDE and physical conditions with increasing age argue against the suggestion that the low estimated prevalence of MDE among the elderly is due to increased confounding with physical disorders. Future study is needed to investigate processes that might lead to a decreasing impact of physical illness on depression among the elderly. PMID:20037917

Small for gestational age and obesity related comorbidities

PubMed Central

Hong, Yong Hee

2018-01-01

Infant born small for gestational age (SGA) are at increased risk of perinatal morbidity, persistent short stature and metabolic alterations in later life. The result of SGA followed by rapid weight gain during early postnatal life has been associated with increased long-term risks for central obesity, insulin resistance, impaired glucose tolerance, type 2 diabetes, hypertension, increased fat mass, and cardiovascular disease. We should carefully monitor their weight during infancy and childhood to prevent excessive rates of weight gain. ‘Healthy catch up growth’ may decreased the risk of obesity-related comorbidities in SGA. Establishing the optimal growth patterns in SGA to minimize short- and long-term risks is important, and further studies will be needed. This review discusses recent studies concentrating on obesity-related morbidities in SGA infants that may provide insight into growth monitoring. PMID:29609443

Sex hormones, aging, and Alzheimer’s disease

PubMed Central

Barron, Anna M.; Pike, Christian J.

2012-01-01

A promising strategy to delay and perhaps prevent Alzheimer’s disease (AD) is to identify the age-related changes that put the brain at risk for the disease. A significant normal age change known to result in tissue-specific dysfunction is the depletion of sex hormones. In women, menopause results in a relatively rapid loss of estradiol and progesterone. In men, aging is associated with a comparatively gradual yet significant decrease in testosterone. We review a broad literature that indicates age-related losses of estrogens in women and testosterone in men are risk factors for AD. Both estrogens and androgens exert a wide range of protective actions that improve multiple aspects of neural health, suggesting that hormone therapies have the potential to combat AD pathogenesis. However, translation of experimental findings into effective therapies has proven challenging. One emerging treatment option is the development of novel hormone mimetics termed selective estrogen and androgen receptor modulators. Continued research of sex hormones and their roles in the aging brain is expected to yield valuable approaches to reducing the risk of AD. PMID:22201929

Gender-specific effects of comorbid depression and anxiety on the propensity to drink in negative emotional states.

PubMed

Karpyak, Victor M; Biernacka, Joanna M; Geske, Jennifer R; Abulseoud, Osama A; Brunner, Michael D; Chauhan, Mohit; Hall-Flavin, Daniel K; Lewis, Kriste A; Loukianova, Larissa L; Melnyk, George J; Onsrud, David A; Proctor, Brian D; Schneekloth, Terry D; Skime, Michelle K; Wittkopp, John E; Frye, Mark A; Mrazek, David A

2016-08-01

Depression and anxiety are often comorbid with alcoholism and contribute to craving and relapse. We aimed to estimate the prevalence of life-time diagnoses of major depressive disorder (MDD), substance-induced depression (SID), anxiety disorder (AnxD) and substance-induced anxiety (SIA), the effects of these comorbidities on the propensity to drink in negative emotional states (negative craving), and test whether these effects differ by sex. Secondary analyses of baseline data collected in a single-arm study of pharmacogenetic predictors of acamprosate response. Academic medical center and affiliated community-based treatment programs in the American upper mid-west. A total of 287 males and 156 females aged 18-80 years, meeting DSM-IV criteria for alcohol dependence. The primary outcome measure was 'propensity to drink in negative emotional situations' (determined by the Inventory of Drug Taking Situations) and the key predictors/covariates were sex and psychiatric comorbidities, including MDD, SID, AnxD and SIA (determined by Psychiatric Research Interview of Substance and Mood Disorders). The prevalence of the MDD, SID and AnxD was higher in females compared with males (33.1 versus 18.4%, 44.8 versus 26.4% and 42.2 versus 27.4%, respectively; P < 0.01, each), while SIA was rare (3.3%) and did not differ by sex. Increased propensity to drink in negative emotional situations was associated with comorbid MDD (β = 6.6, P = 0.013) and AnxD (β = 4.8, P = 0.042) as well as a SID × sex interaction effect (P = 0.003), indicating that the association of SID with propensity to drink in negative emotional situations differs by sex and is stronger in males (β = 7.9, P = 0.009) compared with females (β = -6.6, P = 0.091). There appears to be a higher prevalence of comorbid depression and anxiety disorders as well as propensity to drink in negative emotional situations in female compared with male alcoholics. Substance-induced depression appears to

Charlson comorbidity index as a predictor of periodontal disease in elderly participants

PubMed Central

2018-01-01

Purpose This study investigated the validity of the Charlson comorbidity index (CCI) as a predictor of periodontal disease (PD) over a 12-year period. Methods Nationwide representative samples of 149,785 adults aged ≥60 years with PD (International Classification of Disease, 10th revision [ICD-10], K052–K056) were derived from the National Health Insurance Service-Elderly Cohort during 2002–2013. The degree of comorbidity was measured using the CCI (grade 0–6), including 17 diseases weighted on the basis of their association with mortality, and data were analyzed using multivariate Cox proportional-hazards regression in order to investigate the associations of comorbid diseases (CDs) with PD. Results The multivariate Cox regression analysis with adjustment for sociodemographic factors (sex, age, household income, insurance status, residence area, and health status) and CDs (acute myocardial infarction, congestive heart failure, peripheral vascular disease, cerebral vascular accident, dementia, pulmonary disease, connective tissue disorders, peptic ulcer, liver disease, diabetes, diabetes complications, paraplegia, renal disease, cancer, metastatic cancer, severe liver disease, and human immunodeficiency virus [HIV]) showed that the CCI in elderly comorbid participants was significantly and positively correlated with the presence of PD (grade 1: hazard ratio [HR], 1.11; P<0.001; grade ≥2: HR, 1.12, P<0.001). Conclusions We demonstrated that a higher CCI was a significant predictor of greater risk for PD in the South Korean elderly population. PMID:29770238

Comorbid psychiatric conditions as mediators to predict later social adjustment in youths with autism spectrum disorder.

PubMed

Chiang, Huey-Ling; Gau, Susan Shur-Fen

2015-08-06

Individuals with autism spectrum disorder (ASD) experience long-term social impairment and their comorbid psychiatric conditions negatively impact adaptive functioning. The aims of the study are to investigate whether comorbid psychopathologies, such as anxiety/depression, inattention, hyperactivity/impulsivity, and oppositional behaviors, mediated the link between autistic symptoms and social maladjustment. One hundred and twenty-four youths diagnosed with a clinical diagnosis of DSM-IV ASD (mean age, 10.6 ± 3.3 years) participated in this longitudinal study. They were assessed using semistructured diagnostic interviews on ASD and other psychiatric conditions at recruitment. Follow-up interviews took place approximately 3 years later (37.59 ± 15 months) while the parents reported to the Social Adjustment Inventory for Children and Adolescents on their children's social adjustment. Mediation models were used to examine the mediating effect of comorbid psychopathologies on social adjustment. Youths with ASD had worse school, peer, and home functions than controls at follow-up assessment. In general, comorbid psychiatric conditions mediated the link between autistic symptoms and different domains of social adjustment, independent of age, sex, and full-scale IQ. Additionally, we found specific mediating effects of anxiety/depression and inattention on school functions; anxiety/depression on peer relationships; and oppositional behaviors on home behaviors. Early comorbid psychopathologies may further impair later social adjustment in youths with ASD and an early identification and intervention of these comorbid conditions are suggested. © 2015 Association for Child and Adolescent Mental Health.

Influence of obesity, age, and comorbidities on the multi-biomarker disease activity test in rheumatoid arthritis.

PubMed

Curtis, Jeffrey R; Greenberg, Jeffrey D; Harrold, Leslie R; Kremer, Joel M; Palmer, J Lynn

2018-02-01

Traditional markers of inflammation are often required for inclusion in rheumatoid arthritis trials, yet patients with active disease may have normal lab tests. The potential use of the multi-biomarker disease activity (MBDA) test in this setting is unclear, as is understanding of whether it is influenced by patient characteristics (e.g., age, BMI, and comorbidities). Using data from the Corrona registry, we conducted a cross-sectional analysis of RA patients with MBDA tests. Patients were classified as low (<30), moderate (30-44, and high (>44) and by clinical and RA-related factors. Regression was used to evaluate the association between MBDA score and age, body mass index, comorbidities, and RA-related factors. Of 357 eligible patients, 76% (n = 273) had normal CRP (<10mg/L) with high (33%), moderate (45%), and low (22%) disease activity by MBDA. The MBDA score was significantly associated with BMI, age, CDAI, and SJC. There was no association between MBDA score and fibromyalgia, diabetes, smoking, or COPD; none were confounders between MBDA score and either SJC or CDAI. For patients in CDAI remission, older age (2.6 units per decade; p = 0.03) and obesity (β = 10.5 for BMI > 30, referent to <25; p = 0.02) were independently associated with MBDA score. An adjusted MBDA score was proposed that was highly correlated with the original MBDA (r = 0.91). In this real-world analysis, the MBDA score was associated with RA disease activity, obesity, and age, and was negligibly affected by common comorbidities. Almost one-third of patients with normal CRP had high MBDA scores. An adjustment to the MBDA score to account for body mass index and age is proposed. Copyright © 2018 Elsevier Inc. All rights reserved.

Sex and Age Differences in Trail Half Marathon Running.

PubMed

Navalta, James W; Montes, Jeffrey; Tanner, Elizabeth A; Bodell, Nathaniel G; Young, John C

2018-01-01

Female participation is growing in trail running races. The purpose was to evaluate sex and age differences in top finishers of a trail running half marathon. Velocity differences between males (M) and females (F) were determined for the top 10 finishers of the Moab Trail Half Marathon from 2012 - 2015 across age, and by finishing place. Differences between age category and between sexes were determined through ANOVA with significance accepted at P < 0.05. A significant difference for running velocity was present between sexes at each age category (20-29 yr F = 2.9±0.3, M = 3.4±0.4 m·sec -1 ; 30-39 yr F = 2.8±0.3, M = 3.3±0.3; 40-49 yr F = 2.7±0.3, M = 3.0±0.5; 50-59 yr F = 2.3±0.2, M = 2.8±0.3; 60-69 yr F = 1.6±0.3, M = 2.2±0.4; P < 0.0001). Sex difference in trail running velocity was consistent (~13%) among all age categories with exception of the oldest group (33%, P = 0.0001). There were significantly greater female finishers in every age category (20 - 29 yr F = 107±18, M = 56±1;, 30 - 39 yr F = 150±34, M = 84±21; 40 - 49 yr F = 112±17, M = 64±16; P < 0.01) until 50 - 59 yr (F = 48±13, M = 41±14; P = 0.50). These data indicate that the widening gap in sex differences observed in road races are ameliorated in a trail running environment that has a larger number of female participants.

Working, sex partner age differences, and sexual behavior among African American youth.

PubMed

Bauermeister, José A; Zimmerman, Marc; Xue, Yange; Gee, Gilbert C; Caldwell, Cleopatra H

2009-10-01

Participation in the workplace has been proposed as a potential structural-level HIV/STI prevention strategy for youth. Only a few cross-sectional studies have explored the effect of work during adolescence and young adulthood on sexual behavior and their results have been mixed. This study builds on this literature by exploring whether work influences youths' sexual behavior in a cohort of African American youth (N = 562; 45% males; M = 14.5 years, SD = 0.6) followed from adolescence to young adulthood (ages 13-25 years). Using growth curve modeling, we tested whether working was associated with older sex partners. Then, we explored the association between sex partner age differences and sexual behaviors (i.e., number of sex partners, condom use, and frequency of sexual intercourse). Finally, we tested whether the relationship between sex partner age differences and sexual behaviors was confounded by working. Working greater number of hours was not significantly associated with having older sex partners. Sex partner age differences was associated with number of partners, condom use, and higher sex frequency. These associations were larger for females. Working was associated with higher sex frequency, after accounting for age differences. We discuss the implications of these findings for future research and program planning, particularly in the context of youth development programs.

Comorbidity and health care visit burden in working-age commercially insured patients with diabetic macular edema.

PubMed

Kiss, Szilárd; Chandwani, Hitesh S; Cole, Ashley L; Patel, Vaishali D; Lunacsek, Orsolya E; Dugel, Pravin U

2016-01-01

To examine the comorbidity profile and update estimates of health care resource utilization for commercially insured, working-age adults with diabetic macular edema (DME) relative to a matched comparison group of diabetic adults without DME. Additional comparisons were made in the subgroup of pseudophakic patients. A retrospective matched-cohort study of commercially insured diabetic adults aged 18-63 years was conducted using medical and outpatient pharmacy claims (July 1, 2008-June 30, 2013). Outcomes included diabetes-related and ocular comorbidities and health care resource utilization (any health care visit days, outpatient visit days, inpatient visit days, emergency room visits, eye care-related visit days, unique medications) in the 12-month post-index period. All diabetes-related and ocular comorbidities were significantly more prevalent in DME cases versus non-DME controls ( P <0.05). A significantly greater proportion of DME cases utilized eye care-related visits compared with non-DME controls ( P <0.001). DME cases had almost twice the mean number of total health care visit days compared to non-DME controls (28.6 vs 16.9 days, P <0.001), with a minority of visit days being eye care-related (mean 5.1 vs 1.5 days, P <0.001). Similar trends were observed in pseudophakic cohorts. This working-age DME population experienced a mean of 29 health care visit days per year. Eye care-related visit days were a minority of the overall visit burden (mean 5 days) emphasizing the trade-offs DME patients face between managing DME and their overall diabetic disease. Insights into the complex comorbidity profile and health care needs of diabetic patients with DME will better inform treatment decisions and help optimize disease management.

Evidence for sex differences in cardiovascular aging and adaptive responses to physical activity.

PubMed

Parker, Beth A; Kalasky, Martha J; Proctor, David N

2010-09-01

There are considerable data addressing sex-related differences in cardiovascular system aging and disease risk/progression. Sex differences in cardiovascular aging are evident during resting conditions, exercise, and other acute physiological challenges (e.g., orthostasis). In conjunction with these sex-related differences-or perhaps even as an underlying cause-the impact of cardiorespiratory fitness and/or physical activity on the aging cardiovascular system also appears to be sex-specific. Potential mechanisms contributing to sex-related differences in cardiovascular aging and adaptability include changes in sex hormones with age as well as sex differences in baseline fitness and the dose of activity needed to elicit cardiovascular adaptations. The purpose of the present paper is thus to review the primary research regarding sex-specific plasticity of the cardiovascular system to fitness and physical activity in older adults. Specifically, the paper will (1) briefly review known sex differences in cardiovascular aging, (2) detail emerging evidence regarding observed cardiovascular outcomes in investigations of exercise and physical activity in older men versus women, (3) explore mechanisms underlying the differing adaptations to exercise and habitual activity in men versus women, and (4) discuss implications of these findings with respect to chronic disease risk and exercise prescription.

Evidence for sex differences in cardiovascular aging and adaptive responses to physical activity

PubMed Central

Parker, Beth A.; Kalasky, Martha J.; Proctor, David N.

2010-01-01

There are considerable data addressing sex-related differences in cardiovascular system aging and disease risk/progression. Sex differences in cardiovascular aging are evident during resting conditions, exercise, and other acute physiological challenges (e.g., orthostasis). In conjunction with these sex-related differences—or perhaps even as an underlying cause—the impact of cardiorespiratory fitness and/or physical activity on the aging cardiovascular system also appears to be sex-specific. Potential mechanisms contributing to sex-related differences in cardiovascular aging and adaptability include changes in sex hormones with age as well as sex differences in baseline fitness and the dose of activity needed to elicit cardiovascular adaptations. The purpose of the present paper is thus to review the primary research regarding sex-specific plasticity of the cardiovascular system to fitness and physical activity in older adults. Specifically, the paper will (1) briefly review known sex differences in cardiovascular aging, (2) detail emerging evidence regarding observed cardiovascular outcomes in investigations of exercise and physical activity in older men versus women, (3) explore mechanisms underlying the differing adaptations to exercise and habitual activity in men versus women, and (4) discuss implications of these findings with respect to chronic disease risk and exercise prescription. PMID:20480371

Age- and sex-related growth patterns of the craniofacial complex in European children aged 3-6 years.

PubMed

Tutkuviene, Janina; Cattaneo, Cristina; Obertová, Zuzana; Ratnayake, Melanie; Poppa, Pasquale; Barkus, Arunas; Khalaj-Hedayati, Kerstin; Schroeder, Inge; Ritz-Timme, Stefanie

2016-11-01

Craniofacial growth changes in young children are not yet completely understood. Up-to-date references for craniofacial measurements are crucial for clinical assessment of orthodontic anomalies, craniofacial abnormalities and subsequent planning of interventions. To provide normal reference data and to identify growth patterns for craniofacial dimensions of European boys and girls aged 3-6 years. Using standard anthropometric methodology, body weight, body height and 23 craniofacial measurements were acquired for a cross-sectional sample of 681 healthy children (362 boys and 319 girls) aged 3-6 years from Germany, Italy and Lithuania. Descriptive statistics, correlation coefficients, percentage annual changes and percentage growth rates were used to analyse the dataset. Between the ages of 3-6 years, craniofacial measurements showed age- and sex-related patterns independent from patterns observed for body weight and body height. Sex-related differences were observed in the majority of craniofacial measurements. In both sexes, face heights and face depths showed the strongest correlation with age. Growth patterns differed by craniofacial measurement and can be summarised into eight distinct age- and sex-related patterns. This study provided reference data and identified sex- and age-related growth patterns of the craniofacial complex of young European children, which may be used for detailed assessment of normal growth in paediatrics, maxillofacial reconstructive surgery and possibly for forensic age assessment.

Characteristics and Associated Comorbidities of Pediatric Dental Patients Treated under General Anesthesia.

PubMed

Delfiner, Alexandra; Myers, Aaron; Lumsden, Christie; Chussid, Steve; Yoon, Richard

To describe characteristics and identify common comorbidities of children receiving dental treatment under general anesthesia at Children's Hospital of New York-Presbyterian. Electronic medical records of all children that received dental treatment under general anesthesia through the Division of Pediatric Dentistry from 2012-2014 were reviewed. Data describing patient characteristics (age, sex, race/ethnicity, insurance carrier, and American Society of Anesthesiologists physical status classification system), medical history, and justification for treatment were collected. Descriptive statistics, including frequencies, percentages and t-tests, were calculated. A total of 298 electronic medical records were reviewed, of which 50 records were excluded due to missing information. Of the 248 electronic medical records included, the average age was 5-years-old and 58% were male. The most common reason for dental treatment under general anesthesia was extent and severity of dental disease (53%), followed by significant medical history (47%) and behavior/pre-cooperative age (39%). Those who were ASA III or IV were older (6.6-years) (p<.001). Common medical comorbidities appear evenly distributed: autism (12%), cardiac anomalies (14%), developmental delay (14%), genetic syndromes/chromosomal disorders (13%), and neurological disorders (12%). Younger age groups (1 to 2 years and 3 to 5 years) had a high percentage of hospitalizations due to the extent and severity of the dental disease (83%) and behavior (77%) (p<0.001). No single comorbidity was seen more often than others in this patient population. The range of medical conditions in this population may be a reflection of the range of pediatric specialty services at Children's Hospital of NewYork-Presbyterian.

76 FR 80966 - Agency Information Collection Activities; Proposed Collection: Age, Sex, and Race of Persons...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-27

... Collection Activities; Proposed Collection: Age, Sex, and Race of Persons Arrested 18 Years of Age and Over; Age, Sex, and Race of Persons Arrested Under 18 Years of Age; Revision of a Currently Approved..., Sex, and Race of Persons Arrested 18 Years of Age and Over; Age, Sex, and Race of Persons Arrested...

Prevalence of different comorbidities in COPD patients by gender and GOLD stage.

PubMed

Dal Negro, R W; Bonadiman, L; Turco, P

2015-01-01

Several comorbidities frequently affect COPD progression. Aim of the study was to assess the prevalence of main comorbidities by gender and disease severity in a cohort of COPD patients referring for the first time to a specialist institution. The study was a non-interventional, cross-sectional investigation carried out via automatic and anonymous selection from the institutional data base over the period 2012-2015. Inclusion criteria were: subjects of both sex aged ≥40 years; diagnosis of COPD according to GOLD guidelines 2014; the availability of a complete clinical record file. Variables collected were: lung function; smoking history; BMI; the Charlson Comorbidity Index (CCI); number and kind of comorbidities for each patient. At least one comorbidity of clinical relevance was found in 78.6 % of patients, but at least two in 68.8 %, and three or more were found in 47.9 % of subjects. Mean CCI was 3.4 ± 1.6sd. The overall prevalence was 2.6 comorbidities per patient, but 2.5 in males, and 3.0 in females, respectively (p < 0.05). Cardio-vascular disorders were the most frequent, but significantly more frequent in males (44.7 vs 30.7 %, respectively), while the metabolic, the digestive and the osteo-articular disorders were prevailing in females (12.4 vs 9.2; 14.2 vs 4.8, and 6.0 vs 3.8, respectively). In particular, chronic cor pumonale and arrhythmias mainly prevailed in men and congestive heart failure in females, while arterial hypertension resulted equally distributed. As concerning respiratory disorders, pneumonia, pleural effusions and chronic respiratory failure were more frequently found in men, while bronchiectasis and asthma-COPD overlap syndrome (ACOS) in females. Anaemia, gall bladder stones, osteoporosis and spontaneous fractures mostly prevailed in females, while gastric disorders of inflammatory origin and arthrosis were more frequent in males. Cognition disorders, dementia and signs of degenerative brain disorders were more

Working, Sex Partner Age Differences, and Sexual Behavior among African American Youth

PubMed Central

Bauermeister, José A.; Zimmerman, Marc; Xue, Yange; Gee, Gilbert C.; Caldwell, Cleopatra H.

2009-01-01

Participation in the workplace has been proposed as a potential structural-level HIV/STI prevention strategy for youth. Only a few cross-sectional studies have explored the effect of work during adolescence and young adulthood on sexual behavior and their results have been mixed. This study builds on this literature by exploring whether work influences youths’ sexual behavior in a cohort of African American youth [N = 562; 45% males; M = 14.5 years, SD = 0.6] followed from adolescence to young adulthood (ages 13 to 25). Using growth curve modeling, we tested whether working was associated with older sex partners. Then, we explored the association between sex partner age differences and sexual behaviors (i.e., number of sex partners, condom use, and frequency of sexual intercourse). Finally, we tested whether the relationship between sex partner age differences and sexual behaviors was confounded by working. Working greater number of hours was not significantly associated with having older sex partners. Sex partner age differences was associated with number of partners, condom use, and and higher sex frequency. These associations were larger for females. Working was associated with higher sex frequency, after accounting for age differences. We discuss the implications of these findings for future research and program planning, particularly in the context of youth development programs. PMID:18574686

Psychiatric Comorbidity in Gender Dysphoric Adolescents

ERIC Educational Resources Information Center

de Vries, Annelou L. C.; Doreleijers, Theo A. H.; Steensma, Thomas D.; Cohen-Kettenis, Peggy T.

2011-01-01

Background: This study examined psychiatric comorbidity in adolescents with a gender identity disorder (GID). We focused on its relation to gender, type of GID diagnosis and eligibility for medical interventions (puberty suppression and cross-sex hormones). Methods: To ascertain DSM-IV diagnoses, the Diagnostic Interview Schedule for Children…

Mathematical learning disorder in school-age children with attention-deficit hyperactivity disorder.

PubMed

Capano, Lucia; Minden, Debbie; Chen, Shirley X; Schacher, Russell J; Ickowicz, Abel

2008-06-01

To explore the prevalence of mathematics disorder (MD) relative to reading disorders (RD) in school-age children with attention-deficit hyperactivity disorder (ADHD) and examine the effects of age, sex, cooccurring conduct disorder (CD), and ADHD subtype on this comorbidity. Participants were school-age children (n = 476) with confirmed DSM-IV diagnosis of ADHD. The assessment included semistructured parent and teacher interviews and standardized measures of intelligence, academic attainment, and language abilities. Based on the presence or absence of concurrent learning disorders, we compared the emerging 4 groups: ADHD-only, ADHD + MD, ADHD + RD, and ADHD + MD + RD. Overall prevalence of comorbid ADHD + MD was 18.1%. Age, sex, ADHD subtypes, or comorbid CD did not affect the frequency of MD. Children with concurrent ADHD and either MD or RD attained lower IQ, language, and academic scores than those with ADHD alone. Children with ADHD + MD + RD were more seriously impaired and demonstrated distinct deficits in receptive and expressive language. MDs are relatively common in school-age children with ADHD and are frequently associated with RDs. Children with ADHD + MD + RD are more severely impaired. These deficits simply cannot be explained as consequences of ADHD and might have unique biological underpinnings, with implications for diagnostic classification and therapeutic interventions.

Association between severe eczema in children and multiple comorbid conditions and increased healthcare utilization

PubMed Central

Silverberg, Jonathan I.; Simpson, Eric L.

2015-01-01

Background Atopic dermatitis (AD) is associated with multiple comorbid conditions, such as asthma and food allergy. We sought to determine the impact of eczema severity on the development of these disorders and other non-atopic comorbidities in AD. Methods We used the 2007 National Survey of Children's Health, a prospective questionnaire-based study of a nationally representative sample of 91,642 children age 0-17 years. Prevalence and severity of eczema, asthma, hay fever and food allergy, sleep impairment, healthcare utilization, recurrent ear infections, visual and dental problems were determined. Results In general, more severe eczema correlated with poorer overall health, impaired sleep and increased healthcare utilization, including seeing a specialist, compared to children with mild or moderate disease (Rao-Scott Chi-square, P<0.0001). Severe eczema was associated with higher prevalence of comorbid chronic health disorders, including asthma, hay fever and food allergies (P<0.0001). In addition, the severity of eczema was directly related to the severity of the comorbidities. These associations remained significant in multivariate logistic regression models that included age, sex and race/ethnicity. Severe eczema was also associated with recent dental problems, including bleeding gums (P<0.0001), toothache (P=0.0004), but not broken teeth (P=0.04) or tooth decay (P=0.13). Conclusions These data indicate that severe eczema is associated with multiple comorbid chronic health disorders, impaired overall health and increased healthcare utilization. Further, these data suggest that children with eczema are at risk for decreased oral health. Future studies are warranted to verify this novel association. PMID:23773154

Age, sex, and setting factors and labor force in athletic training.

PubMed

Kahanov, Leamor; Eberman, Lindsey E

2011-01-01

Occupation or occupational setting shifts might be occurring in the athletic training profession, and differences between sexes might exist; however, little evidence exists to confirm this supposition. To evaluate trends in male and female athletic training employment patterns in terms of age and occupational setting. Cross-sectional study. We requested demographic data from the National Athletic Trainers' Association (October 27, 2009) and obtained frequency totals of members by sex across the occupational life span by occupational setting. Our sample included 18 571 athletic trainers employed in the 3 largest classifications of occupational settings within the profession: college or university, clinical, and secondary school. We calculated frequencies and percentages to determine demographic and descriptive data. We analyzed the data using an analysis of variance to identify the differences between sexes across age and setting. We observed trends in occupational setting and sex across ages 22 to 67 years. We identified differences between sexes across the ages 22 to 67 years (F(1,18569) = 110818.080, P < .001, η(2) = .068) and across occupational settings (F(1,18569) = 61.908, P < .001, η(2) = .003), noting a marked decline in female athletic trainers in the workforce beginning around age 28 years and an increase in male athletic trainers in the secondary school setting beginning around their middle to late 40s. We observed differences at the intercept between setting and sex (F(1,18569) = 63529.344, P < .001, η(2) = .845), which were greater when observed across the ages (F(1,18569) = 23566787.642, P < .001, η(2) = .939). We identified differences between sexes across settings and ages in addition to an overall decrease in the workforce among all professionals. A marked decline in female athletic trainers occurred at age 28 years, yet the male population increased at the secondary school level, suggesting a setting shift. Burnout, fatigue, pay scale, and a

The Motive to Avoid Success Studied as a Function of Sex, Age, and Sex of Cue Variables.

ERIC Educational Resources Information Center

Talcott, Lou Ann W.

This thesis describes an experimental study of the "motive to avoid success," as described by Matina Horner (1968), using sex, age, and sex of cues as independent variables. School-aged subjects (5th, 8th, 11th grade and college students) wrote stories in response to one of two written thematic apperceptive cues. The dependent measure was the…

Age, sex and reproductive status affect boldness in dogs.

PubMed

Starling, Melissa J; Branson, Nicholas; Thomson, Peter C; McGreevy, Paul D

2013-09-01

Boldness in dogs is believed to be one end of the shy-bold axis, representing a super-trait. Several personality traits fall under the influence of this super-trait. Previous studies have found that boldness is affected by breed and breed groups, influences performance in sporting dogs, and is affected in some cases by the sex of the dogs. This study investigated the effects of dog age, sex and reproductive status on boldness in dogs by way of a dog personality survey circulated amongst Australian dog owners. Age had a significant effect on boldness (F=4.476; DF=16,758; P<0.001), with boldness decreasing with age in years. Males were bolder than females (F=19.219; DF=1,758; P<0.001) and entire dogs were bolder than neutered dogs (F=4.330; DF=1,758; P<0.038). The study indicates how behaviour may change in adult dogs as they age and adds to the literature on how sex and reproductive status may affect personality in dogs. Copyright © 2013 Elsevier Ltd. All rights reserved.

Sex-specific phenotypes of hyperthyroidism and hypothyroidism in aged mice.

PubMed

Rakov, Helena; Engels, Kathrin; Hönes, Georg Sebastian; Brix, Klaudia; Köhrle, Josef; Moeller, Lars Christian; Zwanziger, Denise; Führer, Dagmar

2017-12-22

Sex and age play a role in the prevalence of thyroid dysfunction (TD), but their interrelationship for manifestation of hyper- and hypothyroidism is still not well understood. Using a murine model, we asked whether sex impacts the phenotypes of hyper- and hypothyroidism at two life stages. Hyper- and hypothyroidism were induced by i.p. T4 or MMI/ClO 4 -/LoI treatment over 7 weeks in 12- and 20-months-old female and male C57BL/6N mice. Control animals underwent PBS treatment (n = 7-11 animals/sex/treatment). Animals were investigated for impact of sex on body weight, food and water intake, body temperature, heart rate, behaviour (locomotor activity, motor coordination and strength) and serum thyroid hormone (TH) status. Distinct sex impact was found in eu- and hyperthyroid mice, while phenotypic traits of hypothyroidism were similar in male and female mice. No sex difference was found in TH status of euthyroid mice; however, T4 treatment resulted in twofold higher TT4, FT4 and FT3 serum concentrations in adult and old females compared to male animals. Hyperthyroid females consistently showed higher locomotor activity and better coordination but more impairment of muscle function by TH excess at adult age. Importantly and in contrast to male mice, adult and old hyperthyroid female mice showed increased body weight. Higher body temperature in female mice was confirmed in all age groups. No sex impact was found on heart rate irrespective of TH status in adult and old mice. By comparison of male and female mice with TD at two life stages, we found that sex modulates TH action in an organ- and function-specific manner. Sex differences were more pronounced under hyperthyroid conditions. Importantly, sex-specific differences in features of TD in adult and old mice were not conclusively explained by serum TH status in mice.

Association of psychiatric co-morbidity and efficacy of treatment in chronic daily headache in Indian population.

PubMed

Singh, Ajai Kumar; Shukla, Rakesh; Trivedi, Jitendra Kumar; Singh, Deepti

2013-04-01

To study the prevalence of psychiatric co-morbidity in patients of chronic daily headache (CDH) and compare the efficacy of treatment between various type of headache associated with psychiatric co-morbidity. Prospective case control cohort study, 92 consecutive patients of CDH meeting eligibility criteria. The diagnosis of various subtypes of CDH was made according to the IHS criteria. Age, sex, educational, marital and socioeconomic status, matched controls were also selected. Patients were evaluated with the Mini International Neuropsychiatric Interview (MINI) scale at the time of enrolment and at 3 months. CDH accounted for 28% of all headache patients. The mean age of presentation was 30.2 ± 10.3 years, male: Female ratio of 28:64 and mean duration of 4.56 ± 0.56 years. Chronic migraine (CM) accounted for 59 patients, chronic tension type headache (CTTH) 22 patients, new daily persistent headache (NDPH) 3 patients and miscellaneous 8 patients. Psychiatric co-morbidity was present in 53.3% patients with CDH, and was more common in CM (62.7%) as compared to CTTH (36.4%). Single psychiatric co-morbidity was seen in 26 patients, while 23 patients had multiple co-morbidity. Major depressive episode, anxiety disorder, agoraphobia and dysthymia were significant psychiatric co-morbidities. Patients with CM were treated with topiramate or divalproex sodium ER and CTTH were treated with amitriptyline. 55 patients came for follow up at 3 months, improvement in headache was seen in 29 patients. Psychiatric co-morbidity was present in more than 50% patients with CDH and its presence along with a duration of ≥2 years was associated with a poor response to treatment.

Influence of Comorbid Mental Disorders on Time to Treatment Seeking for Major Depressive Disorder

PubMed Central

Olfson, Mark; Liu, Shang-Min; Grant, Bridget F.; Blanco, Carlos

2012-01-01

Background Although treatment of depression has increased in recent years, long delays commonly separate disorder onset from first treatment contact. Objectives This study evaluates the effects of psychiatric comorbidities and socio-demographic characteristics on lifetime treatment seeking and speed to first treatment contact for major depressive disorder (MDD). Measures A cross-sectional epidemiological survey including retrospective structured assessments of DSM-IV MDD and other psychiatric disorders, respondent age at disorder onset, and age at first treatment contact. Subjects A nationally representative sample of 5,958 adults aged ≥18 years residing in households and group quarters who met lifetime criteria for MDD. Data Analysis The percentage of respondents with lifetime MDD who reported ever seeking treatment is reported overall and stratified by sociodemographic characteristics. Unadjusted and adjusted hazard ratios are presented of time to first depression treatment seeking by sociodemographic characteristics and comorbid psychiatric disorders. Results A majority (61.3%) of respondents with MDD reported having sought treatment for depression at some point in their lives. Time to first depression treatment contact was significantly related to the occurrence of comorbid panic disorder (AHR=2.01, 95%CI=1.69–2.39), generalized anxiety disorder (AHR=1.55, 95%CI=1.33–1.81), drug dependence (AHR=1.54, 95%CI=1.06–2.26), dysthymic disorder (AHR=1.54, 95%CI=1.35–1.76), and PTSD (AHR=1.34, 95%CI=1.13–1.59) and inversely related to male sex (AHR=0.74, 95%CI=0.66–0.82) and black race/ethnicity (AHR=0.69, 95%CI=0.59–0.81). Conclusion Comorbid psychiatric disorders, especially panic, generalized anxiety, substance use, and dysthymic disorders, appear to play an important role in accelerating treatment seeking for MDD. Outreach efforts should include a focus on depressed individuals without complicating psychiatric comorbidities. PMID:22186769

Family functioning in the context of parental bipolar disorder: associations with offspring age, sex, and psychopathology.

PubMed

Freed, Rachel D; Tompson, Martha C; Wang, Christine H; Otto, Michael W; Hirshfeld-Becker, Dina R; Nierenberg, Andrew A; Henin, Aude

2015-02-01

Previous research has shown that families with a parent who has bipolar disorder (BD) may experience family functioning difficulties. However, the association between family functioning and psychopathology among offspring of parents with BD, and offspring characteristics that may moderate this association, remains poorly understood. This study examined the cross-sectional associations between family functioning (cohesion, expressiveness, and conflict) and psychopathology in 117 offspring (ages 5-18) of 75 parents with BD. We also examined whether age and sex differences moderated these associations. We measured offspring psychopathology by examining current dimensional symptoms and DSM-IV emotional and behavioral disorders. Correlational analyses indicated that higher family conflict and lower cohesion were associated with higher internalizing and externalizing symptoms in offspring. Lower family cohesion was also associated with current offspring mood disorders. Moderation analyses indicated, first, that the link between lower family cohesion and internalizing symptoms was stronger for younger offspring compared to older offspring. Second, higher family conflict and current mood disorder were associated in younger males but not in older males or in females. Results remained the same after controlling for parental anxiety or substance use disorder comorbidity. Our study highlights the importance of accounting for family functioning when working with offspring at risk for BD, while also recognizing that the connections between family functioning and offspring outcomes are complex and differ based on offspring sex and developmental stage. PsycINFO Database Record (c) 2015 APA, all rights reserved.

Sex- and age-related variations of the somatotype in a Chuvasha population.

PubMed

Kalichman, L; Kobyliansky, E

2006-01-01

The aim of this large, cross-sectional study was to describe the age- and sex-related variations of the somatotype, employing Heath and Carter's method, in a Chuvasha population residing in a rural region in central Russia. The investigated sample included 802 males aged 18-89 years (mean 46.9) and 738 females aged 18-90 years (mean 48.6). We evaluated the age and sex differences by one-way ANOVA with somatotype components as dependent variables and sex or age groups as grouping variables. Sex differences of somatotypes appear to be the strongest for endomorphy, with generally higher values in women. Endomorphy in males remained virtually unchanged after 30 years of age, but endomorphy in females kept increasing up to the 6th decade, and then subsequently decreased. Virtually no differences were noted in mesomorphy and a very small difference in ectomorphy between males and females aged 18-30 years. A reduction of sexual dimorphism in all somatotype components after age 70 was also observed. The largest difference of all somatotype components appeared between age groups 18-30 and 31-40 years. Thereafter, somatotypes remained practically unchanged. Mesomorphy continued to increase until the 5th decade in both sexes, while in females, endomorphy continuously increased until their 6th decade. In the 7th and 8th decades, a decrease in mean values was observed. Mesomorphy and ectomorphy showed opposite age-related trends. Results of our study clearly suggest that in physique investigations, the somatotypes need to be studied in each sex separately, and in studies of young people, they need also to be adjusted to age.

Social anxiety disorder diagnostic criteria perform equally across age, comorbid diagnosis, and performance/interaction subtypes.

PubMed

Crome, Erica; Baillie, Andrew

2015-01-01

The prevalence of social anxiety disorder (SAD) is frequently higher in younger age groups and people with other anxiety or mood disorders; however, it is unclear whether these groups have a higher risk for developing SAD or are simply more likely to endorse diagnostic criteria than other people with similar levels of social anxiety. Explicitly testing the assumption all people respond to structured diagnostic interviews in comparable ways (measurement invariance) is essential in ensuring systematic response biases do not create spurious group differences. This research aims to systematically test whether age, comorbidity status, or types of social fears affect responses to a structured diagnostic interview. Responses from 1755 participants in a large-scale survey of mental health in Australia screening into the social phobia/SAD section of the Composite International Diagnostic Interview were used. Three series of multigroup confirmatory factor analyses for categorical data systematically tested for increasingly strict levels of measurement invariance. Overall, patterns of responding to diagnostic criteria were comparable across the groups, supporting assumptions of measurement invariance. Establishment of invariance supports the interpretation of differences between age, comorbidity status, and types of social situations feared as genuine differences in experience as opposed to measurement biases.

Stability and change in same-sex attraction, experience, and identity by sex and age in a New Zealand birth cohort.

PubMed

Dickson, Nigel; van Roode, Thea; Cameron, Claire; Paul, Charlotte

2013-07-01

Gaps remain in knowledge of changes in sexual orientation past adolescence and early adulthood. A longitudinal study of a New Zealand birth cohort was used to examine differences by age and sex in change in sexual attraction between 21 (1993/1994) and 38 years (2010/2011), sexual experiences between 26 and 38 years, and sexual identity between 32 and 38 years. Any same-sex attraction was significantly more common among women than men at all ages. Among women, any same-sex attraction increased up to age 26 (from 8.8 to 16.6 %), then decreased slightly by age 38 (12.0 %); among men, prevalence was significantly higher at age 38 (6.5 %) than 21 (4.2 %), but not in the intermediate assessments. It is likely that the social environment becoming more tolerant was responsible for some of the changes. Same-sex attraction was much more common than same-sex experiences or a same-sex identity, especially among women, with no major sex differences in these latter dimensions. Women exhibited much greater change in sexual attraction between assessments than men; for change in experiences and identity, sex differences were less marked and not statistically confirmed. Changes in the respective dimensions appeared more likely among those initially with mixed attraction and experiences, and among those initially identifying as bisexual, but this did not account for the sex difference in likelihood of change. These results provide contemporary information about the extent and variation of reported sexual attraction, experiences, and identity that we show continues across early and mid-adulthood.

Paternal-age and birth-order effect on the human secondary sex ratio.

PubMed Central

Ruder, A

1985-01-01

Because of conflicting results in previous analyses of possible maternal and paternal effects on the variation in sex ratio at birth, records of United States live births in 1975 were sorted by offspring sex, live birth order (based on maternal parity), parental races, and, unlike prior studies, ungrouped parental ages. Linear regression and logistic analysis showed significant effects of birth order and paternal age on sex ratio in the white race data (1.67 million births; 10,219 different combinations of independent variables). Contrary to previous reported results, the paternal-age effect cannot be ascribed wholly to the high correlation between paternal age and birth order as maternal age, even more highly correlated with birth order, does not account for a significant additional reduction in sex-ratio variation over that accounted for by birth order alone. PMID:3985011

Chronic Obstructive Pulmonary Disease (COPD) as a disease of early aging: Evidence from the EpiChron Cohort.

PubMed

Divo, Miguel J; Celli, Bartolome R; Poblador-Plou, Beatriz; Calderón-Larrañaga, Amaia; de-Torres, Juan Pablo; Gimeno-Feliu, Luis A; Bertó, Juan; Zulueta, Javier J; Casanova, Ciro; Pinto-Plata, Victor M; Cabrera-Lopez, Carlos; Polverino, Francesca; Carmona Píréz, Jonás; Prados-Torres, Alexandra; Marin, Jose M

2018-01-01

Aging is an important risk factor for most chronic diseases. Patients with COPD develop more comorbidities than non-COPD subjects. We hypothesized that the development of comorbidities characteristically affecting the elderly occur at an earlier age in subjects with the diagnosis of COPD. We included all subjects carrying the diagnosis of COPD (n = 27,617), and a similar number of age and sex matched individuals without the diagnosis, extracted from the 727,241 records of individuals 40 years and older included in the EpiChron Cohort (Aragon, Spain). We compared the cumulative number of comorbidities, their prevalence and the mortality risk between both groups. Using network analysis, we explored the connectivity between comorbidities and the most influential comorbidities in both groups. We divided the groups into 5 incremental age categories and compared their comorbidity networks. We then selected those comorbidities known to affect primarily the elderly and compared their prevalence across the 5 age groups. In addition, we replicated the analysis in the smokers' subgroup to correct for the confounding effect of cigarette smoking. Subjects with COPD had more comorbidities and died at a younger age compared to controls. Comparison of both cohorts across 5 incremental age groups showed that the number of comorbidities, the prevalence of diseases characteristic of aging and network's density for the COPD group aged 56-65 were similar to those of non-COPD 15 to 20 years older. The findings persisted after adjusting for smoking. Multimorbidity increases with age but in patients carrying the diagnosis of COPD, these comorbidities are seen at an earlier age.

Systemic Comorbidities of Dry Eye Syndrome: The Korean National Health and Nutrition Examination Survey V, 2010 to 2012.

PubMed

Roh, Hyun Cheol; Lee, Jimmy K; Kim, Martha; Oh, Jong-Hyun; Chang, Min-Wook; Chuck, Roy S; Park, Choul Yong

2016-02-01

To identify systemic comorbidities in patients with dry eye syndrome in South Korea. From 2010 to 2012, 17,364 participants aged 20 or older were randomly included in the nationwide Korean National Health and Nutrition Examination Survey V. The prevalence of dry eye syndrome and demographics of these patients were investigated. We performed conditional logistic regression analyses based on age, sex, residential area, education level, occupation type, and household income level to obtain the odds ratio for each systemic comorbidity among subjects with and without dry eye syndrome. The prevalence of dry eye syndrome in this study was 10.4%. Age [adjusted odds ratio (AOR): 1.02], female gender (AOR: 3.01), and indoor occupation (AOR: 1.30) were associated with a higher prevalence of dry eye syndrome and found to be less prevalent in those residing in rural areas (AOR: 0.73) and with lower education levels (AOR: 0.66-0.99). With regard to systemic comorbidities, dyslipidemia (AOR: 1.63), degenerative arthritis (AOR: 1.56), rheumatoid arthritis (AOR: 1.44), thyroid disease (AOR: 1.79), and renal failure (AOR: 2.56) were associated with a significantly higher prevalence of dry eye syndrome. We found that patients with dry eye syndrome have a higher prevalence of several systemic comorbidities. A more comprehensive therapeutic approach considering the effect of systemic medication may be necessary in these patients.

Cognitive sex differences are not magnified as a function of age, sex hormones, or puberty development during early adolescence.

PubMed

Herlitz, Agneta; Reuterskiöld, Lena; Lovén, Johanna; Thilers, Petra P; Rehnman, Jenny

2013-01-01

Are cognitive sex differences magnified by individual differences in age, sex hormones, or puberty development? Cross-sectional samples of 12- to 14-year-old boys (n = 85) and girls (n = 102) completed tasks assessing episodic memory, face recognition, verbal fluency, and mental rotations. Blood estradiol, free testosterone, and self-rated puberty scores were obtained. Sex differences were found on all cognitive measures. However, the magnitude was not larger for older children, hormones and cognitive performance were not associated, and early maturers did not perform better than late maturers. Thus, cognitive sex differences were not associated with age, levels of sex hormones, or puberty development.

Infant wheeze, comorbidities and school age asthma.

PubMed

Neuman, Asa; Bergström, Anna; Gustafsson, Per; Thunqvist, Per; Andersson, Niklas; Nordvall, Lennart; Kull, Inger; Wickman, Magnus

2014-06-01

Factors associated with early onset of wheeze have been described, but there is limited knowledge on which of these infant wheezers who will have developed asthma in school age. The aim was to identify clinical risk factors for asthma in the 8-yr-old children that wheezed during infancy in a population-based setting. Three thousand two hundred and fifty-one children from a population-based birth cohort followed prospectively from infancy until age 8 yr were included in the study. Data were analyzed using multivariate logistic regression analysis. Parents reported any wheeze episode before age 2 yr in 823 subjects (25%). Infant wheezers had an almost fourfold risk of asthma at age 8 [adjusted odds ratio (aOR) 3.68, 95% CI 2.74-4.96], equivalent to an asthma prevalence of 14% compared with 4% among non-wheezers (p < 0.001). After adjustments for sex, exposure to tobacco smoke and indoor dampness/mould, allergic heredity (aOR 1.53, 95% CI 1.02-2.30), increased frequency of wheeze (aOR 3.41, 95% CI 2.09-5.56 for children with ≥3 episodes compared with ≤2 episodes during the first 2 yr of life), infant eczema (aOR 2.31, 95% CI 1.52-3.49), and recurrent abdominal pain (aOR 2.33, 95% CI 1.30-4.16) remained risk factors for school age asthma in the infant wheezing group. Among infant wheezers, allergic heredity, increased severity of wheeze, infant eczema, and recurrent abdominal pain were independent risk factors for asthma at age 8 yr. Among children with three or four of these risk factors, 38% had asthma at school age. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Impact of comorbidities on stroke rehabilitation outcomes: does the method matter?

PubMed

Berlowitz, Dan R; Hoenig, Helen; Cowper, Diane C; Duncan, Pamela W; Vogel, W Bruce

2008-10-01

To examine the impact of comorbidities in predicting stroke rehabilitation outcomes and to examine differences among 3 commonly used comorbidity measures--the Charlson Index, adjusted clinical groups (ACGs), and diagnosis cost groups (DCGs)--in how well they predict these outcomes. Inception cohort of patients followed for 6 months. Department of Veterans Affairs (VA) hospitals. A total of 2402 patients beginning stroke rehabilitation at a VA facility in 2001 and included in the Integrated Stroke Outcomes Database. Not applicable. Three outcomes were evaluated: 6-month mortality, 6-month rehospitalization, and change in FIM score. During 6 months of follow-up, 27.6% of patients were rehospitalized and 8.6% died. The mean FIM score increased an average of 20 points during rehabilitation. Addition of comorbidities to the age and sex models improved their performance in predicting these outcomes based on changes in c statistics for logistic and R(2) values for linear regression models. While ACG and DCG models performed similarly, the best models, based on DCGs, had a c statistic of .74 for 6-month mortality and .63 for 6-month rehospitalization, and an R(2) of .111 for change in FIM score. Comorbidities are important predictors of stroke rehabilitation outcomes. How they are classified has important implications for models that may be used in assessing quality of care.

Physical Attractiveness, Age, and Sex as Determinants of Reactions to Resumes.

ERIC Educational Resources Information Center

Quereshi, M. Y.; Kay, Janet P.

1986-01-01

Physical attractiveness, age, and sex were manipulated to determine their effect on the evaluation of 54 hypothetical applicants' resumes for three different jobs by 60 Master's in Business Administration students. Physical attractiveness favorably influenced the suitability ratings for all jobs; raters' sex and age were not significant but…

Determination of age, sex, and blood group from a single tooth.

PubMed

Nayar, Amit K; Parhar, Swati; Thind, Gagandeep; Sharma, Aman; Sharma, Divya

2017-01-01

Human identification is one of the most challenging subjects that human has been confronted with. Through the ages, odontological examinations have been a critical determinant in the search of human identity. Data in the form of age, gender, and blood group might provide vital clues in such investigations. In the recent times, it has been often desirable to preserve tissues for further investigations following the unfolding of certain events or discovery of new data. Hence, it is important to gather as much data as possible using less tissue. The purpose of this study was to determine age, sex, and ABO blood group of individual from a single tooth, to determine the effect of different environmental conditions, and to extract maximum information also at the same time preserving some tissue for the further investigation whenever needed. The study sample consisted of sixty teeth divided into four groups under different environmental conditions and time. The teeth were sectioned longitudinally in the buccolingual plane along the midline. Longitudinal ground sections of each tooth were prepared for age determination from cemental lines. Pulp removed was divided into two halves thereafter sex and blood group was determined. For correlation of age between estimated age and actual age, using cemental lines Pearson's correlation coefficient was applied. Further for determination of both sex and blood group between groups, Chi-square test was applied. A strong positive correlation was found between the estimated age and actual age of the study groups. Moreover, there was no significant difference between the actual and determined sex and blood group of the study groups. Although age, sex, and blood group are more reliably determined in freshly extracted teeth, these variables may be of significant help in identification even after a period of 6 weeks postextraction.

Conjectures concerning cross-sex hormone treatment of aging transsexual persons.

PubMed

Gooren, Louis; Lips, Paul

2014-08-01

Guidelines for cross-sex hormone treatment of transsexual people are now in place. However, little attention has been paid to the issue of treatment suitability for older people. Does existing treatment need to be adapted as subjects age, and does it make a difference if treatment is only started when the subject is already older? To assess the necessity of adapting cross-sex hormone administration for elderly transsexual people. Risks/benefits of continued use of cross-sex hormones with regard to bone health, cardiovascular risks, and malignancies. Due to lack of data on the subject population, sex hormone treatment of other conditions in older non-transsexual people has been taken as the best available analogy to determine the extent to which these might be applicable to comparable transsexual persons. Findings in transsexual people receiving cross-sex hormone treatment sometimes modified the above approach of applying guidelines for the elderly to the aging transsexual population. Testosterone administration to female-to-male transsexual persons (FtoM) carries little risk with regard to cardiovascular disease and cancer. For those with high hematocrit or cardiac insufficiency the dose can be reduced. Administration of estrogens to male-to-female transsexual persons (MtoF), particularly when combined with progestins, does significantly increase the risk of developing cardiovascular disease (almost a twofold incidence compared with the general population). This may require dose adjustment or changing from oral to safer transdermal estrogens. Tumors of the breasts, prostate and pituitary may occur. In FtoM, breast cancer can occur even after breast ablation. Older subjects can commence cross-sex hormone treatment without disproportionate risks. Cross-sex hormones may be continued into old age but monitoring for cardiovascular disease and malignancies, both of the old and new sex, is recommended. MtoF will have more health complications in old age than Fto

Assessing the ability of comorbidity indexes to capture comorbid disease in the inpatient rehabilitation burn injury population.

PubMed

Slocum, Chloe S; Goldstein, Richard; DiVita, Margaret A; Mix, Jacqueline; Niewczyk, Paulette; Gerrard, Paul; Sheridan, Robert; Kowalske, Karen J; Zafonte, Ross; Ryan, Colleen M; Schneider, Jeffrey C

2015-05-01

Burn patients exhibit comorbidities that influence outcomes. This study examines whether existing comorbidity measures capture comorbidities in the burn inpatient rehabilitation population. Data were obtained from the Uniform Data System for Medical Rehabilitation from 2002 to 2011 for adults with burn injury. International Classification of Diseases, 9th Revision, codes were used to assess three comorbidity measures (Charlson Comorbidity Index, Elixhauser Comorbidity Index, Centers for Medicare and Medicaid Services Comorbidity Tiers). The number of subjects and unique comorbidity codes (>1% of frequency) captured by each comorbidity measure was calculated. The study included 5347 patients with a median total body surface area burn decile of 20%-29%, mean age of 51.6 yrs, and mean number of comorbidities of 7.6. There were 2809 unique International Classification of Diseases, 9th Revision, comorbidity codes. The Charlson Comorbidity Index, Elixhauser Comorbidity Index, and Centers for Medicare and Medicaid Services Comorbidity Tiers did not capture 67%, 27%, and 58% of the subjects, respectively. There were 107 unique comorbidities that occurred with a frequency of greater than 1%. Of these, 67% were not captured in all three comorbidity measures. Commonly used comorbidity indexes do not reflect the extent of comorbid disease in the burn rehabilitation population. Future work is needed to assess the need for comorbidity indexes specific to the inpatient rehabilitation setting.

Sex differences in neurochemical markers that correlate with behavior in aging mice.

PubMed

Frick, K M; Burlingame, L A; Delaney, S S; Berger-Sweeney, J

2002-01-01

Sex differences in neurochemical markers that correlate with behavior in aging mice NEUROBIOL AGING. We examined whether the enzymatic activities of choline acetyltransferase (ChAT) and glutamic acid decarboxylase (GAD) were altered similarly with age in male and female mice, and whether these changes were correlated with age-related alterations in memory and anxiety. ChAT and GAD activities were measured in neocortex, hippocampus, and striatum of behaviorally characterized male and female C57BL/6 mice (5, 17, and 25 months). Generally, ChAT activity was increased, and GAD activity decreased, with age. However, disparate changes were revealed between the sexes; activities of both enzymes were decreased in 17-month males, whereas alterations in females were not observed until 25-months. Furthermore, enzyme-behavior correlations differed between the sexes; in males, ChAT activity was related to one behavioral task, whereas in females, activities of both enzymes were correlated with multiple tasks. Significant enzyme-behavior correlations were most evident at 17 months of age, likely the result of behavioral and enzymatic sex differences at this age. These data represent the first comprehensive report illustrating differential alterations of ChAT and GAD activities in aging male and female mice.

Sex and Age Differences in the Risk Threshold for Delinquency

PubMed Central

Loeber, Rolf; Slotboom, Anne-Marie; Bijleveld, Catrien C. J. H.; Hipwell, Alison E.; Stepp, Stephanie D.; Koot, Hans M.

2015-01-01

This study examines sex differences in the risk threshold for adolescent delinquency. Analyses were based on longitudinal data from the Pittsburgh Youth Study (n = 503) and the Pittsburgh Girls Study (n = 856). The study identified risk factors, promotive factors, and accumulated levels of risks as predictors of delinquency and nondelinquency, respectively. The risk thresholds for boys and girls were established at two developmental stages (late childhood: ages 10–12 years, and adolescence: ages 13–16 years) and compared between boys and girls. Sex similarities as well as differences existed in risk and promotive factors for delinquency. ROC analyses revealed only small sex differences in delinquency thresholds, that varied by age. Accumulative risk level had a linear relationship with boys’ delinquency and a quadratic relationship with girls’ delinquency, indicating stronger effects for girls at higher levels of risk. PMID:23183920

Chronic Obstructive Pulmonary Disease (COPD) as a disease of early aging: Evidence from the EpiChron Cohort

PubMed Central

Celli, Bartolome R.; Poblador-Plou, Beatriz; Calderón-Larrañaga, Amaia; de-Torres, Juan Pablo; Gimeno-Feliu, Luis A.; Bertó, Juan; Casanova, Ciro; Pinto-Plata, Victor M.; Cabrera-Lopez, Carlos; Polverino, Francesca; Marin, Jose M.

2018-01-01

Background Aging is an important risk factor for most chronic diseases. Patients with COPD develop more comorbidities than non-COPD subjects. We hypothesized that the development of comorbidities characteristically affecting the elderly occur at an earlier age in subjects with the diagnosis of COPD. Methods and findings We included all subjects carrying the diagnosis of COPD (n = 27,617), and a similar number of age and sex matched individuals without the diagnosis, extracted from the 727,241 records of individuals 40 years and older included in the EpiChron Cohort (Aragon, Spain). We compared the cumulative number of comorbidities, their prevalence and the mortality risk between both groups. Using network analysis, we explored the connectivity between comorbidities and the most influential comorbidities in both groups. We divided the groups into 5 incremental age categories and compared their comorbidity networks. We then selected those comorbidities known to affect primarily the elderly and compared their prevalence across the 5 age groups. In addition, we replicated the analysis in the smokers’ subgroup to correct for the confounding effect of cigarette smoking. Subjects with COPD had more comorbidities and died at a younger age compared to controls. Comparison of both cohorts across 5 incremental age groups showed that the number of comorbidities, the prevalence of diseases characteristic of aging and network’s density for the COPD group aged 56–65 were similar to those of non-COPD 15 to 20 years older. The findings persisted after adjusting for smoking. Conclusion Multimorbidity increases with age but in patients carrying the diagnosis of COPD, these comorbidities are seen at an earlier age. PMID:29470502

Risk factors for incident falls in older men and women: the English longitudinal study of ageing.

PubMed

Gale, Catharine R; Westbury, Leo D; Cooper, Cyrus; Dennison, Elaine M

2018-05-16

Falls are a major cause of disability and death in older people, particularly women. Cross-sectional surveys suggest that some risk factors associated with a history of falls may be sex-specific, but whether risk factors for incident falls differ between the sexes is unclear. We investigated whether risk factors for incident falls differ between men and women. Participants were 3298 people aged ≥60 who took part in the Waves 4-6 surveys of the English Longitudinal Study of Ageing. At Wave 4, they provided information about sociodemographic, lifestyle, behavioural and medical factors and had their physical and cognitive function assessed. Data on incident falls during the four-year follow-up period was collected from them at Waves 5 and 6. Poisson regression with robust variance estimation was used to derive relative risks (RR) for the association between baseline characteristics and incident falls. In multivariable-adjusted models that also controlled for history of falls, older age was the only factor associated with increased risk of incident falls in both sexes. Some factors were only predictive of falls in one sex, namely more depressive symptoms (RR (95% CI) 1.03 (1.01,1.06)), incontinence (1.12 (1.00,1.24)) and never having married in women (1.26 (1.03,1.53)), and greater comorbidity (1.04 (1.00,1.08)), higher levels of pain (1.10 (1.04,1.17) and poorer balance, as indicated by inability to attempt a full-tandem stand, (1.23 (1.04,1.47)) in men. Of these, only the relationships between pain, balance and comorbidity and falls risk differed significantly by sex. There were some differences between the sexes in risk factors for incident falls. Our observation that associations between pain, balance and comorbidity and incident falls risk varied by sex needs further investigation in other cohorts.

Sex- and age-related variation in metal content of penguin feathers.

PubMed

Squadrone, Stefania; Abete, Maria Cesarina; Brizio, Paola; Monaco, Gabriella; Colussi, Silvia; Biolatti, Cristina; Modesto, Paola; Acutis, Pier Luigi; Pessani, Daniela; Favaro, Livio

2016-03-01

The presence of xenobiotics, such as metals, in ecosystems is concerning due to their durability and they pose a threat to the health and life of organisms. Moreover, mercury can biomagnify in many marine food chains and, therefore, organisms at higher trophic levels can be adversely impacted. Although feathers have been used extensively as a bio-monitoring tool, only a few studies have addressed the effect of both age and sex on metal accumulation. In this study, the concentrations of trace elements were determined in the feathers of all members of a captive colony of African Penguins (Spheniscus demersus) housed in a zoological facility in Italy. Tests were performed by inductively coupled plasma-mass spectrometry to detect aluminum, arsenic, cadmium, cobalt, chromium, copper, iron, manganese, nickel, lead, selenium, tin, vanadium, and zinc. Mercury was detected by a direct mercury analyzer. Sexing was performed by a molecular approach based on analyzing the chromo-helicase-DNA-binding1 gene, located on the sex chromosomes. Sex- and age-related differences were studied in order to investigate the different patterns of metal bioaccumulation between male and female individuals and between adults and juveniles. Juvenile females had significantly higher arsenic levels than males, while selenium levels increased significantly with age in both sexes. Penguins kept in controlled environments-given that diet and habitat are under strict control-represent a unique opportunity to determine if and how metal bioaccumulation is related to sex and age.

Age-adjusted Charlson comorbidity index score as predictor of survival of patients with digestive system cancer who have undergone surgical resection.

PubMed

Tian, Yaohua; Jian, Zhong; Xu, Beibei; Liu, Hui

2017-10-03

Comorbidities have considerable effects on survival outcomes. The primary objective of this retrospective study was to examine the association between age-adjusted Charlson comorbidity index (ACCI) score and postoperative in-hospital mortality in patients with digestive system cancer who have undergone surgical resection of their cancers. Using electronic hospitalization summary reports, we identified 315,464 patients who had undergone surgery for digestive system cancer in top-rank (Grade 3A) hospitals in China between 2013 and 2015. The Cox proportional hazard regression model was applied to evaluate the effect of ACCI score on postoperative mortality, with adjustments for sex, type of resection, anesthesia methods, and caseload of each healthcare institution. The postoperative in-hospital mortality rate in the study cohort was 1.2% (3,631/315,464). ACCI score had a positive graded association with the risk of postoperative in-hospital mortality for all cancer subtypes. The adjusted HRs for postoperative in-hospital mortality scores ≥ 6 for esophagus, stomach, colorectum, pancreas, and liver and gallbladder cancer were 2.05 (95% CI: 1.45-2.92), 2.00 (95% CI: 1.60-2.49), 2.54 (95% CI: 2.02-3.21), 2.58 (95% CI: 1.68-3.97), and 4.57 (95% CI: 3.37-6.20), respectively, compared to scores of 0-1. These findings suggested that a high ACCI score is an independent predictor of postoperative in-hospital mortality in Chinese patients with digestive system cancer who have undergone surgical resection.

A tabular format of Pyle's ageing and sexing methods for landbirds

Treesearch

W.H. Sakai; C.J. Ralph

2002-01-01

We present a new method of summarizing Peter Pyle's (1997) ageing and sexing guide into a tabular format that has proven to be extremely useful for both novice and experienced banders. This format allows quick and accurate assessment by a bander to distinguish species, age, and sex criteria. Rapid and accurate processing are essential to the health of birds...

Sex-dependent effects of letrozole on anxiety in middle-aged rats.

PubMed

Borbélyová, Veronika; Domonkos, Emese; Csongová, Melinda; Kačmárová, Mária; Ostatníková, Daniela; Celec, Peter; Hodosy, Július

2017-12-01

Aromatase catalyzes the conversion of testosterone to estradiol and is involved in the physiological effects of sex hormones on brain function. Animal experiments have shown that the aromatase inhibitor, letrozole, can induce anxiety in young ovariectomized females that are used as a model of aging. Whether or not these effects would be similar in intact middle-aged animals is unknown. The aim of our study was to analyze the effects of letrozole on anxiety in middle-aged rats of both sexes. Fifteen month old male and female rats were treated daily with either letrozole or vehicle for 2 weeks. The elevated plus maze was used to test anxiety-like behaviour. Sex differences were found not only in plasma concentrations of testosterone but also in the effects of letrozole treatment on plasma testosterone (P<.05). The interaction between sex and treatment was also proven in locomotor activity (P<.05) and time spent in the open arms of the elevated plus maze (P<.05). Letrozole-treated male rats spent 95% less time in the open arms of the elevated plus maze than the control rats did (P<.05) suggesting an anxiogenic effect of aromatase inhibition. This difference was not found between letrozole-treated and vehicle-treated females. In contrast to previous experiments on young animals, letrozole seems to induce anxiety in male but not in female middle-aged rats. This sex-specific effect might be related to sex differences of oestrogen and androgen signalling in aging brains. These results should be taken into account in clinical applications of letrozole, especially in men. © 2017 John Wiley & Sons Australia, Ltd.

Chronic stress and neural function: accounting for sex and age.

PubMed

Luine, V N; Beck, K D; Bowman, R E; Frankfurt, M; Maclusky, N J

2007-10-01

Cognitive responses to stress follow the temporally dependent pattern originally established by Selye (1) wherein short-term stressors elicit adaptive responses whereas continued stress (chronic) results in maladaptive changes--deleterious effects on physiological systems and impaired cognition. However, this pattern for cognitive effects appears to apply to only half the population (males) and, more specifically, to young, adult males. Females show different cognitive responses to stress. In contrast to impaired cognition in males after chronic stress, female rodents show enhanced performance on the same memory tasks after the same stress. Not only cognition, but anxiety, shows sex-dependent changes following chronic stress--stress is anxiolytic in males and anxiogenic in females. Moreover, behavioral responses to chronic stress are different in developing as well as aging subjects (both sexes) as compared to adults. In aged rats, chronic stress enhances recognition memory in both sexes, does not alter spatial memory, and anxiety effects are opposite to young adults. When pregnant dams are exposed to chronic stress, at adulthood the offspring display yet different consequences of stress on anxiety and cognition, and, in contrast to adulthood when the behavioral effects of stress are reversible, prenatal stress effects appear enduring. Changing levels of estradiol in the sexes over the lifespan appear to contribute to the differences in response to stress. Thus, theories of stress dependent modulations in CNS function--developed solely in male models, focused on peripheral physiological processes and tested in adults--may require revision when applied to a more diverse population (age- and sex-wise) at least in relation to the neural functions of cognition and anxiety. Moreover, these results suggest that other stressors and neural functions should be investigated to determine whether age, sex and gonadal hormones also have an impact.

Insomnia, Comorbidity, and Risk of Injury Among Insured Americans: Results from the America Insomnia Survey

PubMed Central

Kessler, Ronald C.; Berglund, Patricia A.; Coulouvrat, Catherine; Fitzgerald, Timothy; Hajak, Goeran; Roth, Thomas; Shahly, Victoria; Shillington, Alicia C.; Stephenson, Judith J.; Walsh, James K.

2012-01-01

Study Objectives: To estimate associations of broadly defined insomnia (i.e., meeting inclusion criteria for International Classification of Diseases, Tenth Revision (ICD-10), Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), or Research Diagnostic Criteria/International Classification of Sleep Disorders, Second Edition (RDC/ICSD-2) diagnosis) with workplace/nonworkplace injuries controlling for comorbid conditions among workers in the America Insomnia Survey (AIS). Design/Setting: Cross-sectional telephone survey. Participants: National sample of 4,991 employed health plan subscribers (age 18 yr and older). Interventions: None. Measurements and Results: Broadly defined insomnia with duration of at least 12 mo was assessed with the Brief Insomnia Questionnaire (BIQ). Injuries in the 12 mo before interview were assessed with a standard self-report measure of injuries causing role impairment or requiring medical attention. Eighteen comorbid condition clusters were assessed with medical/pharmacy claims records and self-reports. Insomnia had significant gross associations (odds ratios, ORs) with both workplace and nonworkplace injuries (OR 2.0 and 1.5, respectively) in logistic regression analyses before controlling for comorbid conditions. The significant population attributable risk proportions (PARPs) of total injuries with insomnia was 4.6% after controlling for comorbid conditions. Only 2 other conditions had PARPs exceeding those of insomnia. The associations of insomnia with injuries did not vary significantly with worker age, sex, or education, but did vary significantly with comorbid conditions. Specifically, insomnia was significantly associated with workplace and nonworkplace injuries (OR 1.8 and 1.5, respectively) among workers having no comorbid conditions, with workplace but not nonworkplace injuries (OR 1.8 and 1.2, respectively) among workers having 1 comorbid condition, and with neither workplace nor nonworkplace injuries

Dermatological comorbidity in psoriasis: results from a large-scale cohort of employees.

PubMed

Zander, N; Schäfer, I; Radtke, M; Jacobi, A; Heigel, H; Augustin, M

2017-07-01

The field of dermatological comorbidity in psoriasis is only passively explored with contradictory results. Objective of this study was to further investigate the complex field of psoriasis and associated skin diseases by identifying skin comorbidity patterns in an extensive cohort of employees in Germany. Retrospective analysis of data deriving from occupational skin cancer screenings was conducted. From 2001 to 2014 German employees between 16 and 70 years from different branches underwent single whole-body screenings by trained dermatologists in their companies. All dermatological findings and need for treatment were documented. Point prevalence rates and their 95% confidence intervals were computed. Logistic regression analysis was performed to calculate odds ratios (OR) of single dermatological diseases to occur together with psoriasis controlled for age and sex. Data from 138,930 persons (56.5% male, mean age 43.2) were evaluated. Psoriasis point prevalence was 2.0%. Of those 20.6% had unmet treatment needs of their disease. Onychomycosis was the most frequent dermatological comorbidity with a prevalence of 7.8%. Regression analysis found rosacea (OR = 1.40, 95% CI 1.13-1.72) and telangiectasia (OR = 1.25, 95% CI 1.10-1.41) to be significantly associated with psoriasis. 17.2% of psoriasis patients had at least one further finding requiring treatment. The highest treatment needs were found for onychomycosis (3.4%), tinea pedis (3.1%), and verruca plantaris (1.0%). It can be concluded that persons with psoriasis are at increased risk to suffer from comorbid skin diseases, which should be considered in treatment regimens. Particular attention should be paid to fungal diseases of the feet.

Use of comorbidity measures to predict the risk of death in Brazilian in-patients.

PubMed

Martins, Monica

2010-06-01

To assess the use of comorbidity measures to predict the risk of death in Brazilian in-patients. Data from the Sistema de Informações Hospitalares do Sistema Unico de Saúde (Unified Health System Hospital Information System) were used, which enables only one secondary diagnosis to be recorded. A total of 1,607,697 hospitalizations were selected, all of which occurred in Brazil, between 2003 and 2004, and whose main diagnoses were: ischemic heart disease, congestive cardiac failure, stroke and pneumonia. Charlson Index and Elixhauser comorbidities were the comorbidity measures used. In addition, the simple record of a certain secondary diagnosis was also used. Logistic regression was applied to assess the impact of comorbidity measures on the estimate of risk of death. The baseline model included the following variables: age, sex and main diagnosis. Models to predict death were assessed, based on C-statistic and Hosmer-Lemeshow test. Hospital mortality rate was 10.4% and mean length of stay was 5.7 days. The majority (52%) of hospitalizations occurred among men and mean age was 62.6 years. Of all hospitalizations, 5.4% included a recorded secondary diagnosis, although the odds ratio between death and presence of comorbidity was 1.93. The baseline model showed a discriminatory capacity (C-statistic) of 0.685. The improvement in the models, attributed to the introduction of comorbidity indices, was poor, equivalent to zero when C-statistic with only two digits was considered. Although the introduction of three comorbidity measures in distinct models to predict death improved the predictive capacity of the baseline model, the values obtained are still considered insufficient. The accuracy of this type of measure is influenced by the completeness of the source of information. In this sense, high underreporting of secondary diagnosis, in addition to the well-known lack of space to note down this type of information in the Sistema de Informações Hospitalares, are the

Comorbidities in patients with gout prior to and following diagnosis: case-control study

PubMed Central

Kuo, Chang-Fu; Grainge, Matthew J; Mallen, Christian; Zhang, Weiya; Doherty, Michael

2016-01-01

Objectives To determine the burden of comorbidities in patients with gout at diagnosis and the risk of developing new comorbidities post diagnosis. Methods There were 39 111 patients with incident gout and 39 111 matched controls identified from the UK Clinical Practice Research Data-link. The risk of comorbidity before (ORs) and after the diagnosis of gout (HRs) were estimated, adjusted for age, sex, diagnosis year, body mass index, smoking and alcohol consumption. Results Gout was associated with adjusted ORs (95% CIs) of 1.39 (1.34 to 1.45), 1.89 (1.76 to 2.03) and 2.51 (2.19 to 2.86) for the Charlson index of 1–2, 3–4 and ≥5, respectively. Cardiovascular and genitourinary diseases, in addition to hyperlipidaemia, hypothyroidism, anaemia, psoriasis, chronic pulmonary diseases, osteoarthritis and depression, were associated with a higher risk for gout. Gout was also associated with an adjusted HR (95% CI) of 1.41 (1.34 to 1.48) for having a Charlson index ≥1. Median time to first comorbidity was 43 months in cases and 111 months in controls. Risks for incident comorbidity were higher in cardiovascular, genitourinary, metabolic/endocrine and musculoskeletal diseases, in addition to liver diseases, hemiplegia, depression, anaemia and psoriasis in patients with gout. After additionally adjusting for all comorbidities at diagnosis, gout was associated with a HR (95% CI) for all-cause mortality of 1.13 (1.08 to 1.18; p<0.001). Conclusions The majority of patients with gout have worse pre-existing health status at diagnosis and the risk of incident comorbidity continues to rise following diagnosis. The range of associated comorbidities is broader than previously recognised and merits further evaluation. PMID:25398375

Sex differences in elite swimming with advanced age are less than marathon running.

PubMed

Senefeld, J; Joyner, M J; Stevens, A; Hunter, S K

2016-01-01

The sex difference in marathon performance increases with finishing place and age of the runner but whether this occurs among swimmers is unknown. The purpose was to compare sex differences in swimming velocity across world record place (1st-10th), age group (25-89 years), and event distance. We also compared sex differences between freestyle swimming and marathon running. The world's top 10 swimming times of both sexes for World Championship freestyle stroke, backstroke, breaststroke, and butterfly events and the world's top 10 marathon times in 5-year age groups were obtained. Men were faster than women for freestyle (12.4 ± 4.2%), backstroke (12.8 ± 3.0%), and breaststroke (14.5 ± 3.2%), with the greatest sex differences for butterfly (16.7 ± 5.5%). The sex difference in swimming velocity increased across world record place for freestyle (P < 0.001), breaststroke, and butterfly for all age groups and distances (P < 0.001) because of a greater relative drop-off between first and 10th place for women. The sex difference in marathon running increased with the world record place and the sex difference for marathon running was greater than for swimming (P < 0.001). The sex difference in swimming increased with world record place and age, but was less than for marathon running. Collectively, these results suggest more depth in women's swimming than marathon running. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Do Comorbidities Play a Role in Hand Osteoarthritis Disease Burden? Data from the Hand Osteoarthritis in Secondary Care Cohort.

PubMed

Damman, Wendy; Liu, Rani; Kroon, Féline P B; Reijnierse, Monique; Huizinga, Tom W J; Rosendaal, Frits R; Kloppenburg, Margreet

2017-11-01

Because the association and its clinical relevance between comorbidities and primary hand osteoarthritis (OA) disease burden is unclear, we studied this in patients with hand OA from our Hand OSTeoArthritis in Secondary care (HOSTAS) cohort. Cross-sectional data from the HOSTAS study were used, including consecutive patients with primary hand OA. Nineteen comorbidities were assessed: 18 self-reported (modified Charlson index and osteoporosis) and obesity (body mass index ≥ 30 kg/m 2 ). Mean differences were estimated between patients with versus without comorbidities, adjusted for age and sex: for general disease burden [health-related quality of life (HRQOL), Medical Outcomes Study Short Form-36 physical component scale (0-100)] and disease-specific burden [self-reported hand function (0-36), pain (0-20; Australian/Canadian Hand OA Index), and tender joint count (TJC, 0-30)]. Differences above a minimal clinically important improvement/difference were considered clinically relevant. The study included 538 patients (mean age 61 yrs, 86% women, 88% fulfilled American College of Rheumatology classification criteria). Mean (SD) HRQOL, function, pain, and TJC were 44.7 (8), 15.6 (9), 9.3 (4), and 4.8 (5), respectively. Any comorbidity was present in 54% (287/531) of patients and this was unfavorable [adjusted mean difference presence/absence any comorbidity (95% CI): HRQOL -4.4 (-5.8 to -3.0), function 1.9 (0.4-3.3), pain 1.4 (0.6-2.1), TJC 1.3 (0.4-2.2)]. Number of comorbidities and both musculoskeletal (e.g., connective tissue disease) and nonmusculoskeletal comorbidities (e.g., pulmonary and cardiovascular disease) were associated with disease burden. Associations with HRQOL and function were clinically relevant. Comorbidities showed clinically relevant associations with disease burden. Therefore, the role of comorbidities in hand OA should be considered when interpreting disease outcomes and in patient management.

Age and sex variation in serum albumin concentration: an observational study.

PubMed

Weaving, Gary; Batstone, Gifford F; Jones, Richard G

2016-01-01

In the UK, a common reference interval for serum albumin is widely used irrespective of age or sex. Implicit in this is that laboratories produce analytically similar results. This paper challenges the validity of this approach. A three-week collection of results sent to all primary care centres in England has been analysed by age, sex and laboratory. In all, 1,079,193 serum albumin reports were included in this analysis. The mean population serum albumin concentration increases to peak at around age 20 years and then decreases with increasing age. Values in females decrease more rapidly but become close to male values at 60 years. The variation between laboratories was large and potentially clinically significant. Reference intervals for serum albumin should be stratified by age and sex. Until there is greater methodological standardization, laboratories should determine their own reference intervals and not accept a single consensus reference interval. © The Author(s) 2015.

In Search of Emerging Same-Sex Sexuality: Romantic Attractions at Age 13 Years.

PubMed

Li, Gu; Hines, Melissa

2016-10-01

Sex-typed behavior in childhood is significantly related to sexual orientation in adulthood. In addition, same-sex attractions in early adolescence are more non-exclusive than in adulthood and can differ from later same-sex orientations. However, little research has focused on romantic attractions as they emerge during early adolescence. Drawing a sample from the Avon Longitudinal Study of Parents and Children (197 girls, 204 boys), the current study examined whether same-sex romantic attractions at age 13 years were exclusive, and whether they were predicted by sex-typed behavior at age 3.5 years. No young adolescents in this sample reported exclusive same-sex attractions, and increased same-sex attractions were not significantly related to reduced other-sex sexualities. Childhood sex-typed behavior did not significantly predict early same-sex attractions, suggesting that early same-sex attractions differ from later same-sex orientations. The current study highlights the importance of studying the development of sexuality beginning prior to adulthood.

Prevalence of self-reported comorbidities in HIV positive and HIV negative men who have sex with men over 55 years-The Australian Positive & Peers Longevity Evaluation Study (APPLES).

PubMed

Petoumenos, Kathy; Huang, Robin; Hoy, Jennifer; Bloch, Mark; Templeton, David J; Baker, David; Giles, Michelle; Law, Matthew G; Cooper, David A

2017-01-01

In Australia, almost half of HIV-positive people are now aged over 50 and are predominately gay and bisexual men (GBM). Compared to the general HIV-negative population, GBM engage more in behaviours that may increase the risk of age-related comorbidities, including smoking, high alcohol consumption and recreational drug use. The objective of APPLES was to compare comorbidities and risk factors in HIV-positive older GBM with an appropriate control group of HIV-negative GBM. We undertook a prospectively recruited cross-sectional sample of HIV-positive and HIV-negative GBM ≥ 55 years. Detailed data collection included clinic data, a health and lifestyle survey, and blood sample collection. We report key demographic, laboratory markers and self-reported comorbidities by HIV status. For selected comorbidities we also adjust HIV status a priori for age, smoking and body mass index. Over 16 months 228 HIV-positive and 218 HIV-negative men were recruited. Median age was 63 years (IQR: 59-67). Although more HIV-positive men reported having ever smoked, smoking status was not statistically different between HIV positive and HIV negative men (p = 0.081). Greater alcohol use was reported by HIV-negative men (p = 0.002), and recreational drug use reported more often by HIV-positive men (p<0.001). After adjustment, HIV-positive men had significantly increased odds of diabetes (adjusted Odds ratio (aOR): 1.97, p = 0.038), thrombosis (aOR: 3.08, p = 0.007), neuropathy (aOR: 34.6, P<0.001), and non-significantly increased odds for heart-disease (aOR: 1.71, p = 0.077). In conclusion, HIV-positive GBM have significantly increased odds for key self-reported comorbidities. This study underscores the importance of an appropriate HIV-negative control group for more accurate evaluation of the risk and attribution of age-related comorbidities in HIV-positive people.

Interactions between Age, Sex, and Hormones in Experimental Ischemic Stroke

PubMed Central

Liu, Fudong; McCullough, Louise D.

2012-01-01

Age, sex, and gonadal hormones have profound effects on ischemic stroke outcomes, although how these factors impact basic stroke pathophysiology remains unclear. There is a plethora of inconsistent data reported throughout the literature, primarily due to differences in the species examined, the timing and methods used to evaluate injury, the models used, and confusion regarding differences in stroke incidence as seen in clinical populations versus effects on acute neuroprotection or neurorepair in experimental stroke models. Sex and gonadal hormone exposure have considerable independent impact on stroke outcome, but these factors also interact with each other, and the contribution of each differs throughout the lifespan. The contribution of sex and hormones to experimental stroke will be the focus of this review. Recent advances and our current understanding of age, sex, and hormone interactions in ischemic stroke with a focus on inflammation will be discussed. PMID:23068990

Age, sex, and symptom intensity influence test taking parameters on functional patient-reported outcomes.

PubMed

Cheville, Andrea L; Wang, Chun; Ni, Pengsheng; Jette, Alan M; Basford, Jeffrey R

2014-11-01

Item response theory-based patient-reported outcomes such as the Activity Measure for Post Acute Care Computerized Adaptive Test are gaining use because of their flexibility and ease of administration. Their psychometric properties are being explored, but little is known about how respondent characteristics may impact precision. The goal of this study was, therefore, to assess the effects of age, sex, and symptom intensity on respondents' test taking behaviors and scores. Three hundred eleven adults with late-stage lung cancer were consecutively enrolled between April 2008 and April 2009. Demographics and comorbidities were abstracted from their electronic medical records. The participants were followed on a 3- to 4-wk basis by telephonic interviews that involved administration of the Activity Measure for Post Acute Care Computerized Adaptive Test, followed by numerical rating scales scoring of their pain, fatigue, and dyspnea. In more than 2538 computerized adaptive test (CAT) sessions, three findings were prominent. First, the women and the older patients took longer to complete CAT sessions, were more likely to skip items, and produced scores with larger standard errors. Second, the respondents with higher levels of dyspnea and fatigue, but not pain, completed their CAT sessions more rapidly and were less likely to skip items. Third, fatigue and dyspnea interact with age but not sex to influence CAT duration and skip count. The findings of this study suggest that certain common clinical populations, for example, women, geriatric patients, and patients with intense symptoms, differ systematically in the time they are willing to devote to testing and the precision of their responses. The latter finding, unstable precision, is unlikely to be CAT specific and has implications for the interpretation of the scores of the Activity Measure for Post Acute Care Computerized Adaptive Test and other patient-reported outcomes.

Empathy Mediates the Effects of Age and Sex on Altruistic Moral Decision Making.

PubMed

Rosen, Jan B; Brand, Matthias; Kalbe, Elke

2016-01-01

Moral decision making involves affective and cognitive functions like emotional empathy, reasoning and cognitive empathy/theory of mind (ToM), which are discussed to be subject to age-related alterations. Additionally, sex differences in moral decision making have been reported. However, age-related changes in moral decision making from early to late adulthood and their relation to sex and neuropsychological functions have not been studied yet. One hundred ninety seven participants (122 female), aged 19-86 years, were tested with a moral decision making task comprising forced choice "everyday life" situations in which an altruistic option that favors a socially accepted alternative had to be considered against an egoistic option that favors personal benefit over social interests. The percentage of altruistic decisions was analyzed. A structural equation model (SEM) was calculated to test the hypothesis whether age and sex predict altruistic moral decision, and whether relevant neuropsychological domains mediate these hypothesized relationships. A significant relationship between age and moral decision making was found indicating more frequent altruistic decisions with increasing age. Furthermore, women decided more altruistically than men. The SEM showed that both age and sex are significant predictors of altruistic moral decision making, mediated by emotional empathy but not by reasoning. No cognitive empathy and ToM scores were correlated to age and moral decision making at the same time and thus were not included in the SEM. Our data suggest that increasing age and female sex have an effect on altruistic moral decisions, but that this effect is fully mediated by emotional empathy. The fact that changes of moral decision making with age are mediated by emotional empathy can be interpreted in the light of the so-called "positivity effect" and increasing avoidance of negative affect in aging. The mediated sex effect might represent both biological aspects and

Empathy Mediates the Effects of Age and Sex on Altruistic Moral Decision Making

PubMed Central

Rosen, Jan B.; Brand, Matthias; Kalbe, Elke

2016-01-01

Moral decision making involves affective and cognitive functions like emotional empathy, reasoning and cognitive empathy/theory of mind (ToM), which are discussed to be subject to age-related alterations. Additionally, sex differences in moral decision making have been reported. However, age-related changes in moral decision making from early to late adulthood and their relation to sex and neuropsychological functions have not been studied yet. One hundred ninety seven participants (122 female), aged 19–86 years, were tested with a moral decision making task comprising forced choice “everyday life” situations in which an altruistic option that favors a socially accepted alternative had to be considered against an egoistic option that favors personal benefit over social interests. The percentage of altruistic decisions was analyzed. A structural equation model (SEM) was calculated to test the hypothesis whether age and sex predict altruistic moral decision, and whether relevant neuropsychological domains mediate these hypothesized relationships. A significant relationship between age and moral decision making was found indicating more frequent altruistic decisions with increasing age. Furthermore, women decided more altruistically than men. The SEM showed that both age and sex are significant predictors of altruistic moral decision making, mediated by emotional empathy but not by reasoning. No cognitive empathy and ToM scores were correlated to age and moral decision making at the same time and thus were not included in the SEM. Our data suggest that increasing age and female sex have an effect on altruistic moral decisions, but that this effect is fully mediated by emotional empathy. The fact that changes of moral decision making with age are mediated by emotional empathy can be interpreted in the light of the so-called “positivity effect” and increasing avoidance of negative affect in aging. The mediated sex effect might represent both biological aspects

Fitness prospects: effects of age, sex and recruitment age on reproductive value in a long-lived seabird.

PubMed

Zhang, He; Rebke, Maren; Becker, Peter H; Bouwhuis, Sandra

2015-01-01

Reproductive value is an integrated measure of survival and reproduction fundamental to understanding life-history evolution and population dynamics, but little is known about intraspecific variation in reproductive value and factors explaining such variation, if any. By applying generalized additive mixed models to longitudinal individual-based data of the common tern Sterna hirundo, we estimated age-specific annual survival probability, breeding probability and reproductive performance, based on which we calculated age-specific reproductive values. We investigated effects of sex and recruitment age (RA) on each trait. We found age effects on all traits, with survival and breeding probability declining with age, while reproductive performance first improved with age before levelling off. We only found a very small, marginally significant, sex effect on survival probability, but evidence for decreasing age-specific breeding probability and reproductive performance with RA. As a result, males had slightly lower age-specific reproductive values than females, while birds of both sexes that recruited at the earliest ages of 2 and 3 years (i.e. 54% of the tern population) had somewhat higher fitness prospects than birds recruiting at later ages. While the RA effects on breeding probability and reproductive performance were statistically significant, these effects were not large enough to translate to significant effects on reproductive value. Age-specific reproductive values provided evidence for senescence, which came with fitness costs in a range of 17-21% for the sex-RA groups. Our study suggests that intraspecific variation in reproductive value may exist, but that, in the common tern, the differences are small. © 2014 The Authors. Journal of Animal Ecology © 2014 British Ecological Society.

Sex, gender, and age: contributions to laboratory pain responding in children and adolescents.

PubMed

Myers, Cynthia D; Tsao, Jennie C I; Glover, Dorie A; Kim, Su C; Turk, Norman; Zeltzer, Lonnie K

2006-08-01

A cross-sectional design across late childhood and adolescence examined the influence of sex, gender socialization, and age on responses to controlled laboratory pain tasks. Healthy children and adolescents (n = 240, 50% female, age 8 to 18 years) completed the Child Sex Role Inventory, a self-report measure of identification with stereotypically masculine and feminine personality traits, as an index of gender socialization and participated in pressure, cold pressor, and heat pain tasks. Pain tolerance, pain intensity, and bothersomeness of each pain task were assessed. Masculinity correlated with lower heat pain ratings in boys but not girls. Logistic regression indicated cold pain intensity ratings were predicted by sex, gender score, and the age-by-gender score interaction. Heat pain intensity was predicted by age, gender score, age-by-gender score interaction, and sex-by-gender score. The current findings support closer examination of the influence of gender socialization on young people's pain responses and highlight the importance of a multifactorial, developmental approach to studying the impact of gender socialization on the emergence of sex differences in pain responses after puberty.

Depression, comorbid anxiety disorders, and heart rate variability in physically healthy, unmedicated patients: implications for cardiovascular risk.

PubMed

Kemp, Andrew H; Quintana, Daniel S; Felmingham, Kim L; Matthews, Slade; Jelinek, Herbert F

2012-01-01

There is evidence that heart rate variability (HRV) is reduced in major depressive disorder (MDD), although there is debate about whether this effect is caused by medication or the disorder per se. MDD is associated with a two to fourfold increase in the risk of cardiac mortality, and HRV is a robust predictor of cardiac mortality; determining a direct link between HRV and not only MDD, but common comorbid anxiety disorders, will point to psychiatric indicators for cardiovascular risk reduction. To determine in physically healthy, unmedicated patients whether (1) HRV is reduced in MDD relative to controls, and (2) HRV reductions are driven by MDD alone, comorbid generalized anxiety disorder (GAD, characterized by anxious anticipation), or comorbid panic and posttraumatic stress disorders (PD/PTSD, characterized by anxious arousal). A case-control study in 2006 and 2007 on 73 MDD patients, including 24 without anxiety comorbidity, 24 with GAD, and 14 with PD/PTSD. Seventy-three MDD and 94 healthy age- and sex-matched control participants were recruited from the general community. Participants had no history of drug addiction, alcoholism, brain injury, loss of consciousness, stroke, neurological disorder, or serious medical conditions. There were no significant differences between the four groups in age, gender, BMI, or alcohol use. HRV was calculated from electrocardiography under a standardized short-term resting state condition. HRV was reduced in MDD relative to controls, an effect associated with a medium effect size. MDD participants with comorbid generalized anxiety disorder displayed the greatest reductions in HRV relative to controls, an effect associated with a large effect size. Unmedicated, physically healthy MDD patients with and without comorbid anxiety had reduced HRV. Those with comorbid GAD showed the greatest reductions. Implications for cardiovascular risk reduction strategies in otherwise healthy patients with psychiatric illness are discussed.

Impact of Age and Sex on Response to Asthma Therapy.

PubMed

Dunn, Ryan M; Lehman, Erik; Chinchilli, Vernon M; Martin, Richard J; Boushey, Homer A; Israel, Elliot; Kraft, Monica; Lazarus, Stephen C; Lemanske, Robert F; Lugogo, Njira L; Peters, Stephen P; Sorkness, Christine A; Szefler, Stanley; Wechsler, Michael E

2015-09-01

Age and sex are associated with differences in asthma prevalence and morbidity. To determine if age and sex associate with distinct phenotypes and a variable response to therapy in subjects with mild to moderate asthma. We used Asthma Clinical Research Network data to determine the impact of age and sex on phenotypes and treatment failures among subjects participating in 10 trials from 1993 to 2003. A total of 1,200 subjects were identified (median age, 30.4 yr; male, 520 [43.3%]; female, 680 [56.7%]) and analyzed. A higher proportion of subjects greater than or equal to 30 years old experienced treatment failures (17.3% vs. 10.3%; odds ratio [OR], 1.82; confidence interval [CI], 1.30-2.54; P < 0.001), and rates increased proportionally with increasing age older than 30 across the cohort (OR per yr, 1.02 [CI, 1.01-1.04]; OR per 5 yr, 1.13 [CI, 1.04-1.22]; P < 0.001). Lower lung function and longer duration of asthma were associated with a higher risk of treatment failures. A higher proportion of subjects greater than or equal to 30 years old receiving controller therapy experienced treatment failures. When stratified by specific therapy, treatment failures increased consistently for every year older than age 30 in subjects on inhaled corticosteroids (OR per year, 1.03; CI, 1.01-1.07). Females had a slightly higher FEV1 % predicted (84.5% vs. 81.1%; P < 0.001) but similar asthma control measures. There was not a statistically significant difference in treatment failures between females and males (15.2% vs. 11.7%; P = 0.088). Older age is associated with an increased risk of treatment failure, particularly in subjects taking inhaled corticosteroids. There was no significant difference in treatment failures between sexes.

Complex Psychiatric Comorbidity of Treatment-Seeking Youth With Autism Spectrum Disorder and Anxiety Symptoms

PubMed Central

HEPBURN, SUSAN L.; STERN, JESSICA A.; BLAKELEY-SMITH, AUDREY; KIMEL, LILA K.; REAVEN, JUDITH A.

2015-01-01

Anxiety disorders and other co-occurring psychiatric disorders significantly impact adaptive functioning for many children with autism spectrum disorder (ASD). This descriptive study examines the complexity of psychiatric comorbidity in treatment-seeking youth with ASD and anxiety symptoms. Forty-two parents of 8- to 14-year-old children with ASD and anxiety symptoms completed a structured psychiatric interview (K-SADS) and provided information about the child’s past and current psychological functioning as part of a screening process to enter an anxiety intervention program. Overall, comorbidity was very complex, with children obtaining an average of 4 psychiatric diagnoses (including anxiety disorders) on a structured clinical interview (range = 0–9). Onset and course differed by psychiatric disorder. Complexity of comorbidity did not differ significantly by age, sex, or autism severity. Despite clinical significance of the symptoms reported, few children were currently (or ever) engaged in mental health treatment or group psychosocial intervention. Although the specificity of the current sample limits the generalizability of these results, findings suggest that treatment-seeking children with ASD and anxiety often present with additional psychiatric symptoms, which supports a transdiagnostic approach to research and intervention in this area. Accurate assessment of comorbidity may provide valuable information for families and clinicians regarding individualized treatment approaches. PMID:25960821

A systematic review of the incidence and prevalence of comorbidity in multiple sclerosis: Overview

PubMed Central

Cohen, Jeffrey; Stuve, Olaf; Trojano, Maria; Sørensen, Per Soelberg; Reingold, Stephen; Cutter, Gary; Reider, Nadia

2015-01-01

Background: Comorbidity is an area of increasing interest in multiple sclerosis (MS). Objective: The objective of this review is to estimate the incidence and prevalence of comorbidity in people with MS and assess the quality of included studies. Methods: We searched the PubMed, SCOPUS, EMBASE and Web of Knowledge databases, conference proceedings, and reference lists of retrieved articles. Two reviewers independently screened abstracts. One reviewer abstracted data using a standardized form and the abstraction was verified by a second reviewer. We assessed study quality using a standardized approach. We quantitatively assessed population-based studies using the I2 statistic, and conducted random-effects meta-analyses. Results: We included 249 articles. Study designs were variable with respect to source populations, case definitions, methods of ascertainment and approaches to reporting findings. Prevalence was reported more frequently than incidence; estimates for prevalence and incidence varied substantially for all conditions. Heterogeneity was high. Conclusion: This review highlights substantial gaps in the epidemiological knowledge of comorbidity in MS worldwide. Little is known about comorbidity in Central or South America, Asia or Africa. Findings in North America and Europe are inconsistent. Future studies should report age-, sex- and ethnicity-specific estimates of incidence and prevalence, and standardize findings to a common population. PMID:25623244

Vocabulary, Grammar, Sex, and Aging.

PubMed

Moscoso Del Prado Martín, Fermín

2017-05-01

Understanding the changes in our language abilities along the lifespan is a crucial step for understanding the aging process both in normal and in abnormal circumstances. Besides controlled experimental tasks, it is equally crucial to investigate language in unconstrained conversation. I present an information-theoretical analysis of a corpus of dyadic conversations investigating how the richness of the vocabulary, the word-internal structure (inflectional morphology), and the syntax of the utterances evolves as a function of the speaker's age and sex. Although vocabulary diversity increases throughout the lifetime, grammatical diversities follow a different pattern, which also differs between women and men. Women use increasingly diverse syntactic structures at least up to their late fifties, and they do not deteriorate in terms of fluency through their lifespan. However, from age 45 onward, men exhibit a decrease in the diversity of the syntactic structures they use, coupled with an increased number of speech disfluencies. Copyright © 2016 Cognitive Science Society, Inc.

Age and sex identification of Akohekohe

USGS Publications Warehouse

Simon, John C.; Pratt, T.K.; Berlin, Kim E.; Kowalsky, James R.

1998-01-01

We present methods to determine the age and sex of Akohekohe (Palmeria dolei), an endangered Hawaiian honeycreeper, developed on the basis of 45 museum specimens and 91 live birds captured on the island of Maui. Akohekohe retained all Juvenal primaries, some Juvenal secondaries, and some body feathers after the first prebasic molt; they attained full adult plumage after the second prebasic molt. Retention of brown Juvenal body feathers, especially on the head, distinguished most birds in the first basic plumage from adults, which have a full complement of distinctive, black lanceolate body feathers with white, gray, or orange tips. Male Akohekohe were heavier than females and had longer wing, tail, and tarsometatarsus lengths. We present a linear discriminant function to sex both adults and juveniles using lengths of their wing and tarsometatarsus.

Gender differences in substance abuse treatment and barriers to care among persons with substance use disorders with and without comorbid major depression.

PubMed

Chen, Lian-Yu; Strain, Eric C; Crum, Rosa M; Mojtabai, Ramin

2013-01-01

To compare substance use disorders (SUD) treatment patterns and barriers to such treatment among men and women with SUD with and without comorbid major depressive episodes (MDE) in a community sample. Using data from adult participants in the National Survey on Drug Use and Health 2005-2010, we investigated differences by sex in the association of MDE comorbidity with SUD on patterns of, perceived unmet need for, and the perceived barriers to SUD treatments. Compared with participants with SUD without MDE, both men and women with comorbid SUD and MDE were more likely to use SUD services or to report an unmet need for such treatment. Sex modified the association of comorbidity and treatment patterns: males with MDE comorbidity had a greater likelihood of emergency room visits and use of inpatient services than females. Barriers to substance treatment were remarkably similar for males and females in both the SUD without MDE group and with MDE group, with attitudinal factors being the most common barriers. Comorbidity with MDE seems to be an important predictor of service utilization and perceived need for SUD treatment in both men and women. The association of comorbidity with the use of some types of services, however, seems to vary according to sex. The findings have implications for the design of sex-specific SUD treatment programs.

The influence of averageness on judgments of facial attractiveness: no own-age or own-sex advantage among children attending single-sex schools.

PubMed

Vingilis-Jaremko, Larissa; Maurer, Daphne; Gao, Xiaoqing

2014-04-01

We examined how recent biased face experience affects the influence of averageness on judgments of facial attractiveness among 8- and 9-year-old children attending a girls' school, a boys' school, and a mixed-sex school. We presented pairs of individual faces in which one face was transformed 50% toward its group average, whereas the other face was transformed 50% away from that average. Across blocks, the faces varied in age (adult, 9-year-old, or 5-year-old) and sex (male or female). We expected that averageness might influence attractiveness judgments more strongly for same-age faces and, for children attending single-sex schools, same-sex faces of that age because their prototype(s) should be best tuned to the faces they see most frequently. Averageness influenced children's judgments of attractiveness, but the strength of the influence was not modulated by the age of the face, nor did the effects of sex of face differ across schools. Recent biased experience might not have affected the results because of similarities between the average faces of different ages and sexes and/or because a minimum level of experience with a particular group of faces may be adequate for the formation of a veridical prototype and its influence on judgments of attractiveness. The results suggest that averageness affects children's judgments of the attractiveness of the faces they encounter in everyday life regardless of age or sex of face. Copyright © 2013 Elsevier Inc. All rights reserved.

Sex and Age Differences in Future Temporal Perspective.

ERIC Educational Resources Information Center

Grant, Edward; Sawler, Joyce

This study explored sex differences in the Future Temporal Perspectives (FTP) of children. The influences of age, social class and intelligence were also investigated, or FTP was generally believed to be affected by them. Subjects were 96 boys and 96 girls, selected from 26 schools in Nova Scotia, from three age groups: 9.6-11.0, 12.0-13.6, and…

Multiple Comorbidities of 21 Psychological Disorders and Relationships With Psychosocial Variables: A Study of the Online Assessment and Diagnostic System Within a Web-Based Population

PubMed Central

Klein, Britt; Meyer, Denny

2015-01-01

Background While research in the area of e-mental health has received considerable attention over the last decade, there are still many areas that have not been addressed. One such area is the comorbidity of psychological disorders in a Web-based sample using online assessment and diagnostic tools, and the relationships between comorbidities and psychosocial variables. Objective We aimed to identify comorbidities of psychological disorders of an online sample using an online diagnostic tool. Based on diagnoses made by an automated online assessment and diagnostic system administered to a large group of online participants, multiple comorbidities (co-occurrences) of 21 psychological disorders for males and females were identified. We examined the relationships between dyadic comorbidities of anxiety and depressive disorders and the psychosocial variables sex, age, suicidal ideation, social support, and quality of life. Methods An online complex algorithm based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision, was used to assign primary and secondary diagnoses of 21 psychological disorders to 12,665 online participants. The frequency of co-occurrences of psychological disorders for males and females were calculated for all disorders. A series of hierarchical loglinear analyses were performed to examine the relationships between the dyadic comorbidities of depression and various anxiety disorders and the variables suicidal ideation, social support, quality of life, sex, and age. Results A 21-by-21 frequency of co-occurrences of psychological disorders matrix revealed the presence of multiple significant dyadic comorbidities for males and females. Also, for those with some of the dyadic depression and the anxiety disorders, the odds for having suicidal ideation, reporting inadequate social support, and poorer quality of life increased for those with two-disorder comorbidity than for those with only one of the same

Multiple comorbidities of 21 psychological disorders and relationships with psychosocial variables: a study of the online assessment and diagnostic system within a web-based population.

PubMed

Al-Asadi, Ali M; Klein, Britt; Meyer, Denny

2015-02-26

While research in the area of e-mental health has received considerable attention over the last decade, there are still many areas that have not been addressed. One such area is the comorbidity of psychological disorders in a Web-based sample using online assessment and diagnostic tools, and the relationships between comorbidities and psychosocial variables. We aimed to identify comorbidities of psychological disorders of an online sample using an online diagnostic tool. Based on diagnoses made by an automated online assessment and diagnostic system administered to a large group of online participants, multiple comorbidities (co-occurrences) of 21 psychological disorders for males and females were identified. We examined the relationships between dyadic comorbidities of anxiety and depressive disorders and the psychosocial variables sex, age, suicidal ideation, social support, and quality of life. An online complex algorithm based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision, was used to assign primary and secondary diagnoses of 21 psychological disorders to 12,665 online participants. The frequency of co-occurrences of psychological disorders for males and females were calculated for all disorders. A series of hierarchical loglinear analyses were performed to examine the relationships between the dyadic comorbidities of depression and various anxiety disorders and the variables suicidal ideation, social support, quality of life, sex, and age. A 21-by-21 frequency of co-occurrences of psychological disorders matrix revealed the presence of multiple significant dyadic comorbidities for males and females. Also, for those with some of the dyadic depression and the anxiety disorders, the odds for having suicidal ideation, reporting inadequate social support, and poorer quality of life increased for those with two-disorder comorbidity than for those with only one of the same two disorders. Comorbidities of

[Sociodemographic Traits and Comorbidities in Pathological Gamblers With a Suicide Attempt in Spain].

PubMed

Verdura-Vizcaíno, Ernesto José; Fernández-Navarro, Pablo; Vian-Lains, Antonio; Ibañez, Ángela; Baca-García, Enrique

2015-01-01

Suicide is the first cause of non-natural death in Spain. Among addictive disorders, pathological gambling is one the most significant independent risk factors for suicidal behavior. The objective of this study is to describe and compare the sociodemographic traits, comorbidity and attempt characteristics, between suicide attempters who fulfill diagnostic criteria for pathological gambling and those who do not. A total of 345 patients admitted to the emergency department of a University Hospital in Madrid between 1999 and 2004 were interviewed for this study. To describe and compare the demographic characteristics, comorbidity and those related to attempted suicide, using logistic regression models adjusted for sex and age were used. Suicide attempters who fulfilled diagnostic criteria for pathological gambling were predominantly male, with a low education level, and had more offspring. Furthermore, these patients had more comorbidities, such as: global substance dependence, nicotine, cocaine and opioid dependence. The present study suggests that pathological gamblers represent a distinct subgroup among suicide attempters, with particular characteristics, similar to those found in pathological gamblers in the general population. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Age-related changes in the craniofacial region in a modern Greek population sample of known age and sex.

PubMed

Chovalopoulou, Maria-Eleni; Bertsatos, Andreas; Papageorgopoulou, Christina

2017-07-01

The aim of this paper is to investigate ageing changes in craniofacial region in both sexes and evaluate whether these shape changes are substantial to achieve age discrimination of samples used in anthropological analyses. The study sample consisted of 157 crania of known sex and age (81 males and 76 females) belonging to individuals who lived in Greece during the twentieth century. The sample was divided in three age groups: young adults (YA, 18-39 years old), middle adults (MA, 40-59 years old) and old adults (OA, >60 years old). The three-dimensional coordinates of 31 ecto-cranial landmarks were digitized using a Microscribe 3DX contact digitizer, and landmark configurations were analyzed using the generalized least-squares Procrustes method. The results indicate that both males and females show significant difference among the age groups; however, shape differences can not be used for age group discrimination due to a large range on the accuracy of age group classification. The morphometric changes related to age were different between sexes.

Functional Impairments in Children with ADHD: Unique Effects of Age and Comorbid Status

ERIC Educational Resources Information Center

Booster, Genery D.; DuPaul, George J.; Eiraldi, Ricardo; Power, Thomas J.

2012-01-01

Objective: Children with ADHD and comorbid disorders display poorer overall functioning compared with children with ADHD alone, though little research has examined the differential impact of externalizing versus internalizing comorbidities. Method: This study examined the impact of internalizing and externalizing comorbidities on the academic and…

Effects of age and sex on developmental neural networks of visual-spatial attention allocation.

PubMed

Rubia, Katya; Hyde, Zoe; Halari, Rozmin; Giampietro, Vincent; Smith, Anna

2010-06-01

Compared to our understanding of the functional maturation of brain networks underlying complex cognitive abilities, hardly anything is known of the neurofunctional development of simpler cognitive abilities such as visuo-spatial attention allocation. Furthermore, nothing is known on the effect of gender on the functional development of attention allocation. This study employed event related functional magnetic resonance imaging to investigate effects of age, sex, and sex by age interactions on the brain activation of 63 males and females, between 13 to 38years, during a visual-spatial oddball task. Behaviourally, with increasing age, speed was traded for accuracy, indicative of a less impulsive performance style in older subjects. Increasing age was associated with progressively increased activation in typical areas of selective attention of lateral fronto-striatal and temporo-parietal brain regions. Sex difference analysis showed enhanced activation in right-hemispheric inferior frontal and superior temporal regions in females, and in left-hemispheric inferior temporo-parietal regions in males. Importantly, the age by sex interaction findings showed that these sex-dimorphic patterns of brain activation may be the result of underlying sex differences in the functional maturation of these brain regions, as females had sex-specific progressive age-correlations in the same right inferior fronto-striato-temporal areas, while male-specific age-correlations were in left medial temporal and parietal areas. The findings demonstrate progressive functional maturation of fronto-striato-parieto-temporal networks of the relatively simple function of attention allocation between early adolescence and mid-adulthood. They furthermore show that sex-dimorphic patterns of enhanced reliance on right inferior frontal, striatal and superior temporal regions in females and of left temporo-parietal regions in males during attention allocation may be the result of underlying sex

A method of decision analysis quantifying the effects of age and comorbidities on the probability of deriving significant benefit from medical treatments

PubMed Central

Bean, Nigel G.; Ruberu, Ravi P.

2017-01-01

Background The external validity, or generalizability, of trials and guidelines has been considered poor in the context of multiple morbidity. How multiple morbidity might affect the magnitude of benefit of a given treatment, and thereby external validity, has had little study. Objective To provide a method of decision analysis to quantify the effects of age and comorbidity on the probability of deriving a given magnitude of treatment benefit. Design We developed a method to calculate probabilistically the effect of all of a patient’s comorbidities on their underlying utility, or well-being, at a future time point. From this, we derived a distribution of possible magnitudes of treatment benefit at that future time point. We then expressed this distribution as the probability of deriving at least a given magnitude of treatment benefit. To demonstrate the applicability of this method of decision analysis, we applied it to the treatment of hypercholesterolaemia in a geriatric population of 50 individuals. We highlighted the results of four of these individuals. Results This method of analysis provided individualized quantifications of the effect of age and comorbidity on the probability of treatment benefit. The average probability of deriving a benefit, of at least 50% of the magnitude of benefit available to an individual without comorbidity, was only 0.8%. Conclusion The effects of age and comorbidity on the probability of deriving significant treatment benefits can be quantified for any individual. Even without consideration of other factors affecting external validity, these effects may be sufficient to guide decision-making. PMID:29090189

Development of a Healthy Aging Score in the Population-Based Rotterdam Study: Evaluating Age and Sex Differences.

PubMed

Jaspers, Loes; Schoufour, Josje D; Erler, Nicole S; Darweesh, Sirwan K L; Portegies, Marileen L P; Sedaghat, Sanaz; Lahousse, Lies; Brusselle, Guy G; Stricker, Bruno H; Tiemeier, Henning; Ikram, M Arfan; Laven, Joop S E; Franco, Oscar H; Kavousi, Maryam

2017-03-01

To develop a healthy aging score (HAS), to assess age and sex differences in HAS, and to evaluate the association of the HAS with survival. Prospective population-based cohort. Inhabitants of Ommoord, Rotterdam, The Netherlands. A total of 1405 men and 2122 women, mean (standard deviation) age 75.9 (6.4) years. We included 7 domains in the total score of HAS: chronic diseases, mental health, cognitive function, physical function, pain, social support, and quality of life; each scored 0, 1, or 2 in each domain. A total score (range 0-14) was constructed and was assessed continuously and in tertiles (13-14: healthy aging, 11-12: intermediate aging, 0-10: poor aging). Sex-specific change in the mean HAS was computed for the age categories of 65-69, 70-74, 75-79, 80-84, and ≥85 years. The association between HAS and mortality was assessed with Cox proportional hazards models. Mean follow-up was 8.6 (3.4) years. Men had poorer scores in the chronic disease domain than women. However, women had poorer mental health, worse physical function, more pain, and lower quality of life compared with men. The prevalence of healthy aging was higher in men (n = 396, 28.2%), than in women (n = 526, 24.8%). The mean (standard deviation) HAS was 11.1 (2.2) in men and 10.7 (2.3) in women. Mean HAS was higher in men than in women for all age categories. The β for change in mean HAS across the 5 increasing age categories was -0.55 (-0.65 to -0.45) in men and -0.65 (-0.73 to -0.57) in women. The age-adjusted hazard ratio per unit increase in HAS with mortality was 0.86 (0.83-0.89) in men, and 0.89 (0.87-0.91) in women. Levels of HAS were lower in women compared with men, in all age categories. The HAS declined with increasing age for both sexes, albeit slightly steeper in women. The HAS was strongly associated with mortality in both sexes. A better understanding of population healthy aging and sex differences in this regard could aid to implement strategies for sustainable

High levels of comorbidity and disability cancel out the dementia effect in predictions of long-term mortality after discharge in the very old.

PubMed

Zekry, Dina; Herrmann, François R; Graf, Christophe E; Giannelli, Sandra; Michel, Jean-Pierre; Gold, Gabriel; Krause, Karl-Heinz

2011-01-01

The relative weight of various etiologies of dementia as predictors of long-term mortality after other risk factors have been taken into account remains unclear. We investigated the 5-year mortality risk associated with dementia in elderly people after discharge from acute care, taking into account comorbid conditions and functionality. A prospective cohort study of 444 patients (mean age: 85 years; 74% female) discharged from the acute geriatric unit of Geneva University Hospitals. On admission, each subject underwent a standardized diagnostic evaluation: demographic variables, cognitive, comorbid medical conditions and functional assessment. Patients were followed yearly by the same team. Predictors of survival at 5 years were evaluated by Cox proportional hazards models. The univariate model showed that being older and male, and having vascular and severe dementia, comorbidity and functional disability, were predictive of shorter survival. However, in the full multivariate model adjusted for age and sex, the effect of dementia type or severity completely disappeared when all the variables were added. In multivariate analysis, the best predictor was higher comorbidity score, followed by functional status (R(2) = 23%). The identification of comorbidity and functional impairment effects as predictive factors for long-term mortality independent of cognitive status may increase the accuracy of long-term discharge planning. Copyright © 2011 S. Karger AG, Basel.

The Spanish Society of Neurology's official clinical practice guidelines for epilepsy. Special considerations in epilepsy: comorbidities, women of childbearing age, and elderly patients.

PubMed

Mauri Llerda, J A; Suller Marti, A; de la Peña Mayor, P; Martínez Ferri, M; Poza Aldea, J J; Gomez Alonso, J; Mercadé Cerdá, J M

2015-10-01

The characteristics of some population groups (patients with comorbidities, women of childbearing age, the elderly) may limit epilepsy management. Antiepileptic treatment in these patients may require adjustments. We searched articles in Pubmed, clinical practice guidelines for epilepsy, and recommendations by the most relevant medical societies regarding epilepsy in special situations (patients with comorbidities, women of childbearing age, the elderly). Evidence and recommendations are classified according to the prognostic criteria of Oxford Centre of Evidence-Based Medicine (2001) and the European Federation of Neurological Societies (2004) for therapeutic interventions. Epilepsy treatment in special cases of comorbidities must be selected properly to improve efficacy with the fewest side effects. Adjusting antiepileptic medication and/or hormone therapy is necessary for proper seizure management in catamenial epilepsy. Exposure to antiepileptic drugs (AED) during pregnancy increases the risk of birth defects and may affect fetal growth and/or cognitive development. Postpartum breastfeeding is recommended, with monitoring for adverse effects if sedative AEDs are used. Finally, the elderly are prone to epilepsy, and diagnostic and treatment characteristics in this group differ from those of other age groups. Although therapeutic limitations may be more frequent in older patients due to comorbidities, they usually respond better to lower doses of AEDs than do other age groups. Copyright © 2014 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

[Comorbidity and related costs as a burden in the treatment of outpatients with depressive disorders in a primary care setting].

PubMed

Sicras Mainar, A; Navarro Artieda, R; Rejas Gutiérrez, J; Blanca Tamayo, M; Serrat Tarrés, J; Llopart López, J R

2007-01-01

To study the impact of depressive disorders (DD) on health care expenditure and to measure associated comorbidity in patients in primary care settings (PCS) under normal clinical practice conditions. A retrospective cohort study was carried out. The study cohort consisted of outpatients aged over 14 years of age with an established diagnosis of DD (ICPC; P76) treated in a PC health centre during 2004. A comparative cohort was formed with the remaining outpatients without DD, treated in that health centre. Main factors for calculation were: age, gender, history/comorbidity and health resource use and the corresponding outpatient costs; drugs, diagnostic tests, visits to specialists and PC physicians. Multiple logistic regression analysis and ANCOVA models were used in order to adjust costs and comorbidities between the cohorts of patients. A total of 64,072 subjects were assessed; 6,592 patients with DD [10.3% (CI: 8.2-12.4%), 74.5% (CI: 73.4%-75.6%) females]. DD outpatients displayed a higher number of episodes of comorbidities/year (mean +/- SD; 7.4 +/- 4.3 vs. 4.7 +/- 3.3, p < 0.0001) and global medical visits/patient/year (12.0 +/- 9.3 vs. 7.4 +/- 7.6, p < 0.0001). The main comorbidities associated to DD were neurological disorders [Odds ratio (95% CI); 2.1 (CI: 1.5-2.6), p < 0.0001], alcoholism [1.6 (CI: 1.3-1.9), p < 0.0001] and malignancies [1.3 (CI: 1.1-1.5), p < 0.0001]. DD were associated with significantly higher adjusted total costs; 1,083.8 euro (SEM; 8.4 euro) vs. 684.1 euro (3.4 euro), p < 0.0001. Higher costs were displayed for elderly patients. Sixty-two percent of the total cost was related to drugs. Prevalence of DD was higher, particularly in women. Following adjustment in accordance with comorbidity, age and sex, DD outpatients used more health care resources and implied higher costs. Higher costs were associated with age.

Examining the Association Between Comorbidity Indexes and Functional Status in Hospitalized Medicare Fee-for-Service Beneficiaries

PubMed Central

Graham, James E.; Resnik, Linda; Karmarkar, Amol M.; Deutsch, Anne; Tan, Alai; Al Snih, Soham; Ottenbacher, Kenneth J.

2016-01-01

Background Medicare data from acute hospitals do not contain information on functional status. This lack of information limits the ability to conduct rehabilitation-related health services research. Objective The purpose of this study was to examine the associations between 5 comorbidity indexes derived from acute care claims data and functional status assessed at admission to an inpatient rehabilitation facility (IRF). Comorbidity indexes included tier comorbidity, Functional Comorbidity Index (FCI), Charlson Comorbidity Index, Elixhauser Comorbidity Index, and Hierarchical Condition Category (HCC). Design This was a retrospective cohort study. Methods Medicare beneficiaries with stroke, lower extremity joint replacement, and lower extremity fracture discharged to an IRF in 2011 were studied (N=105,441). Data from the beneficiary summary file, Medicare Provider Analysis and Review (MedPAR) file, and Inpatient Rehabilitation Facility–Patient Assessment Instrument (IRF-PAI) file were linked. Inpatient rehabilitation facility admission functional status was used as a proxy for acute hospital discharge functional status. Separate linear regression models for each impairment group were developed to assess the relationships between the comorbidity indexes and functional status. Base models included age, sex, race/ethnicity, disability, dual eligibility, and length of stay. Subsequent models included individual comorbidity indexes. Values of variance explained (R2) with each comorbidity index were compared. Results Base models explained 7.7% of the variance in motor function ratings for stroke, 3.8% for joint replacement, and 7.3% for fracture. The R2 increased marginally when comorbidity indexes were added to base models for stroke, joint replacement, and fracture: Charlson Comorbidity Index (0.4%, 0.5%, 0.3%), tier comorbidity (0.2%, 0.6%, 0.5%), FCI (0.4%, 1.2%, 1.6%), Elixhauser Comorbidity Index (1.2%, 1.9%, 3.5%), and HCC (2.2%, 2.1%, 2.8%). Limitation Patients

Age and Sex Differences in Interaction with a Human Infant.

ERIC Educational Resources Information Center

Blakemore, Judith E. O.

1981-01-01

Examines sex differences in vocalizations and play behaviors displayed toward an infant by preschoolers, preadolescents, and adults. Preschoolers showed less interaction than older subjects. Males talked and played less with the baby than did females at all ages; however, among adult subjects, no sex-role effects were found. (Author/RH)

Intrinsic connectivity networks from childhood to late adolescence: Effects of age and sex.

PubMed

Solé-Padullés, Cristina; Castro-Fornieles, Josefina; de la Serna, Elena; Calvo, Rosa; Baeza, Inmaculada; Moya, Jaime; Lázaro, Luisa; Rosa, Mireia; Bargalló, Nuria; Sugranyes, Gisela

2016-02-01

There is limited evidence on the effects of age and sex on intrinsic connectivity of networks underlying cognition during childhood and adolescence. Independent component analysis was conducted in 113 subjects aged 7-18; the default mode, executive control, anterior salience, basal ganglia, language and visuospatial networks were identified. The effect of age was examined with multiple regression, while sex and 'age × sex' interactions were assessed by dividing the sample according to age (7-12 and 13-18 years). As age increased, connectivity in the dorsal and ventral default mode network became more anterior and posterior, respectively, while in the executive control network, connectivity increased within frontoparietal regions. The basal ganglia network showed increased engagement of striatum, thalami and precuneus. The anterior salience network showed greater connectivity in frontal areas and anterior cingulate, and less connectivity of orbitofrontal, middle cingulate and temporoparietal regions. The language network presented increased connectivity of inferior frontal and decreased connectivity within the right middle frontal and left inferior parietal cortices. The visuospatial network showed greater engagement of inferior parietal and frontal cortices. No effect of sex, nor age by sex interactions was observed. These findings provide evidence of strengthening of cortico-cortical and cortico-subcortical networks across childhood and adolescence. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effects of age and sex on the results of an ankle plantar-flexor manual muscle test.

PubMed

Jan, Mei-Hwa; Chai, Huei-Ming; Lin, Yeong-Fwu; Lin, Janice Chien-Ho; Tsai, Li-Ying; Ou, Yu-Chih; Lin, Da-Hon

2005-10-01

The ability to perform 20 or more one-leg heel-rises is considered a "normal" grade for muscle strength (force-generating capacity of muscle) of the ankle plantar flexors, regardless of age and sex. Because muscle strength is closely related to age and sex, the "normal" test criterion was re-evaluated in different groups categorized by age and sex. One hundred eighty sedentary volunteers (21-80 years of age) without lower-limb lesions performed as many repetitions of one-leg heel-rise as possible. Lunsford and Perry criteria were used to determine completion of the test. The age and sex of the participants influenced the maximal repetitions of heel-rise, and the repetitions decreased with age and in female subjects. The muscle strength of the ankle plantar flexors, as measured by manual muscle testing, varied with age and sex. Clinicians should consider the variances of age and sex when they perform manual muscle testing of the ankle plantar flexors.

Home Treatment of Deep Venous Thrombosis According to Comorbid Conditions.

PubMed

Stein, Paul D; Matta, Fadi; Hughes, Mary J

2016-04-01

Cautious exploration of the safety of home treatment of deep venous thrombosis has been recommended by many. Our goal was to identify categories of patients with deep venous thrombosis who typically are hospitalized, and categories frequently treated at home. The Nationwide Emergency Department Sample and the Nationwide Inpatient Sample, 2007-2012, were used to determine the number of patients seen in emergency departments throughout the US with deep venous thrombosis and no diagnosis of pulmonary embolism, the proportion of such patients hospitalized according to comorbid conditions and age, the proportion discharged early (≤2 days), and charges for hospitalization and emergency department visits. From 2007-2012, home treatment was selected for 905,152 of 2,671,452 (33.9%) patients with deep venous thrombosis. Home treatment was more frequent in those with no comorbid conditions than with comorbid conditions, 58.0% compared with 15.5% (P <.0001). Early discharge (≤2 days) was in 23.9% with no comorbid conditions, compared with 12.8% with comorbid conditions. Among patients aged 18-50 years, home treatment was selected in 62.9% with no comorbid conditions, compared with 24.2% with comorbid conditions (P <.0001). Among hospitalized patients with no comorbid conditions, 40.7% were aged 18-50 years. Their charges for hospitalization in 2012 were $494 million. Patients aged 50 years or younger with deep venous thrombosis and no comorbid conditions appear to be a group that can be targeted for more frequent home treatment, which would save millions of dollars. Copyright © 2016 Elsevier Inc. All rights reserved.

Anti-aging drugs reduce hypothalamic inflammation in a sex-specific manner.

PubMed

Sadagurski, Marianna; Cady, Gillian; Miller, Richard A

2017-08-01

Aging leads to hypothalamic inflammation, but does so more slowly in mice whose lifespan has been extended by mutations that affect GH/IGF-1 signals. Early-life exposure to GH by injection, or to nutrient restriction in the first 3 weeks of life, also modulate both lifespan and the pace of hypothalamic inflammation. Three drugs extend lifespan of UM-HET3 mice in a sex-specific way: acarbose (ACA), 17-α-estradiol (17αE2), and nordihydroguaiaretic acid (NDGA), with more dramatic longevity increases in males in each case. In this study, we examined the effect of these anti-aging drugs on neuro-inflammation in hypothalamus and hippocampus. We found that age-associated hypothalamic inflammation is reduced in males but not in females at 12 months of age by ACA and 17αE2 and at 22 months of age in NDGA-treated mice. The three drugs blocked indices of hypothalamic reactive gliosis associated with aging, such as Iba-1-positive microglia and GFAP-positive astrocytes, as well as age-associated overproduction of TNF-α. This effect was not observed in drug-treated female mice or in the hippocampus of the drug-treated animals. On the other hand, caloric restriction (CR; an intervention that extends the lifespan in both sexes) significantly reduced hypothalamic microglia and TNF-α in both sexes at 12 months of age. Together, these results suggest that the extent of drug-induced changes in hypothalamic inflammatory processes is sexually dimorphic in a pattern that parallels the effects of these agents on mouse longevity and that mimics the changes seen, in both sexes, of long-lived nutrient restricted or mutant mice. © 2017 The Authors. Aging Cell published by the Anatomical Society and John Wiley & Sons Ltd.

Effects of age and sex on voice onset time: Evidence from Mandarin voiceless stops.

PubMed

Ma, Junzhou; Chen, Xiaoxiang; Wu, Yezhou; Zhang, Linjie

2018-07-01

Considerable studies have addressed effects of age and sex on voice onset time (VOT) in English. However, few studies have examined these effects on Mandarin stops. This study attempts to examine effects of age and sex on VOT in Mandarin. A total of 85 Mandarin-speaking children, aged 4-18 years old, and 13 adults as reference participated in a production experiment. Productions were elicited by reading target words in carrier phrases. Results showed that children aged 6-7 years old had longer VOTs than older ones for highly aspirated stops, and the same tendency was not observed for unaspirated stops. However, no linear developmental trend was observed for both highly aspirated and unaspirated stops. In addition, females displayed longer VOTs for highly aspirated stops and shorter for unaspirated stops, whereas significant sex differences in VOTs existed from 14 years old to adulthood for highly aspirated stops, and no significant sex differences in VOTs were found for unaspirated stops in each group, indicating that sex differences in VOTs varied with age and aspiration. The findings suggest that physiological changes in and differences between males and females provide account for some, but not all differences in VOTs across age and sex.

Impact of Age and Sex on Response to Asthma Therapy

PubMed Central

Dunn, Ryan M.; Lehman, Erik; Chinchilli, Vernon M.; Martin, Richard J.; Boushey, Homer A.; Israel, Elliot; Kraft, Monica; Lazarus, Stephen C.; Lemanske, Robert F.; Lugogo, Njira L.; Peters, Stephen P.; Sorkness, Christine A.; Szefler, Stanley

2015-01-01

Rationale: Age and sex are associated with differences in asthma prevalence and morbidity. Objectives: To determine if age and sex associate with distinct phenotypes and a variable response to therapy in subjects with mild to moderate asthma. Methods: We used Asthma Clinical Research Network data to determine the impact of age and sex on phenotypes and treatment failures among subjects participating in 10 trials from 1993 to 2003. Measurements and Main Results: A total of 1,200 subjects were identified (median age, 30.4 yr; male, 520 [43.3%]; female, 680 [56.7%]) and analyzed. A higher proportion of subjects greater than or equal to 30 years old experienced treatment failures (17.3% vs. 10.3%; odds ratio [OR], 1.82; confidence interval [CI], 1.30–2.54; P < 0.001), and rates increased proportionally with increasing age older than 30 across the cohort (OR per yr, 1.02 [CI, 1.01–1.04]; OR per 5 yr, 1.13 [CI, 1.04–1.22]; P < 0.001). Lower lung function and longer duration of asthma were associated with a higher risk of treatment failures. A higher proportion of subjects greater than or equal to 30 years old receiving controller therapy experienced treatment failures. When stratified by specific therapy, treatment failures increased consistently for every year older than age 30 in subjects on inhaled corticosteroids (OR per year, 1.03; CI, 1.01–1.07). Females had a slightly higher FEV1 % predicted (84.5% vs. 81.1%; P < 0.001) but similar asthma control measures. There was not a statistically significant difference in treatment failures between females and males (15.2% vs. 11.7%; P = 0.088). Conclusions: Older age is associated with an increased risk of treatment failure, particularly in subjects taking inhaled corticosteroids. There was no significant difference in treatment failures between sexes. PMID:26068329

Employment Discrimination: Age, Sex and National Origin.

ERIC Educational Resources Information Center

Carter, David G.; Lawson, Miriam

Chapter 17 of a book on school law is an historical review of judicial decisions and legislative enactments that apply to employment. The purpose of the chapter is to analyze those cases concerned with discrimination because of sex, age, or national origin, and to discuss the decisions of the U.S. Supreme Court in these areas. Not until the…

Sex ratio of equine offspring is affected by the ages of the mare and stallion.

PubMed

Santos, Marianna Machado; Maia, Leonardo Lara; Nobre, Daniel Magalhães; Oliveira Neto, José Ferraz; Garcia, Tiago Rezende; Lage, Maria Coeli Gomes Reis; de Melo, Maria Isabel Vaz; Viana, Walmir Santos; Palhares, Maristela Silveira; da Silva Filho, José Monteiro; Santos, Renato Lima; Valle, Guilherme Ribeiro

2015-10-15

The aim of this study was to determine the influence of parental age on the sex ratio of offspring in horses. Two trials were performed. In the first trial, the data from a randomly obtained population with a 1:1 sex ratio of 59,950 Mangalarga Marchador horses born in Brazil from 1990 to 2011 were analyzed. The sex ratios of the offspring were compared among groups according to the mare and the stallion ages (from 3 to 25 years). In the first step of the analysis, the mares and stallions were grouped according to age in 5-year intervals. In the second step, the groups were based on the parental age gap at conception. In the third step, the group of the mares and stallions with similar ages from the second step was subdivided, and the different parental age subgroups that were divided into 5-year intervals were compared. In the fourth step, the sex ratio of the offspring was determined according to the ages of the mares and the stallions at conception. The second trial was based on the data from 253 horses of several breeds that were born after natural gestation into a herd from 1989 to 2010, and the offspring of groups that were younger or older than 15 years were compared. The data from both trials were analyzed using a chi-square test (P ≤ 0.01 for the first trial; and P ≤ 0.05 for the second trial) for the comparisons of the sex ratios. In the first trial, the Spearman test (P ≤ 0.01) was used to verify the correlations between the parental age and the offspring sex ratio. In the first trial, the offspring sex ratio decreased as the mare or stallion age increased, and the decrease was more marked for the mares than for the stallions. In the second trial, the mares older than 15 years had more fillies than the younger mares, but the stallion age had no effect on the sex of the offspring. The first trial, with a large number of horses, revealed the pattern of the distribution of the sex ratios of offspring according to the parental age in horses, whereas the

Age and sex differences in ranges of motion and motion patterns.

PubMed

Hwang, Jaejin; Jung, Myung-Chul

2015-01-01

This study investigated the effects of age and sex on joint ranges of motion (ROMs) and motion patterns. Forty participants performed 18 motions using eight body segments at self-selected speeds. Older subjects showed smaller ROMs than younger subjects for 11 motions; the greatest difference in ROM was 44.9% for eversion/inversion of the foot. Older subjects also required more time than younger subjects to approach the peak angular velocity for six motions. In contrast, sex significantly affected ROMs but not motion patterns. Male subjects exhibited smaller ROMs than female subjects for four motions; the greatest sex-dependent difference in ROM was 29.7% for ulnar/radial deviation of the hand. The age and sex effects depended on the specific segments used and motions performed, possibly because of differences in anatomical structures and frequencies of use of the joints in habitual physical activities between the groups.

Muscularity as a function of species, sex and age in small mammals

NASA Technical Reports Server (NTRS)

Pace, N.; Rahlmann, D. F.; Smith, A. H.

1984-01-01

Changes in the body skeletal muscle mass SMM (measured as a function of the ratio between the body creatine mass and the fat-free muscle creatine), and in muscularity (expressed as the ratio of SMM to fat-free body mass) were studied as functions of age, sex, and species in mouse, rat, hamster, guinea pig, and rabbit. Six animals of each sex were examined in eight age cohorts ranging from 1 to 24 months. Both species and age factors affect SMM. Strong sexual dimorphism in the SMM changes with age was displayed by mouse, rat, and guinea pig, whereas the hamster and rabbit were statistically monomorphic. The mouse, rat, and hamster attain a maximal SMM at about 1 year of age, whereas in the guinea pig and rabbit the decrease in SMM starts after 2 years. The value of muscularity reached a peak at age of 2-3 months in all animals of both sexes, with a pronounced difference among the species. The mouse emerged as the most muscular, while the guinea pig the least muscular, of all species.

Physical fitness in preschool children: association with sex, age and weight status.

PubMed

Latorre Román, P Á; Moreno Del Castillo, R; Lucena Zurita, M; Salas Sánchez, J; García-Pinillos, F; Mora López, D

2017-03-01

Because fitness level is a potent biomarker of health from an early age, the improvements of physical fitness performance through the promotion of physical activity could be important for the health of preschool children, particularly in obesity prevention. The purpose of this study is to determine the physical fitness in children aged 3-6 years, discriminating performance by sex, age and body mass index (BMI). A total of 3868 children from 3 to 6 years agreed voluntarily to participate. Demographic characteristics revealed that 1961 children were male (age: 55.71 ± 11.11 months old, BMI = 16.03 ± 1.93 kg/m 2 ), and 1907 were female (age 56.16 ± 0.97 months old, BMI = 15.85 ± 1.89 kg/m 2 ), and they were selected from 51 schools in southern Spain. Significant differences were found between sexes: boys showed a greater performance on cardio respiratory endurance, reaction time, strength and running speed. We found significant differences by sex in the different age groups (3, 4, 5 and 6 years old). Sex differences in physical fitness are evident at an early age; in addition, the relationship between physical fitness and BMI is inconsistent in preschool children. The improvements of physical fitness performance and its association with physical activity could be important for the health of children, particularly in obesity prevention. © 2016 John Wiley & Sons Ltd.

Psychiatric comorbidities in adolescents with attention-deficit hyperactivity disorder and their siblings.

PubMed

Yang, Li-Kuang; Shang, Chi-Yung; Gau, Susan Shur-Fen

2011-05-01

Despite high psychiatric comorbidities in adolescents with clinical diagnosis of attention-deficit hyperactivity disorder (ADHD), little is known about psychiatric comorbidities in their siblings. We investigated the psychiatric comorbid conditions in adolescents with ADHD, their siblings, and healthy control subjects from their school. The sample included 136 adolescent probands with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), diagnostic criteria; 136 siblings (47 affected and 89 unaffected) and 136 age- and sex-matched healthy school control subjects. All participants and their parents received the structured psychiatric interviews for current and lifetime DSM-IV psychiatric disorders of the participants. The rate of ADHD (34.6%) in the siblings of probands with ADHD was about 7 times higher than in the general population. Probands with ADHD were significantly more likely than unaffected siblings (OR 6.38; 95% CI 3.43 to 11.88) and healthy school control subjects (OR 9.60; 95% CI 5.31 to 17.34) to have a DSM-IV psychiatric disorder, including oppositional defiant disorder (ODD), conduct disorder (CD), tic disorders, major depressive disorder, specific phobia (more than control subjects only), nicotine use disorder, and sleep disorders. The affected siblings were significantly more likely than healthy school control subjects to have ODD, CD, specific phobia, and to have consumed alcohol (ORs ranging from 2.30 to 20.16). Our findings suggest that siblings of probands with ADHD have increased risks for ADHD and that the affected siblings have more psychiatric comorbidities than healthy school control subjects. It warrants early identification of ADHD symptoms and other psychiatric comorbid conditions as well in siblings of adolescents with ADHD.

The Impact of Older Age and Sex on Motion Discrimination.

PubMed

Conlon, Elizabeth G; Power, Garry F; Hine, Trevor J; Rahaley, Nicole

2017-01-01

Background/Study Context: Reports of age-related differences on motion discrimination tasks have produced inconsistent findings concerning the influence of sex. Some studies have reported that older women have higher thresholds than older men, with others finding that women have higher motion thresholds regardless of age group. Reports of the age at which declines in motion discrimination first occur also differ, with some studies reporting declines only in groups aged over 70 years, with others reporting that age-related decline occurs at a younger age. The current study aimed to determine whether the sex differences found occur because relative to men, women have greater difficulty extracting motion signals from noise (Experiment 1) or have greater difficulty making use of the available motion cues (Experiment 2) in these complex moving stimuli. In addition, the influence of these manipulations on groups aged under and over 70 years was explored. Motion discrimination measures were obtained using 39 older adults aged between 60 and 85 years (21 women) and 40 younger adults aged between 20 and 45 years (20 women). In Experiment 1, coherent motion and relative motion displacement thresholds were obtained. In Experiment 2, coherent motion thresholds were obtained for stimuli containing either 150 or 600 dots. In Experiment 1, the older group had significantly higher thresholds on the relative motion displacement and coherent motion tasks than a younger group. No differences in motion sensitivity were found in the older groups aged under or over 70 years. Women regardless of age group had significantly higher thresholds than men on both tasks. In Experiment 2, the older group had higher coherence thresholds than the younger group, and the number of dots presented had no influence on thresholds, for the older group or older women specifically. In the younger group, women had higher coherence thresholds than men with presentation of 150 but not 600 dots. There

Sex-related differences and age of peak performance in breaststroke versus freestyle swimming

PubMed Central

2013-01-01

Background Sex-related differences in performance and in age of peak performance have been reported for freestyle swimming. However, little is known about the sex-related differences in other swimming styles. The aim of the present study was to compare performance and age of peak performance for elite men and women swimmers in breaststroke versus freestyle. Methods Race results were analyzed for swimmers at national ranked in the Swiss high score list (during 2006 through 2010) and for international swimmers who qualified for the finals of the FINA World Swimming Championships (during 2003 through 2011). Results The sex-related difference in swimming speed was significantly greater for freestyle than for breaststroke over 50 m, 100 m, and 200 m race distances for Swiss swimmers, but not for FINA finalists. The sex-related difference for both freestyle and breaststroke swimming speeds decreased significantly with increasing swimming distance for both groups. Race distance did not affect the age of peak performance by women in breaststroke, but age of peak performance was four years older for FINA women than for Swiss women. Men achieved peak swimming performance in breaststroke at younger ages for longer race distances, and the age of peak swimming performance was six years older for FINA men than for Swiss men. In freestyle swimming, race distance did not affect the age of peak swimming performance for Swiss women, but the age of peak swimming performance decreased with increasing race distance for Swiss men and for both sexes at the FINA World Championships. Conclusions Results of the present study indicate that (i) sex-related differences in swimming speed were greater for freestyle than for breaststroke for swimmers at national level, but not for swimmers at international level, and (ii) both female and male swimmers achieved peak swimming speeds at younger ages in breaststroke than in freestyle. Further studies are required to better understand differences

Insurance status, comorbidity level, and survival among colorectal cancer patients age 18 to 64 years in the National Cancer Data Base from 2003 to 2005.

PubMed

Robbins, Anthony S; Pavluck, Alexandre L; Fedewa, Stacey A; Chen, Amy Y; Ward, Elizabeth M

2009-08-01

Previous analyses have found that insurance status is a strong predictor of survival among patients with colorectal cancer aged 18 to 64 years. We investigated whether differences in comorbidity level may account in part for the association between insurance status and survival. We used 2003 to 2005 data from the National Cancer Data Base, a national hospital-based cancer registry, to examine the relationship between baseline characteristics and overall survival at 1 year among 64,304 white and black patients with colorectal cancer. In race-specific analyses, we used Cox proportional hazards models to assess 1-year survival by insurance status, controlling first for age, stage, facility type, and neighborhood education level and income, and then further controlling for comorbidity level. RESULTS; Comorbidity level was lowest among those with private insurance, higher for those who were uninsured or insured by Medicaid, and highest for those insured by Medicare. Survival at 1 year was significantly poorer for patients without private insurance, even after adjusting for important covariates. In these multivariate models, risk of death at 1 year was approximately 50% to 90% higher for white and black patients without private insurance. Further adjustment for number of comorbidities had only a modest impact on the association between insurance status and survival. In multivariate analyses, patients with > or = three comorbid conditions had approximately 40% to 50% higher risk of death at 1 year. CONCLUSION Among white and black patients aged 18 to 64 years, differences in comorbidity level do not account for the association between insurance status and survival in patients with colorectal cancer.

Relationships Between Meibomian Gland Loss and Age, Sex, and Dry Eye.

PubMed

Pult, Heiko

2018-02-12

This study evaluated relationships between meibomian gland loss (MGL) and age, sex, and dry eye. Dry eye and MGL of the lower eyelid was evaluated from 112 randomly selected subjects (66 women; mean age 62.8; SD ±15.7; and age range: 19-89 years) from Horst Riede GmbH, Weinheim, Germany. In addition, subjects were grouped into dry eye and non-dry eye by the Ocular Surface Disease Index (OSDI) score, lid-parallel conjunctival folds and non-invasive break-up time. Symptoms were evaluated by the OSDI. Meibography of the lower eyelid was performed using a Cobra camera (bon Optic, Lübeck, Germany), and images were analyzed by its digital grading tool. Data were analyzed by backward, multiple regression analyses and Pearson correlation. Analyzing all subjects, multiple regression analyses detected that age and dry eye status (dry eye diagnosis or OSDI) but not sex were significantly related to MGL. In both, non-dry eye (n=66) and dry eye subjects (n=46), dry eye status (OSDI) but not age or sex was significantly related to MGL. Ocular Surface Disease Index scores were significantly correlated with MGL, but this correlation was stronger among all subjects (Pearson correlation; r=0.536, P<0.001) and dry eye group subjects (r=0.520, P<0.001) than in non-dry eye group subjects (r=0.275, P=0.014). Dry eye group subjects showed significantly increased MGL of the lower eyelid. Age and dry eye status were related to MGL of the lower eyelid, but sex was not; dry eye status was the dominant factor.

Comorbidity Assessment Using Charlson Comorbidity Index and Simplified Comorbidity Score and Its Association With Clinical Outcomes During First-Line Chemotherapy for Lung Cancer.

PubMed

Singh, Navneet; Singh, Potsangbam Sarat; Aggarwal, Ashutosh N; Behera, Digambar

2016-05-01

Limited data is available on comorbidity assessment in patients with lung cancer. The present prospective study assessed the prevalence and association of the Charlson comorbidity index (CCI) and simplified comorbidity score (SCS) with clinical outcomes in patients with newly diagnosed lung cancer undergoing chemotherapy. All patients received histology-guided platinum doublets. The outcomes assessed were overall survival (OS), radiologic responses using Response Evaluation Criteria in Solid Tumors and toxicity using the Common Toxicity Criteria, version 3.0. The groups analyzed were SCS ≤ 9 (n = 173) and > 9 (n = 65) and CCI = 0 (n = 88), 1 (n = 97), and ≥ 2 (n = 53). Correlations of the CCI and SCS were assessed using Spearman's (rho) method. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated for the factors affecting OS using Cox proportional hazard (CPH) modeling. Most patients had advanced disease (stage IIIB in 33.6%, stage IV in 42.4%). The median SCS was 7 (interquartile range, 7-11), and the median CCI was 1 (interquartile range, 0-1). The correlation between the CCI and SCS was moderate (rho = 0.474; P < .001). Age correlated weakly with both SCS (rho = 0.293; P < .001) and CCI (rho = 0.205; P < .001). The SCS > 9 group (vs. SCS ≤ 9) had a significantly older mean age, patients aged ≥ 70 years, men, smokers, and squamous cell histologic type. The mean age in the CCI groups was 55.2 years for a CCI of 0, 59.6 years for a CCI of 1, and 60.3 years for a CCI of 2, with a statistically significant difference (P = .002). The radiologic responses and toxicity profiles were similar between the SCS and CCI groups. The median OS was 287 days (95% CI, 232-342 days) and did not differ between the SCS and CCI groups. On multivariate CPH analyses, worse OS was independently associated with stage IV disease (adjusted HR, 2.0; 95% CI, 1.4-2.7) and poor performance status (Eastern Cooperative Oncology Group score ≥ 2

Sex modifies the relationship between age and gait: a population-based study of older adults.

PubMed

Callisaya, Michele L; Blizzard, Leigh; Schmidt, Michael D; McGinley, Jennifer L; Srikanth, Velandai K

2008-02-01

Adequate mobility is essential to maintain an independent and active lifestyle. The aim of this cross-sectional study is to examine the associations of age with temporal and spatial gait variables in a population-based sample of older people, and whether these associations are modified by sex. Men and women aged 60-86 years were randomly selected from the Southern Tasmanian electoral roll (n = 223). Gait speed, step length, cadence, step width, and double-support phase were recorded with a GAITRite walkway. Regression analysis was used to model the relationship between age, sex, and gait variables. For men, after adjusting for height and weight, age was linearly associated with all gait variables (p <.05) except cadence (p =.11). For women, all variables demonstrated a curvilinear association, with age-related change in these variables commencing during the 7th decade. Significant interactions were found between age and sex for speed (p =.04), cadence (p =.01), and double-support phase (p =.03). Associations were observed between age and a broad range of temporal and spatial gait variables in this study. These associations differed by sex, suggesting that the aging process may affect gait in men and women differently. These results provide a basis for further research into sex differences and mechanisms underlying gait changes with advancing age.

Identifying sex and age of akiapolaau

USGS Publications Warehouse

Pratt, T.K.; Fancy, S.G.; Harada, C.K.; Lindsey, G.D.; Jacobi, J.D.

1994-01-01

Methods for identifying the sex and age of the Akiapolaau (Hemignathus munroi), an endangered honeycreeper found only on the island of Hawaii, were developed by examination and measurement of 73 museum specimens and 24 live birds captured in mist nests. Akiapolaau probably undergo a single annual molt, with most birds molting between February and July. The mottled juvenal plumage is replaced by a first basic plumage characterized by yellowish-gray or yellowish-green underparts and often by retained wingbars. Male Akiapolaau may not attain adult plumage until their third molt. In adult females, only the throat and upper breast become yellow, whereas in adult males the superciliaries, cheeks, and entire underparts are yellow. Adult males have greater exposed culmen, gonys, wing chord, tail, and tarsus lengths than do females. Akiapolaau in first prebasic molt or older can be identified as to sex by culmen length, that of males being >23.4 mm.

Effect of comorbidity on relative survival following hospitalisation for fall-related hip fracture in older people.

PubMed

Hindmarsh, Diane; Loh, Ming; Finch, Caroline F; Hayen, Andrew; Close, Jacqueline C T

2014-09-01

To assess the effect of comorbidity on relative survival after hip fracture. Relative survival analysis was undertaken in 16 838 fall-related hip fracture hospitalisations in New South Wales, Australia. Comorbidity was measured on the basis of additional diagnosis codes on the same hospital separation as the hip fracture using the Charlson Comorbidity Index (CCI). Interval-specific relative survival and relative excess risk of death were calculated. Comorbidity was more frequently documented in men than women across the age groups. Survival decreased with increasing age and increasing comorbidity, but the relative impact of comorbidity was greater in the younger-old age group (65-74 years). The excess mortality in men was not accounted for by age or comorbidities. This study demonstrates an association between increasing comorbidity and death particularly in the first 3 months post hip fracture. It also highlights a relative excess risk of death in men after hip fracture after adjusting for age and comorbidity. © 2012 The Authors. Australasian Journal on Ageing © 2012 ACOTA.

A cross-sectional analysis of age and sex patterns in grip strength, tooth loss, near vision and hearing levels in Chinese aged 50-74 years.

PubMed

Wu, Yili; Pang, Zengchang; Zhang, Dongfeng; Jiang, Wenjie; Wang, Shaojie; Li, Shuxia; Kruse, Torben A; Christensen, Kaare; Tan, Qihua

2012-01-01

By focusing on four health variables, handgrip strength, near visual acuity, tooth loss and hearing level, this study examined the different patterns of age-related changes in these variables in Chinese aged from 50 to 74 years, as well as explored the relationship among the variables in a cross-sectional sample of 2006 individuals. The data exhibited high quality with a low missing rate of under 5% in any age groups for each variable. Effects of age and sex on the changes in the four health variables were assessed using multiple regression models with age and sex interactions included. Upon the highly significant effects of age on all four measurements, we observed substantially higher grip strength for men who, however, exhibited a faster age-related decline than for women. No sex difference or age-sex interaction was found in the number of teeth lost. Near visual acuity displayed a faster age-related decline in women than in men but neither the overall sex difference nor age-sex interaction reached statistical significance. For hearing function, while no sex difference was found at middle frequency, women had better sensitivity at high frequency and men were more sensitive at low frequency. Multivariate analysis did not support an age-related common mechanism underlying the four health variables. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Predicting excess cost for older inpatients with clinical complexity: A retrospective cohort study examining cognition, comorbidities and complications.

PubMed

Bail, Kasia; Draper, Brian; Berry, Helen; Karmel, Rosemary; Goss, John

2018-01-01

Hospital-acquired complications increase length of stay and contribute to poorer patient outcomes. Older adults are known to be at risk for four key hospital-acquired complications (pressure injuries, pneumonia, urinary tract infections and delirium). These complications have been identified as sensitive to nursing characteristics such as staffing levels and level of education. The cost of these complications compared to the cost of admission severity, dementia, other comorbidities or age has not been established. To investigate costs associated with nurse-sensitive hospital-acquired complications in an older patient population 157,178 overnight public hospital episodes for all patients over age 50 from one Australian state, 2006/07 were examined. A retrospective cohort study design with linear regression analysis provided modelling of length-of-stay costs. Explanatory variables included patient age, sex, comorbidities, admission severity, dementia status, surgical status and four complications. Extra costs were based on above-average length-of-stay for each patient's Diagnosis Related Group from hospital discharge data. For adults over 50 who have length of stay longer than average for their diagnostic condition, comorbid dementia predicts an extra cost of A$874, (US$1,247); any one of four key complications predicts A$812 (US$1,159); each increase in admission severity score predicts A$295 ($US421); each additional comorbidity predicts A$259 (US$370), and for each year of age above 50 predicts A$20 (US$29) (all estimates significant at p<0.0001). Hospital-acquired complications and dementia cost more than other kinds of inpatient complexity, but admission severity is a better predictor of excess cost. Because complications are potentially preventable and dementia care in hospitals can be improved, risk-reduction strategies for common complications, particularly for patients with dementia could be cost effective. Complications and dementia were found to cost more

Differences between physicians in the likelihood of referral and acceptance of elderly patients for dialysis-influence of age and comorbidity.

PubMed

Visser, Annemieke; Dijkstra, Geke J; Huisman, Roel M; Gansevoort, Ron T; de Jong, Paul E; Reijneveld, Sijmen A

2007-11-01

Incidence of dialysis in elderly patients in the Netherlands is low compared to other countries. This study aims to assess the impact of patients' age and comorbidity on the likelihood of referral and acceptance of patients for dialysis and whether this is affected by physician characteristics. A vignette study was performed among 209 primary care physicians, 162 non-nephrology specialists and 20 nephrologists working in the north of the Netherlands. Physicians were offered six vignettes concerning case-reports of patients with end-stage renal disease (ESRD) and varying comorbidities or circumstances and asked about the likelihood of referral/acceptance of the patient in the given circumstances. The likelihood of referral within groups of physicians varied widely, especially within the group of primary care physicians and non-nephrology specialists, but was not affected by characteristics of physicians. The likelihood of referral or acceptance of patients for dialysis depended on the patient's age, and type and severity of comorbidity. In general, primary care physicians and non-nephrology specialists were less likely to refer than nephrologists were to accept. Differences within and between groups of physicians were larger for 80- than for 65-year-old patients, and for patients with less severe shortness of breath and cognitive impairments and more severe diabetes and social impairments. Hardly any differences were found for patients with cancer. Patients' age and comorbidities affect the likelihood of referral. Differences between groups of physicians suggest that there is insufficient agreement on the extent to which these factors should affect the referral/acceptance of patients for dialysis. These findings underline the need for more research into circumstances under which patients might benefit from dialysis. Guidelines should be developed to improve the referral of elderly and less healthy patients.

The measured effect magnitude of co-morbidities on burn injury mortality.

PubMed

Knowlin, Laquanda; Stanford, Lindsay; Moore, Danier; Cairns, Bruce; Charles, Anthony

2016-11-01

The ability to better prognosticate burn injury outcome is challenging and historically, most center use the Baux or revised Baux score to help prognosticate burn outcome, however, the weighted contribution of comorbidity on burn mortality has traditionally not been accounted for nor adequately studied. We therefore sought to determine the effect of comorbidities, using the Charlson comorbidity index (CCI) on burn mortality. The purpose of this study was to determine the effect of comorbidities on burn injury mortality as determined by the LA50 (lethal TBSA burn at which 50% of the cohort will succumb from the burn injury) in a retrospective analysis of patients admitted to a regional burn center from 2002 to 2012. Independent variables analyzed included basic demographics, burn mechanism, presence of inhalation injury, TBSA (total body surface area), length of hospital stay, and pre-existing comorbidities. Bivariate analysis was performed and logistic regression modeling using significant variables was utilized to estimate odds of death. 7640 patients were included in this study. Overall survival rate was 96%. 40% of our burn cohort had at least one comorbidity. There was a linear increase in the likelihood of death with an increase in CCI. The logistic regression model for mortality outcomes identified four statistically significant variables: age, TBSA, inhalational injury and the presence of comorbidities (OR=1.59 for each 1 point increase in CCI; 95% CI 1.44-1.77). The unadjusted LA50 was 53% for the entire cohort. Partial adjustment multivariate regression controlling for burn mechanism and inhalation injury only, produced a slight reduction in LA50 for the 0-18 and 19-64 age categories to 76% and 48% TBSA, respectively, but a significant decrease occurred in the ≥65 years age group with a reduced LA50 to 20% TBSA (p<0.001). After full adjustment for all significant covariates, including comorbidities, the independent magnitude of effect of comorbidities on

The Measured Effect Magnitude of Co-Morbidities on Burn injury Mortality

PubMed Central

Knowlin, Laquanda; Stanford, Lindsay; Moore, Danier; Cairns, Bruce; Charles, Anthony

2016-01-01

Introduction The ability to better prognosticate burn injury outcome is challenging and historically, most center use the Baux or revised Baux score to help prognosticate burn outcome, however, the weighted contribution of comorbidity on burn mortality has traditionally not been accounted for nor adequately studied. We therefore sought to determine the effect of comorbidities, using the Charlson comorbidity index (CCI) on burn mortality. Methods The purpose of this study was to determine the effect of comorbidities on burn injury mortality as determined by the LA50 (lethal TBSA burn at which 50% of the cohort will succumb from the burn injury) in a retrospective analysis of patients admitted to a regional burn center from 2002–2012. Independent variables analyzed included basic demographics, burn mechanism, presence of inhalation injury, TBSA (total body surface area), length of hospital stay, and pre-existing comorbidities. Bivariate analysis was performed and logistic regression modeling using significant variables was utilized to estimate odds of death. Results 7640 patients were included in this study. Overall survival rate was 96%. 40% of our burn cohort had at least one comorbidity. There was a linear increase in the likelihood of death with an increase in CCI. The logistic regression model for mortality outcomes identified four statistically significant variables: age, TBSA, inhalational injury and the presence of comorbidities (OR = 1.59 for each 1 point increase in CCI; 95% CI 1.44–1.77). The unadjusted LA50 was 53% for the entire cohort. Partial adjustment multivariate regression controlling for burn mechanism and inhalation injury only, produced a slight reduction in LA50 for the 0–18 and 19–64 age categories to 76% and 48%, respectively, but a significant decrease occurred in the ≥ 65 years age group with a reduced LA50 to 20% (p<0.001). After full adjustment for all significant covariates, including comorbidities, the independent magnitude of

Age and Sex Differences in Rates of Influenza-Associated Hospitalizations in Hong Kong.

PubMed

Wang, Xi-Ling; Yang, Lin; Chan, Kwok-Hung; Chan, King-Pan; Cao, Pei-Hua; Lau, Eric Ho-Yin; Peiris, J S Malik; Wong, Chit-Ming

2015-08-15

Few studies have explored age and sex differences in the disease burden of influenza, although men and women probably differ in their susceptibility to influenza infections. In this study, quasi-Poisson regression models were applied to weekly age- and sex-specific hospitalization numbers of pneumonia and influenza cases in the Hong Kong SAR, People's Republic of China, from 2004 to 2010. Age and sex differences were assessed by age- and sex-specific rates of excess hospitalization for influenza A subtypes A(H1N1), A(H3N2), and A(H1N1)pdm09 and influenza B, respectively. We found that, in children younger than 18 years, boys had a higher excess hospitalization rate than girls, with the male-to-female ratio of excess rate (MFR) ranging from 1.1 to 2.4. MFRs of hospitalization associated with different types/subtypes were less than 1.0 for adults younger than 40 years except for A(H3N2) (MFR = 1.6), while all the MFRs were equal to or higher than 1.0 in adults aged 40 years or more except for A(H1N1)pdm09 in elderly persons aged 65 years or more (MFR = 0.9). No MFR was found to be statistically significant (P < 0.05) for hospitalizations associated with influenza type/subtype. There is some limited evidence on age and sex differences in hospitalization associated with influenza in the subtropical city of Hong Kong. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Targeted Vision Function Goals and Use of Vision Resources in Ophthalmology Patients with Age-Related Macular Degeneration and Comorbid Depressive Symptoms

ERIC Educational Resources Information Center

Casten, Robin; Rovner, Barry W.; Fontenot, Joseph L.

2016-01-01

Introduction: This study characterizes self-reported functional vision goals and the use of low vision resources (for example, services and devices) in ophthalmology clinic patients with age-related macular degeneration (AMD) and comorbid depressive symptoms. Methods: From July 2009 to February 2013, we assessed 188 consecutive patients (age 65+;…

Antidepressant medication use for primary care patients with and without medical comorbidities: a national electronic health record (EHR) network study.

PubMed

Gill, James M; Klinkman, Michael S; Chen, Ying Xia

2010-01-01

Because comorbid depression can complicate medical conditions (eg, diabetes), physicians may treat depression more aggressively in patients who have these conditions. This study examined whether primary care physicians prescribe antidepressant medications more often and in higher doses for persons with medical comorbidities. This secondary data analysis of electronic health record data was conducted in the Centricity Health Care User Research Network (CHURN), a national network of ambulatory practices that use a common outpatient electronic health record. Participants included 209 family medicine and general internal medicine providers in 40 primary care CHURN offices in 17 US states. Patients included adults with a new episode of depression that had been diagnosed during the period October 2006 through July 2007 (n = 1513). Prescription of antidepressant medication and doses of antidepressant medication were compared for patients with and without 6 comorbid conditions: diabetes, coronary heart disease, congestive heart failure, cerebrovascular disease, chronic obstructive pulmonary disease, and cancer. 20.7% of patients had at least one medical comorbidity whereas 5.8% had multiple comorbidities. Overall, 77% of depressed patients were prescribed antidepressant medication. After controlling for age and sex, patients with multiple comorbidities were less likely to be prescribed medication (adjusted odds ratio, 0.58; 95% CI, 0.35-0.96), but there was no significant difference by individual comorbidities. Patients with cerebrovascular disease were less likely to be prescribed a full dose of medication (adjusted odds ratio, 0.26; 95% CI, 0.08-0.88), but there were no differences for other comorbidities or for multiple comorbidities, and there was no difference for any comorbidities in the prescription of minimally effective doses. Patients with new episodes of depression who present to a primary care practice are not treated more aggressively if they have medical

Sex hormones in Malay and Chinese men in Malaysia: are there age and race differences?

PubMed Central

Chin, Kok-Yong; Soelaiman, Ima-Nirwana; Mohamed, Isa Naina; Ahmad, Fairus; Ramli, Elvy Suhana Mohd; Aminuddin, Amilia; Ngah, Wan Zurinah Wan

2013-01-01

OBJECTIVES: Variations in the prevalence of sex-hormone-related diseases have been observed between Asian ethnic groups living in the same country; however, available data concerning their sex hormone levels are limited. The present study aimed to determine the influence of ethnicity and age on the sex hormone levels of Malay and Chinese men in Malaysia. METHODS: A total of 547 males of Malay and Chinese ethnicity residing in the Klang Valley Malaysia underwent a detailed screening, and their blood was collected for sex hormones analyses. RESULTS: Testosterone levels were normally distributed in the men (total, free and non-sex hormone-binding globulin (SHBG) bound fractions), and significant ethnic differences were observed (p<0.05); however, the effect size was small. In general, testosterone levels in males began to decline significantly after age 50. Significant ethnic differences in total, free and non-SHBG bound fraction estradiol levels were observed in the 20-29 and 50-59 age groups (p<0.05). The estradiol levels of Malay men decreased as they aged, but they increased for Chinese men starting at age 40. CONCLUSIONS: Small but significant differences in testosterone levels existed between Malay and Chinese males. Significant age and race differences existed in estradiol levels. These differences might contribute to the ethnic group differences in diseases related to sex hormones, which other studies have found in Malaysia. PMID:23525310

Sex hormones in Malay and Chinese men in Malaysia: are there age and race differences?

PubMed

Chin, Kok-Yong; Soelaiman, Ima-Nirwana; Mohamed, Isa Naina; Ahmad, Fairus; Ramli, Elvy Suhana Mohd; Aminuddin, Amilia; Ngah, Wan Zurinah Wan

2013-01-01

Variations in the prevalence of sex-hormone-related diseases have been observed between Asian ethnic groups living in the same country; however, available data concerning their sex hormone levels are limited. The present study aimed to determine the influence of ethnicity and age on the sex hormone levels of Malay and Chinese men in Malaysia. A total of 547 males of Malay and Chinese ethnicity residing in the Klang Valley Malaysia underwent a detailed screening, and their blood was collected for sex hormones analyses. Testosterone levels were normally distributed in the men (total, free and non-sex hormone-binding globulin (SHBG) bound fractions), and significant ethnic differences were observed (p<0.05); however, the effect size was small. In general, testosterone levels in males began to decline significantly after age 50. Significant ethnic differences in total, free and non-SHBG bound fraction estradiol levels were observed in the 20-29 and 50-59 age groups (p<0.05). The estradiol levels of Malay men decreased as they aged, but they increased for Chinese men starting at age 40. Small but significant differences in testosterone levels existed between Malay and Chinese males. Significant age and race differences existed in estradiol levels. These differences might contribute to the ethnic group differences in diseases related to sex hormones, which other studies have found in Malaysia.

Leading causes of injury hospitalisation in children aged 0-4 years in New South Wales by injury submechanism: a brief profile by age and sex.

PubMed

Schmertmann, Marcia; Williamson, Ann; Black, Deborah

2012-11-01

To identify the leading causes of injury in children aged 0-4 years by single year of age using injury submechanisms and present a brief epidemiologic profile of each cause. Hospitalisation data for New South Wales from 1999 to 2009 were used to identify the leading causes of injury for children aged 0-4 years by single year of age. For each leading cause, rates over time and by sex were calculated by single year of age. Associated age and sex risk ratios were estimated. The leading causes of injury for children aged <1, 1 and 2 years were falls while being carried, burns by hot non-aqueous substances and poisoning by other and unspecified pharmaceutical substances, respectively. Falls involving playground equipment ranked first for children aged 3-4 years. Each leading injury cause exhibited an age pattern that remained stable over time and by sex. Age predicted falls while being carried and both age and sex predicted the remaining leading injury causes, with age and sex interacting to predict burns by hot non-aqueous substances. Epidemiologic analysis using single-year age intervals and injury submechanisms results in a clearer picture of injury risk for young children. The findings of this study provide detailed information regarding the leading causes of hospitalised injury in young children by age and sex. Child health-care providers can use this information to focus discussions of child development and injury risk with families of young children and suggest appropriate prevention measures in terms of a child's age and sex. © 2012 The Authors. Journal of Paediatrics and Child Health © 2012 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Exploring Alcohol-Use Behaviors Among Heterosexual and Sexual Minority Adolescents: Intersections With Sex, Age, and Race/Ethnicity

PubMed Central

Hughes, Tonda L.; Aranda, Frances; Birkett, Michelle; Marshal, Michael P.

2014-01-01

Objectives. We examined sexual orientation status differences in alcohol use among youths aged 13 to 18 years or older, and whether differences were moderated by sex, age, or race/ethnicity. Methods. We pooled data from the 2005 and 2007 Youth Risk Behavior Surveys and conducted weighted analyses, adjusting for complex design effects. We operationalized sexual orientation status with items assessing sexual orientation identity, sexual behavior, sexual attraction, or combinations of these. Results. Compared with exclusively heterosexual youths, sexual-minority youths were more likely to report each of the primary study outcomes (i.e., lifetime and past-month alcohol use, past-month heavy episodic drinking, earlier onset of drinking, and more frequent past-month drinking). Alcohol-use disparities were larger and more robust for (1) bisexual youths than lesbian or gay youths, (2) girls than boys, and (3) younger than older youths. Few differences in outcomes were moderated by race/ethnicity. Conclusions. Bisexual youths, sexual-minority girls, and younger sexual-minority youths showed the largest alcohol-use disparities. Research is needed that focuses on identifying explanatory or mediating mechanisms, psychiatric or mental health comorbidities, and long-term consequences of early onset alcohol use, particularly frequent or heavy use, among sexual-minority youths. PMID:24328614

Woodcock age and sex determination from wings

USGS Publications Warehouse

Martin, F.W.

1964-01-01

Age of woodcock (Philohela minor) can be accurately determined throughout the year by differences in pattern, color, and wear of secondary feathers. Immature woodcock retain most secondaries during the postjuvenal molt that begins in July or August and ends in October. In contrast, subadults (first-year adults) and older woodcock molt all secondaries during the postnuptial molt beginning in June or July and ending in October. Retention of juvenal secondaries by immatures and molt of these feathers by adults form the basis for age determination. Sex of woodcock can be accurately determined by width of the outer three primaries, which are conspicuously narrower on males.

Prevalence of overweight and obesity and their cardiometabolic comorbidities in Hispanic adults living in Puerto Rico.

PubMed

Pérez, Cynthia M; Sánchez, Hesmy; Ortiz, Ana P

2013-12-01

This study characterized the prevalence of overweight and obesity and assessed their cardiometabolic comorbidities in the population aged 21-79 years living in the San Juan metropolitan area of Puerto Rico. We analyzed data from a household survey conducted in Puerto Rico between 2005 and 2007 that used a representative sample of 840 non-institutionalized adults living in the San Juan metropolitan area. Body mass index categories were classified as normal weight, overweight and obese. Poisson regression model with robust variance was used to estimate the prevalence ratio to assess the association of each cardiometabolic comorbidity (hypertension, dyslipidemia, diabetes, prediabetes, systemic inflammation, prothrombotic state, and coronary heart disease) with overweight and obesity. Age-standardized prevalence of overweight and obesity was 35.9 and 41.5%, respectively, figures higher than the combined prevalence for the U.S. adult population (68.8%) but similar to all mainland Hispanics (78.8%). Men were more likely to be overweight than women (40.4 vs. 33.4%), whereas more women than men were obese (43.7 vs. 37.6%). Prevalence of all cardiometabolic comorbidities was significantly (p < 0.05) higher among overweight and obese adults than those of normal weight after adjusting for age, sex, years of education, smoking status, alcohol consumption and physical activity. A considerable proportion of adults in this population are overweight or obese. In view of the wide-ranging effects that overweight and obesity have on health, preventive actions to avert the rise of excess body weight as well as the design of lifestyle interventions are largely needed in this population.

Maths performance as a function of sex, laterality, and age of pubertal onset.

PubMed

Sappington, John; Topolski, Richard

2005-07-01

Sex differences in math/spatial performance demand explanations. Within the biological view, the complexity and number of variables make the explanation difficult at best. Laterality and age of pubertal onset have been investigated prominently in this context but rarely considered as interactions in the same study. Some 468 college subjects with SAT MATH (SAT M) scores were divided into 12 groups defined by sex, laterality, and age (early, middle, and late) of pubertal onset. Significant main effects for sex and age of onset emerged, as did an interaction between lateral preference and pubertal onset. Generally males outperformed females. The combination of maleness, sinistrality, and early maturation was associated with high SAT M scores. Sinistrality and late maturation among females predicted very poor math performance.

Association between maternal comorbidity and preterm birth by severity and clinical subtype: retrospective cohort study

PubMed Central

2011-01-01

Background Preterm birth (PTB) is a major cause of infant morbidity and mortality, but the relationship between comorbidity and PTB by clinical subtype and severity of gestational age remains poorly understood. We evaluated associations between maternal comorbidities and PTB by clinical subtype and gestational age. Methods We conducted a retrospective cohort study of 1,329,737 singleton births delivered in hospitals in the province of Québec, Canada, 1989-2006. PTB was classified by clinical subtype (medically indicated, preterm premature rupture of membranes (PPROM), spontaneous preterm labour) and gestational age (< 28, 28-31, 32-36 completed weeks). Odds ratios (OR) of PTB by clinical subtype for systemic and localized maternal comorbidities were estimated using polytomous logistic regression, adjusting for maternal age, grand multiparity, and period. Attributable fractions were calculated. Results PTB rates were higher among mothers with comorbidity (10.9%) compared to those without comorbidity (4.7%). Several comorbidities were associated with greater odds of medically indicated PTB compared with no comorbidity, but only comorbidities localized to the reproductive system were associated with spontaneous PTB. Drug dependence and mental disorders were strongly associated with PPROM and spontaneous PTBs across all gestational ages (OR > 2.0). At the population level, several major comorbidities (placental abruption, chorioamnionitis, oliogohydramnios, structural abnormality, cervical incompetence) were key contributors to all clinical subtypes of PTB, especially at < 32 weeks. Major systemic comorbidities (preeclampsia, anemia) were key contributors to PPROM and medically indicated PTBs. Conclusions The relationship between comorbidity and clinical subtypes of PTB depends on gestational age. Prevention of PPROM and spontaneous PTB may benefit from greater attention to preeclampsia, anemia and comorbidities localized to the reproductive system. PMID:21970736

Association between maternal comorbidity and preterm birth by severity and clinical subtype: retrospective cohort study.

PubMed

Auger, Nathalie; Le, Thi Uyen Nhi; Park, Alison L; Luo, Zhong-Cheng

2011-10-04

Preterm birth (PTB) is a major cause of infant morbidity and mortality, but the relationship between comorbidity and PTB by clinical subtype and severity of gestational age remains poorly understood. We evaluated associations between maternal comorbidities and PTB by clinical subtype and gestational age. We conducted a retrospective cohort study of 1,329,737 singleton births delivered in hospitals in the province of Québec, Canada, 1989-2006. PTB was classified by clinical subtype (medically indicated, preterm premature rupture of membranes (PPROM), spontaneous preterm labour) and gestational age (< 28, 28-31, 32-36 completed weeks). Odds ratios (OR) of PTB by clinical subtype for systemic and localized maternal comorbidities were estimated using polytomous logistic regression, adjusting for maternal age, grand multiparity, and period. Attributable fractions were calculated. PTB rates were higher among mothers with comorbidity (10.9%) compared to those without comorbidity (4.7%). Several comorbidities were associated with greater odds of medically indicated PTB compared with no comorbidity, but only comorbidities localized to the reproductive system were associated with spontaneous PTB. Drug dependence and mental disorders were strongly associated with PPROM and spontaneous PTBs across all gestational ages (OR > 2.0). At the population level, several major comorbidities (placental abruption, chorioamnionitis, oliogohydramnios, structural abnormality, cervical incompetence) were key contributors to all clinical subtypes of PTB, especially at < 32 weeks. Major systemic comorbidities (preeclampsia, anemia) were key contributors to PPROM and medically indicated PTBs. The relationship between comorbidity and clinical subtypes of PTB depends on gestational age. Prevention of PPROM and spontaneous PTB may benefit from greater attention to preeclampsia, anemia and comorbidities localized to the reproductive system.

Refractive errors in a Brazilian population: age and sex distribution.

PubMed

Ferraz, Fabio H; Corrente, José E; Opromolla, Paula; Padovani, Carlos Roberto; Schellini, Silvana A

2015-01-01

To determine the prevalence of refractive errors and their distribution according to age and sex in a Brazilian population. This population-based cross-sectional study involved 7654 Brazilian inhabitants of nine municipalities of Sao Paulo State, Brazil, between March 2004 and July 2005. Participants aged >1 year were selected using a random, stratified, household cluster sampling technique, excluding individuals with previous refractive or cataract surgery. Myopia was defined as spherical equivalent (SE) ≤-0.5D, high myopia as SE ≤-3.0D, hyperopia as SE ≥+0.5D, high hyperopia as SE ≥+3D, astigmatism as ≤-0.5DC and anisometropia as ≥1.0D difference between eyes. Age, sex, complaints and a comprehensive eye examination including cycloplegic refraction test were collected and analysed using descriptive analysis, univariate and multivariate methods. The prevalence of astigmatism was 59.7%, hyperopia 33.8% and myopia was 25.3%. Astigmatism had a progressive increase with age. With-the-rule (WTR) axes of astigmatism were more frequently observed in the young participants and the against-the-rule (ATR) axes were more frequent in the older subjects. The onset of myopia occurred more frequently between the 2nd and 3rd decades of life. Anisometropia showed a prevalence of 13.2% (95% CI 12.4-13.9; p < 0.001). There was an association between age and all types of refractive error and hyperopia was also associated with sex. Hyperopia was associated with WTR axes (odds ratio 0.73; 95% CI: 0.6-0.8; p < 0.001) and myopia with ATR axes (odds ratio 0.66; 95% CI: 0.6-0.8; p < 0.001). Astigmatism was the most prevalent refractive error in a Brazilian population. There was a strong relationship between age and all refractive errors and between hyperopia and sex. WTR astigmatism was more frequently associated with hyperopia and ATR astigmatism with myopia. The vast majority of participants had low-grade refractive error, which favours planning aimed at correction of

The Most Common Comorbidities in Dandy-Walker Syndrome Patients: A Systematic Review of Case Reports.

PubMed

Stambolliu, Emelina; Ioakeim-Ioannidou, Myrsini; Kontokostas, Kimonas; Dakoutrou, Maria; Kousoulis, Antonis A

2017-09-01

Dandy-Walker syndrome (DWS) is a rare neurologic multi-entity malformation. This review aimed at reporting its main nonneurologic comorbidities. Following PRISMA guidelines, search in Medline was conducted (2000-2014, keyword: dandy-walker). Age, sex, country, DWS type, consanguinity or siblings with DWS, and recorded coexistent conditions (by ICD10 category) were extracted for 187 patients (46.5% male, 43% from Asia) from 168 case reports. Diagnosis was most often set in <1 year old (40.6%) or >12 years old (27.8%). One-third of cases had a chromosomal abnormality or syndrome (n = 8 PHACE), 27% had a cardiovascular condition (n = 7 Patent Ductus Arteriosus), 24% had a disease of eye and ear (n = 9 cataract); most common malignancy was nephroblastoma (n = 8, all Asian). Almost one-fifth had a mental illness diagnosis; only 6.4% had mild or severe intellectual disability. The spread of comorbidities calls for early diagnosis and multidisciplinary research and practice, especially as many cases remain clinically asymptomatic for years.

Age, Sex, and Cultural Differences in the Meaning of Achievement.

ERIC Educational Resources Information Center

Salili, Farideh

This study explored variations in the meaning and psychological dimensions of achievement among people of different ages, sexes, and cultures. Subjects were 504 male and female British and Chinese students aged 13-55 in Hong Kong. Repertory grid technique was used to elicit success situations and related constructs. A group grid was then…

Co-occurrence of antisocial behavior and substance use: testing for sex differences in the impact of older male friends, low parental knowledge and friends' delinquency.

PubMed

McAdams, Tom A; Salekin, Randall T; Marti, C Nathan; Lester, Whiney S; Barker, Edward D

2014-04-01

Delinquency and substance use (SU) are commonly comorbid during adolescence. In the present study we investigate this co-morbidity with 3 main objectives: 1. Evaluate reciprocal relationships between delinquency/SU across early adolescence. 2. Assess the impact of older male friends, low parental knowledge and friends' delinquency on subsequent development and inter-relationships of delinquency and SU. 3. Evaluate sex differences in these relationships. We applied cross-lagged structural equation models to the analysis of a longitudinal sample (n=3699). Findings demonstrated: (1) At ages 13-14 delinquency predicted SU more so than vice versa but effects became equal between ages 14 and 15. (2) Low parental knowledge and friends' delinquency predicted delinquency and SU. Older male friends predicted ASB. (3) Sex differences were present. For example, in the absence of antisocial friends low parent knowledge at age 12 indirectly predicted increased age 15 SU for girls more than boys. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Developmental Course(s) of Lifetime Cigarette Use and Panic Attack Comorbidity

ERIC Educational Resources Information Center

Bernstein, Amit; Zvolensky, Michael J.; Schmidt, Norman B.; Sachs-Ericcson, Natalie

2007-01-01

The present investigation examined the developmental course(s) of lifetime cigarette use and panic attack comorbidity. Participants included 4,409 adults, ages 15 to 54 years of age (M[Age] = 33.1, SD = 10.7, N (females) = 2,221) from the National Comorbidity Survey (NCS). The primary objective of the present investigation was to better understand…

The interaction of glottal-pulse rate and vocal-tract length in judgements of speaker size, sex, and age

NASA Astrophysics Data System (ADS)

Smith, David R. R.; Patterson, Roy D.

2005-11-01

Glottal-pulse rate (GPR) and vocal-tract length (VTL) are related to the size, sex, and age of the speaker but it is not clear how the two factors combine to influence our perception of speaker size, sex, and age. This paper describes experiments designed to measure the effect of the interaction of GPR and VTL upon judgements of speaker size, sex, and age. Vowels were scaled to represent people with a wide range of GPRs and VTLs, including many well beyond the normal range of the population, and listeners were asked to judge the size and sex/age of the speaker. The judgements of speaker size show that VTL has a strong influence upon perceived speaker size. The results for the sex and age categorization (man, woman, boy, or girl) show that, for vowels with GPR and VTL values in the normal range, judgements of speaker sex and age are influenced about equally by GPR and VTL. For vowels with abnormal combinations of low GPRs and short VTLs, the VTL information appears to decide the sex/age judgement.

Conduct Disorder and Comorbidity.

ERIC Educational Resources Information Center

Stahl, Nicole D.; Clarizio, Harvey F.

1999-01-01

Provides critical examination of research published during past ten years addressing Conduct Disorder (CD), Attention Deficit Hyperactivity Disorder, Oppositional Defiant Disorder (ODD), and internalizing disorders. Concludes comorbidity varies with age, gender, informant, diagnostic criteria, and nature of the sample. Implications of comorbidity…

Neurobehavioral Deficits Consistent Across Age and Sex in Youth with Prenatal Alcohol Exposure

PubMed Central

Panczakiewicz, Amy L.; Glass, Leila; Coles, Claire D.; Kable, Julie A.; Sowell, Elizabeth R.; Wozniak, Jeffrey R.; Jones, Kenneth Lyons; Riley, Edward P.; Mattson, Sarah N.

2016-01-01

Background Neurobehavioral consequences of heavy prenatal alcohol exposure are well documented, however the role of age or sex in these effects has not been studied. The current study examined the effects of prenatal alcohol exposure, sex, and age on neurobehavioral functioning in children. Methods Subjects were 407 youth with prenatal alcohol exposure (n=192) and controls (n=215). Two age groups [child (5–7y) or adolescent (10–16y)] and both sexes were included. All subjects completed standardized neuropsychological testing and caregivers completed parent-report measures of psychopathology and adaptive behavior. Neuropsychological functioning, psychopathology, and adaptive behavior were analyzed with separate 2 (exposure history) × 2 (sex) × 2 (age) MANOVAs. Significant effects were followed by univariate analyses. Results No three-way or two-way interactions were significant. The main effect of group was significant in all three MANOVAs, with the control group performing better than the alcohol-exposed group on all measures. The main effect of age was significant for neuropsychological performance and adaptive functioning across exposure groups with younger children performing better than older children on three measures (language, communication, socialization). Older children performed better than younger children on a different language measure. The main effect of sex was significant for neuropsychological performance and psychopathology; across exposure groups, males had stronger language and visual-spatial scores and fewer somatic complaints than females. Conclusion Prenatal alcohol exposure resulted in impaired neuropsychological and behavioral functioning. Although adolescents with prenatal alcohol exposure may perform more poorly than younger exposed children, the same was true for non-exposed children. Thus, these cross-sectional data indicate that the developmental trajectory for neuropsychological and behavioral performance is not altered by

Neurobehavioral Deficits Consistent Across Age and Sex in Youth with Prenatal Alcohol Exposure.

PubMed

Panczakiewicz, Amy L; Glass, Leila; Coles, Claire D; Kable, Julie A; Sowell, Elizabeth R; Wozniak, Jeffrey R; Jones, Kenneth Lyons; Riley, Edward P; Mattson, Sarah N

2016-09-01

Neurobehavioral consequences of heavy prenatal alcohol exposure are well documented; however, the role of age or sex in these effects has not been studied. The current study examined the effects of prenatal alcohol exposure, sex, and age on neurobehavioral functioning in children. Subjects were 407 youth with prenatal alcohol exposure (n = 192) and controls (n = 215). Two age groups (child [5 to 7 years] or adolescent [10 to 16 years]) and both sexes were included. All subjects completed standardized neuropsychological testing, and caregivers completed parent-report measures of psychopathology and adaptive behavior. Neuropsychological functioning, psychopathology, and adaptive behavior were analyzed with separate 2 (exposure history) × 2 (sex) × 2 (age) multivariate analyses of variance (MANOVAs). Significant effects were followed by univariate analyses. No 3-way or 2-way interactions were significant. The main effect of group was significant in all 3 MANOVAs, with the control group performing better than the alcohol-exposed group on all measures. The main effect of age was significant for neuropsychological performance and adaptive functioning across exposure groups with younger children performing better than older children on 3 measures (language, communication, socialization). Older children performed better than younger children on a different language measure. The main effect of sex was significant for neuropsychological performance and psychopathology; across exposure groups, males had stronger language and visual spatial scores and fewer somatic complaints than females. Prenatal alcohol exposure resulted in impaired neuropsychological and behavioral functioning. Although adolescents with prenatal alcohol exposure may perform more poorly than younger exposed children, the same was true for nonexposed children. Thus, these cross-sectional data indicate that the developmental trajectory for neuropsychological and behavioral performance is not

Comorbidity among older American Indians: the native elder care study.

PubMed

Goins, R Turner; Pilkerton, Courtney S

2010-12-01

Comorbidity is a growing challenge and the older adult population is most at risk of developing comorbid conditions. Comorbidity is associated with increased risk of mortality, increased hospitalizations, increased doctor visits, increased prescription medications, nursing home placement, poorer mental health, and physical disability. American Indians experience some of the highest rates of chronic conditions, but to date there have been only two published studies on the subject of comorbidity in this population. With a community-based sample of 505 American Indians aged 55 years or older, this study identified the most prevalent chronic conditions, described comorbidity, and identified socio-demographic, functional limitations, and psychosocial correlates of comorbidity. Results indicated that older American Indians experience higher rates of hypertension, diabetes, back pain, and vision loss compared to national statistics of older adults. Two-thirds of the sample experienced some degree of comorbidity according to the scale used. Older age, poorer physical functioning, more depressive symptomatology, and lower personal mastery were all correlates of higher comorbidity scores. Despite medical advances increasing life expectancy, morbidity and mortality statistics suggest that the health of older American Indians lags behind the majority population. These findings highlight the importance of supporting chronic care and management services for the older American Indian population.

Orthopaedic co-morbidities in the elderly haemophilia population: a review.

PubMed

Stephensen, D; Rodriguez-Merchan, E C

2013-03-01

Due to improvements in the treatment and medical care of haemophilia, the life expectancy of individuals with haemophilia has approached that of the general population. To review the main co-morbidities of the musculoskeletal system in elderly persons with haemophilia, we have performed a review of the literature on the musculoskeletal problems of elderly haemophiliacs. Chronic arthropathy is the main co-morbidity in the ageing person with haemophilia. Age-related orthopaedic co-morbidities include degenerative joint changes, osteoporosis, muscle atrophy or sarcopenia, muscle weakness and disturbance of gait and balance. Increased pain, muscle weakness and atrophy along with an increased risk of falling are key features of advanced haemophilic arthropathy and ageing. An ageing haemophilia population in which arthropathy continues to be the primary co-morbidity is a current challenge for those responsible for their care. Exercise programmes undertaken two to three times per week for at least 12 weeks seem most effective in reducing the impact of age-related changes on the musculoskeletal system. Establishing effective exercise programmes and strategies to identify individuals who would benefit from early surgical intervention together with presurgical physiotherapy prehabilitation is a priority for future research. © 2012 Blackwell Publishing Ltd.

Comorbid psychiatric disorders in 201 cases of encopresis.

PubMed

Unal, Fatih; Pehlivantürk, Berna

2004-01-01

Although encopresis is a common and complex disorder, relatively few studies have evaluated the comorbid psychiatric disorders in this condition. This study was performed to investigate the comorbid psychiatric disorders in encopresis. One hundred and sixty boys (79.6%) and 41 girls (20.4%) fulfilled the diagnostic criteria for encopresis according to DSM-IV. There was at least one comorbid diagnosis in 149 (74.1%) patients. The most frequent comorbid diagnosis was enuresis (55.2%). Clinical and demographical data were compared between patients with comorbid disorders and others. Primary encopresis was significantly more frequent in patients with comorbid disorders, and the mean age at admission was lower in these patients. The mean interval between the onset of symptoms and the diagnosis was significantly shorter in secondary encopretic patients with comorbid disorders. Furthermore, there were significantly more psychiatric disorders in the first-degree relatives of patients with comorbid disorders. Encopresis is frequently accompanied with a psychiatric disorder. Clinicians need to inquire about symptoms of other psychiatric disorders in patients who present with encopresis and vice versa.

Age, Sex, and Religious Beliefs Impact the Attitude towards Cord Blood Banking.

PubMed

Sundell, Inger Birgitta; Setzer, Teddi J

2015-01-01

In this study, a self-administered questionnaire was used to assess opinions about stem cell research and cord blood banking. Three attitudes were examined: willingness to accept cord blood banking, willingness to accept embryonic stem cell research, and religious belief system. A total of 90 Wayne State University students enrolled in the study in response to an invitation posted on a web page for the university. Sex distribution among study participants was 79 females and eight males; three declined to state their sex. Support for cord blood banking was high (> 70%) among students. Students over the age of 25 years of age were more (85%) positive than students 18 to 24 years old (57%). They prefered a public cord blood bank over a private cord blood bank. Atheist/agnostic or spiritual/not religious students (> 90%), Catholic students (78%) and Christian students (58%) support cord blood banking. Age, sex and religion seems influence the student's attitude towards stem cell research and cord blood banking.

Comorbid anxiety and depression in school-aged children with attention deficit hyperactivity disorder (ADHD) and selfreported symptoms of ADHD, anxiety, and depression among parents of school-aged children with and without ADHD

PubMed Central

XIA, Weiping; SHEN, Lixiao; ZHANG, Jinsong

2015-01-01

Background Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder in children that can extend into adulthood and that is often associated with a variety of comorbid psychiatric disorders. Aim Assess the comorbidity of ADHD with anxiety disorders and depressive disorders in school-aged children, and the relationship of the severity of ADHD, anxiety, and depressive symptoms in children who have ADHD with the severity of the corresponding symptoms in their parents. Methods A two-stage screening process identified children 7-10 years of age with and without ADHD treated at the Xin Hua Hospital in Shanghai. ADHD and other DSM-IV diagnoses were determined by a senior clinician using the Schedule for Affective Disorder and Schizophrenia for School-Aged Children (K-SADS-PL). One parent for each enrolled child completed three self-report scales: the ADHD Adult Self Report Scale (ASRS), the State-Trait Anxiety Inventory (STAI), and the Beck Depression Inventory (BDI). In total 135 children with ADHD and 65 control group children without ADHD were enrolled; parents for 94 of the children with ADHD and 63 of the children without ADHD completed the parental assessment scales. Results Among the 135 children with ADHD, 27% had a comorbid anxiety disorder, 18% had a comorbid depressive disorder, and another 15% had both comorbid anxiety and depressive disorders. Parents of children with ADHD self-reported more severe ADHD inattention symptoms than parents of children without ADHD and were more likely to meet criteria for adult ADHD. Mothers (but not fathers) of children with ADHD had significantly more severe trait anxiety and depressive symptoms than mothers of children without ADHD. Among children with ADHD, the severity of ADHD symptoms was not significantly correlated with the severity of ADHD symptoms in parents, but depressive symptoms and anxiety symptoms in the children were significantly correlated with the corresponding symptoms in the parents

Methods of Suicide by Age: Sex and Race Differences among the Young and Old.

ERIC Educational Resources Information Center

McIntosh, John L.; Santos, John F.

1986-01-01

Annual official statistics for specific methods of suicide (firearms, hanging, poisons) by age for different sex and racial groups (Whites, Blacks, non-Whites excluding Black) were examined from 1960 to 1978. Comparisons among the age-sex-race groups, along with trends over time and differences in the methods employed, were noted. (Author/ABL)

Sex differences, sexual selection, and ageing: an experimental evolution approach.

PubMed

Maklakov, Alexei A; Bonduriansky, Russell; Brooks, Robert C

2009-10-01

Life-history (LH) theory predicts that selection will optimize the trade-off between reproduction and somatic maintenance. Reproductive ageing and finite life span are direct consequences of such optimization. Sexual selection and conflict profoundly affect the reproductive strategies of the sexes and thus can play an important role in the evolution of life span and ageing. In theory, sexual selection can favor the evolution of either faster or slower ageing, but the evidence is equivocal. We used a novel selection experiment to investigate the potential of sexual selection to influence the adaptive evolution of age-specific LH traits. We selected replicate populations of the seed beetle Callosobruchus maculatus for age at reproduction ("Young" and "Old") either with or without sexual selection. We found that LH selection resulted in the evolution of age-specific reproduction and mortality but these changes were largely unaffected by sexual selection. Sexual selection depressed net reproductive performance and failed to promote adaptation. Nonetheless, the evolution of several traits differed between males and females. These data challenge the importance of current sexual selection in promoting rapid adaptation to environmental change but support the hypothesis that sex differences in LH-a historical signature of sexual selection-are key in shaping trait responses to novel selection.

Naked at Our Age: Talking out Loud about Senior Sex

ERIC Educational Resources Information Center

Davis, Melanie

2012-01-01

"Naked at Our Age" is an excellent resource for sexually interested and/or active adults over the age of 60. The book combines the author's personal reflections, questions and stories shared by older adults, and advice from sex therapists, sexuality educators, the author, and health care providers. The breadth of topics makes the book useful to…

Endogenous sex hormones and cognitive function in the elderly.

PubMed

Boss, Lisa; Kang, Duck-Hee; Bergstrom, Nancy; Leasure, J Leigh

2015-08-01

Estrogen and testosterone may influence cognitive function in the older adult, but the relationship between sex hormones and cognitive function is complex. To examine associations of sex hormones and cognitive function among older adults ≥65 years old. Using a cross-sectional research design, data were collected once from 71 elderly (mean age 86.4 years). Global cognitive function and executive function were measured with standardized instruments, and saliva samples were collected for salivary estradiol and testosterone. Estradiol was significantly and positively correlated with global cognitive function in men only (r = 0.54, p < 0.05). Testosterone was not significantly correlated with global cognitive function or executive function in either gender. Associations between sex hormones and cognitive function were mostly non-significant. However, higher estradiol was significantly correlated with better global cognitive function in men, suggesting gender-specific differences. Along with sex hormones, other comorbidity may need to be assessed together in relation to cognitive function in the elderly. Accordingly, clinicians play an important role in educating and promoting beneficial actions to preserve cognitive function.

Age, sex, marital status and suicide: an empirical study of east and west.

PubMed

Yip, P S

1998-02-01

The relationships among age, sex, marital status and suicidal behaviour in Australia and Hong Kong showed disparity in age-specific suicide rates among the four marital status groups, never married, married, widowed and divorced, for both sexes in the two locations. Examining the coefficients of preservation suggested the coefficient for never married to married in all cases was larger than 1, except for the groups of teenagers aged 15-19 years for both sexes and of elderly women aged 60 years or over in Hong Kong. The widowed or divorced groups have lower suicide rates than the married women among the elderly in Hong Kong. Hong Kong women seem not to have been benefited in marriage as much as men. Responsibility and workload in married life rather than low social status are the likely reasons for the relative high female suicide rate in Hong Kong. Possible cultural and environmental factors which are somewhat speculative (yet to be confirmed) are discussed.

Impact of obsessive-compulsive disorder comorbidity on the sociodemographic and clinical features of patients with bipolar disorder.

PubMed

Koyuncu, Ahmet; Tükel, Raşit; Ozyildirim, Ilker; Meteris, Handan; Yazici, Olcay

2010-01-01

In this study, our aim is to determine the prevalence rates of obsessive-compulsive disorder (OCD) comorbidity and to assess the impact of OCD comorbidity on the sociodemographic and clinical features of patients with bipolar disorder (BD). Using the Yale-Brown Obsessive Compulsive Scale Symptom Checklist and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-IV/Clinical Version on bipolar patients, 2 groups, BD with OCD comorbidity (BD-OCD) and BD without OCD comorbidity, were formed. These groups were compared for sociodemographic and clinical variables. Of 214 patients with BD, 21.9% of them had obsession and/or compulsion symptoms and 16.3% had symptoms at the OCD level. Although there was no statistically significant difference between the frequency of comorbid OCD in BD-I (22/185, 11.9%) and BD-II (3/13, 23.1%) patients, but OCD was found to be significantly high in BD not otherwise specified (10/16, %62.5) patients than BD-I (P < .001) and BD-II (P = .03). Six patients (17.1%) of the BD-OCD group had chronic course (the presence of at least 1 mood disorder episode with a duration of longer than 2 years), whereas the BD without OCD group had none, which was statistically significant. There were no statistically significant differences between BD-OCD and BD without OCD groups in terms of age, sex, education, marital status, polarity, age of BD onset, presence of psychotic symptoms, presence of rapid cycling, history of suicide attempts, first episode type, and predominant episode type. Main limitation of our study was the assessment of some variables based on retrospective recall. Our study confirms the high comorbidity rates for OCD in BD patients. Future studies that examine the relationship between OCD and BD using a longitudinal design may be helpful in improving our understanding of the mechanism of this association. 2010 Elsevier Inc. All rights reserved.

Fitkids Treadmill Test: Age- and Sex-Related Normative Values in Dutch Children and Adolescents.

PubMed

Kotte, Elles M W; de Groot, Janke F; Bongers, Bart C; Winkler, Alexander M F; Takken, Tim

2016-11-01

Recent research has shown that the Fitkids Treadmill Test (FTT) is a valid and reproducible exercise test for the assessment of aerobic exercise capacity in children and adolescents who are healthy. The study objective was to provide sex- and age-related normative values for FTT performance in children and adolescents who were healthy, developing typically, and 6 to 18 years of age. This was a cross-sectional, observational study. Three hundred fifty-six children and adolescents who were healthy (174 boys and 182 girls; mean age=12.9 years, SD=3.7) performed the FTT to their maximal effort to assess time to exhaustion (TTE). The least-mean-square method was used to generate sex- and age-related centile charts (P3, P10, P25, P50, P75, P90, and P97) for TTE on the FTT. In boys, the reference curve (P50) showed an almost linear increase in TTE with age, from 8.8 minutes at 6 years of age to 16.1 minutes at 18 years of age. In girls, the P50 values for TTE increased from 8.8 minutes at 6 years of age to 12.5 minutes at 18 years of age, with a plateau in TTE starting at approximately 10 years of age. Youth who were not white were underrepresented in this study. This study describes sex- and age-related normative values for FTT performance in children and adolescents who were healthy, developing typically, and 6 to 18 years of age. These age- and sex-related normative values will increase the usefulness of the FTT in clinical practice. © 2016 American Physical Therapy Association.

Age and Sex Related Differences in Subcortical Brain Iron Concentrations among Healthy Adults

PubMed Central

Persson, Ninni; Wu, Jianlin; Zhang, Qing; Liu, Ting; Shen, Jing; Bao, Ruyi; Ni, Mingfei; Liu, Tian; Wang, Yi; Spincemaille, Pascal

2015-01-01

Age and sex can influence brain iron levels. We studied the influence of these variables on deep gray matter magnetic susceptibilities. In 183 healthy volunteers (44.7 ± 14.2 years, range 20-69, ♀ 49%), in vivo Quantitative Susceptibility Mapping (QSM) at 1.5T was performed to estimate brain iron accumulation in the following regions of interest (ROIs): caudate nucleus (Cd), putamen (Pt), globus pallidus (Gp), thalamus (Th), pulvinar (Pul), red nucleus (Rn), substantia nigra (Sn) and the cerebellar dentate nuclei (Dn). We gauged the influence of age and sex on magnetic susceptibility by specifying a series of Structural Equation Models. The distributions of susceptibility varied in degree across the structures, conforming to histologic findings (Hallgren & Sourander, 1958), with the highest degree of susceptibility in the Gp and the lowest in the Th. Iron increase correlated across several ROIs, which may reflect an underlying age-related process. Advanced age was associated with a particularly strong linear rise of susceptibility in the striatum. Nonlinear age trends were found in the Rn, where they were the most pronounced, followed by the Pul and Sn, while minimal nonlinear trends were observed for the Pt, Th, and Dn. Moreover, sex related variations were observed, so that women showed lower levels of susceptibility in the Sn after accounting for age. Regional susceptibility of the Pul increased linearly with age in men but exhibited a nonlinear association with age in women with a leveling off starting from midlife. Women expected to be post menopause (+51 years) showed lower total magnetic susceptibility in the subcortical gray matter. The current report is consistent with previous reports of age related variations of brain iron, but also adds to the current knowledge by reporting age-related changes in less studied, smaller subcortical nuclei. This is the first in-vivo report to show lower total subcortical brain iron levels selectively in women from

Age and sex related differences in subcortical brain iron concentrations among healthy adults.

PubMed

Persson, Ninni; Wu, Jianlin; Zhang, Qing; Liu, Ting; Shen, Jing; Bao, Ruyi; Ni, Mingfei; Liu, Tian; Wang, Yi; Spincemaille, Pascal

2015-11-15

Age and sex can influence brain iron levels. We studied the influence of these variables on deep gray matter magnetic susceptibilities. In 183 healthy volunteers (44.7 ± 14.2 years, range 20-69, ♀ 49%), in vivo quantitative susceptibility mapping (QSM) at 1.5T was performed to estimate brain iron accumulation in the following regions of interest (ROIs): caudate nucleus (Cd), putamen (Pt), globus pallidus (Gp), thalamus (Th), pulvinar (Pul), red nucleus (Rn), substantia nigra (Sn) and the cerebellar dentate nuclei (Dn). We gauged the influence of age and sex on magnetic susceptibility by specifying a series of structural equation models. The distributions of susceptibility varied in degree across the structures, conforming to histologic findings (Hallgren and Sourander, 1958), with the highest degree of susceptibility in the Gp and the lowest in the Th. Iron increase correlated across several ROIs, which may reflect an underlying age-related process. Advanced age was associated with a particularly strong linear rise of susceptibility in the striatum. Nonlinear age trends were found in the Rn, where they were the most pronounced, followed by the Pul and Sn, while minimal nonlinear trends were observed for the Pt, Th, and Dn. Moreover, sex related variations were observed, so that women showed lower levels of susceptibility in the Sn after accounting for age. Regional susceptibility of the Pul increased linearly with age in men but exhibited a nonlinear association with age in women with a leveling off starting from midlife. Women expected to be post menopause (+51 years) showed lower total magnetic susceptibility in the subcortical gray matter. The current report not only is consistent with previous reports of age related variations of brain iron, but also adds to the current knowledge by reporting age-related changes in less studied, smaller subcortical nuclei. This is the first in-vivo report to show lower total subcortical brain iron levels selectively in women

Social phobia and subtypes in the national comorbidity survey-adolescent supplement: prevalence, correlates, and comorbidity.

PubMed

Burstein, Marcy; He, Jian-Ping; Kattan, Gabriela; Albano, Anne Marie; Avenevoli, Shelli; Merikangas, Kathleen R

2011-09-01

Social phobia typically develops during the adolescent years, yet no nationally representative studies in the United States have examined the rates and features of this condition among youth in this age range. The objectives of this investigation were to: (1) present the lifetime prevalence, sociodemographic and clinical correlates, and comorbidity of social phobia in a large, nationally representative sample of U.S. adolescents; and (2) examine differences in the rates and features of social phobia across the proposed DSM-5 social phobia subtypes. The National Comorbidity Survey Replication-Adolescent Supplement is a nationally representative face-to-face survey of 10,123 adolescents 13 to 18 years of age in the continental United States. Approximately 9% of adolescents met criteria for any social phobia in their lifetime. Of these adolescents, 55.8% were affected with the generalized subtype and 44.2% exhibited nongeneralized social phobia. Only 0.7% met criteria for the proposed DSM-5 performance-only subtype. Generalized social phobia was more common among female adolescents and risk for this subtype increased with age. Adolescents with generalized social phobia also had a younger age of onset, higher levels of disability and clinical severity, and a greater degree of comorbidity relative to adolescents with nongeneralized forms of the disorder. This study indicates that social phobia is a highly prevalent, persistent, and impairing psychiatric disorder among adolescent youth. Results of this study also provide evidence for the clinical utility of the generalized subtype and highlight the importance of considering the heterogeneity of social phobia in this age group. Copyright © 2011 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Social Phobia and Subtypes in the National Comorbidity Survey-Adolescent Supplement: Prevalence, Correlates, and Comorbidity

PubMed Central

Burstein, Marcy; He, Jian-Ping; Kattan, Gabi; Albano, Anne Marie; Avenevoli, Shelli; Merikangas, Kathleen R.

2011-01-01

Objective Social phobia typically develops during the adolescent years, yet no nationally representative studies in the United States have examined the rates and features of this condition among youth in this age range. The objectives of this investigation are to: (1) present the lifetime prevalence, sociodemographic and clinical correlates, and comorbidity of social phobia in a large, nationally representative sample of U.S. adolescents; (2) examine differences in the rates and features of social phobia across the proposed DSM-5 social phobia subtypes. Method The National Comorbidity Survey Replication-Adolescent Supplement (NCS-A) is a nationally representative face-to-face survey of 10,123 adolescents aged 13–18 years in the continental U.S. Results Approximately 9% of adolescents met criteria for any social phobia in their lifetime. Of these adolescents, 55.8% were affected with the generalized subtype and 44.2% exhibited non-generalized social phobia. Only 0.7% met criteria for the proposed DSM-5 performance only subtype. Generalized social phobia was more common among female adolescents and risk for this subtype increased with age. Adolescents with generalized social phobia also experienced an earlier age of onset, higher levels of disability and clinical severity, and a greater degree of comorbidity relative to adolescents with non-generalized forms of the disorder. Conclusions This study indicates that social phobia is a highly prevalent, persistent, and impairing psychiatric disorder among adolescent youth. Results of this study also provide evidence for the clinical utility of the generalized subtype and highlight the importance of considering the heterogeneity of social phobia in this age group. PMID:21871369

The Hispanic Paradox and Predictors of Mortality in an Aging Bi-ethnic Cohort of Mexican Americans and European Americans: The San Antonio Longitudinal Study of Aging

PubMed Central

Espinoza, Sara E.; Jung, Inkyung; Hazuda, Helen

2013-01-01

OBJECTIVES To examine predictors of mortality in aging Mexican Americans (MAs) and European Americans (EAs). DESIGN Longitudinal, observational cohort study. SETTING Socioeconomically diverse neighborhoods in San Antonio, Texas. PARTICIPANTS Three hundred and ninety-four MA and 355 EA community-dwelling older adults (65+) who completed the baseline examination (1992–96) of the San Antonio Longitudinal Study of Aging (SALSA) and for whom vital status was ascertained over an average 8.2 years of follow-up. MEASUREMENTS Ethnic group was classified using a validated algorithm. Hazards ratios (HR) for mortality were estimated using Cox proportional hazards models with age, sex, ethnic group, education, income, frailty, diabetes with and without complications, comorbidity, cognition, depressive symptoms, and body mass index included as predictors in sequential models. RESULTS At baseline, MAs had higher prevalence of diabetes and frailty and lower socioeconomic status (SES) compared to EAs. The age- and sex-adjusted ethnic HR (MA vs. EA) for mortality was 1.54 (95% CI: 1.17–2.03). After adjusting for SES, the ethnic HR was no longer significant (HR = 1.16, 95% CI: 0.83–1.61). In the final model, comorbidity, diabetes with complications, depressive symptoms, and cognitive impairment were significant independent risk factors for mortality. CONCLUSION Contrary to the Hispanic paradox, MAs were at increased risk of mortality. Moreover, this ethnic disparity was largely explained by SES differences. Significant independent predictors of mortality, regardless of ethnic group, included diabetes with complications, comorbidity, depressive symptoms and cognitive impairment. Mortality reduction in older MAs requires attention to both socioeconomic disparities and disease factors. PMID:24000922

Prevalence and associated factors of tuberculosis and diabetes mellitus comorbidity: A systematic review.

PubMed

Workneh, Mahteme Haile; Bjune, Gunnar Aksel; Yimer, Solomon Abebe

2017-01-01

The dual burden of tuberculosis (TB) and diabetes mellitus (DM) has become a major global public health concern. There is mounting evidence from different countries on the burden of TB and DM comorbidity. The objective of this systematic review was to summarize the existing evidence on prevalence and associated/risk factors of TBDM comorbidity at global and regional levels. Ovid Medline, Embase, Global health, Cochrane library, Web of science and Scopus Elsevier databases were searched to identify eligible articles for the systematic review. Data were extracted using standardized excel form and pilot tested. Median with interquartile range (IQR) was used to estimate prevalence of TBDM comorbidity. Associated/risk factors that were identified from individual studies were thematically analyzed and described. The prevalence of DM among TB patients ranged from 1.9% to 45%. The overall median global prevalence was 16% (IQR 9.0%-25.3%) Similarly, the prevalence of TB among DM patients ranged from 0.38% to 14% and the overall median global prevalence was 4.1% (IQR 1.8%-6.2%). The highest prevalence of DM among TB patients is observed in the studied countries of Asia, North America and Oceania. On the contrary, the prevalence of TB among DM patients is low globally, but relatively higher in the studied countries of Asia and the African continents. Sex, older age, urban residence, tobacco smoking, sedentary lifestyle, poor glycemic control, having family history of DM and TB illness were among the variables identified as associated/risk factors for TBDM comorbidity. This systematic review revealed that there is a high burden of DM among TB patients at global level. On the contrary, the global prevalence of TB among DM patients is low. Assessing the magnitude and risk/associated factors of TBDM comorbidity at country/local level is crucial before making decisions to undertake TBDM integrated services.

Psychiatric Comorbidity Among Egyptian Patients With Opioid Use Disorders Attributed to Tramadol.

PubMed

Bassiony, Medhat M; Youssif, Usama M; Hussein, Ramadan A; Saeed, Mervat

2016-01-01

Opioid use disorders attributed to tramadol (OUD-T) is a public health problem in Egypt. The objective of this study was to assess the psychiatric comorbidity among patients with opioid use disorder attributed to tramadol. This study included 100 patients with opioid use disorders attributed to tramadol (according to DSM-IV-TR) and 100 control persons (matched for age, sex, and education), who were recruited from Zagazig University Hospital, Egypt. The participants were interviewed using Structured Clinical Interview for DSM disorders (SCID-I and SCID-II), Addiction Severity Index scale (patients), and urine screening for drugs. Twenty-four percent of the patients used tramadol only (pure tramadol group), whereas 76% of the patients used other substances in addition to tramadol (polysubstance group). Most (91%) of the patients had tramadol dependence. Forty-nine percent of the patients had psychiatric comorbidity, especially mood disorders (59.2%), whereas only 24% of the control persons had psychiatric comorbidity, especially anxiety disorders (83.3%). The most common personality disorders among patients were borderline (24%) and antisocial (22%), whereas in control persons, the most common personality disorders were obsessive compulsive personality disorder (8%) and the avoidant personality disorder (7%). Cluster B (76.6%) was the most common category among patients (compared with 25.8% in control persons), whereas cluster C (51.6%) was the most common category among control persons (compared with 15.6% in patients). Most of the patients were dependent on tramadol, and approximately 3 out of 4 used many substances. Almost half of the patients had psychiatric comorbidity, and approximately 3 out of 4 had cluster B personality disorders.

Age and sex differences of risk factors of activity limitations in Japanese older adults.

PubMed

Monma, Takafumi; Takeda, Fumi; Noguchi, Haruko; Tamiya, Nanako

2016-06-01

The objective of the present study was to verify how socioeconomic and physical/mental health status would be associated with activity limitations by age and sex among older adults, using nationally representative cross-sectional data in Japan. The present study focused on 8373 older adults aged 65 years or older extracted from the Comprehensive Survey of Living Conditions conducted in 2007 by the Japanese Ministry of Health, Labor and Welfare. Univariate and multiple logistic regression analyses and population-attributable risk were applied to validate the relationships of socioeconomic and physical/mental health status with activity limitations among the total population, and by age groups (young-old or old-old) and sex. Mental health showed the highest odds ratio and population-attributable risk in the total population. In addition, low back pain was associated with activity limitations regardless of age and sex. Other musculoskeletal diseases, such as arthropathy and osteoporosis, were related to activity limitations for women, regardless of age, whereas cardiovascular diseases, including angina pectoris/myocardial infarction and cerebral stroke, were associated with activity limitations for men in any age group. There were no statistically significant correlations between socioeconomic status and activity limitations in any groups. Mental health was the most important factor of activity limitations in Japanese older adults. Furthermore, low back pain regardless of age and sex, other musculoskeletal diseases only for women and cardiovascular diseases mainly for men could also be significant risk factors to activity limitations. Therefore, preventive approaches of activity limitations considering sex differences are important for older adults in Japan. Geriatr Gerontol Int 2015; ●●: ●●-●●. © 2015 Japan Geriatrics Society.

Psychiatric comorbidities in patients with major depressive disorder.

PubMed

Thaipisuttikul, Papan; Ittasakul, Pichai; Waleeprakhon, Punjaporn; Wisajun, Pattarabhorn; Jullagate, Sudawan

2014-01-01

Psychiatric comorbidities are common in major depressive disorder (MDD). They may worsen outcome and cause economic burden. The primary objective was to examine the prevalence of psychiatric comorbidities in MDD. The secondary objectives were to compare the presence of comorbidities between currently active and past MDD, and between patients with and without suicidal risk. This was a cross-sectional study. A total of 250 patients with lifetime MDD and age ≥18 years were enrolled. The Mini International Neuropsychiatric Interview (MINI), Thai version, was used to confirm MDD diagnosis and classify comorbidities. MDD diagnosis was confirmed in 190, and 60 patients were excluded due to diagnosis of bipolar disorder. Of the 190 MDD patients, 25.8% had current MDD and 74.2% had past MDD. Eighty percent were women. The mean age at enrollment was 50 years, and at MDD onset was 41 years. Most patients were married (53.2%), employed (54.8%), and had ≥12 years of education (66.9%). There were 67 patients (35.3%) with one or more psychiatric comorbidities. Comorbidities included dysthymia (19.5%), any anxiety disorders (21.1%) (panic disorder [6.8%], agoraphobia [5.8%], social phobia [3.7%], obsessive-compulsive disorder [OCD] [4.7%], generalized anxiety disorder [5.3%], and post-traumatic stress disorder [4.2%]), alcohol dependence (0.5%), psychotic disorder (1.6%), antisocial personality (1.1%), and eating disorders (0%). Compared with past MDD, the current MDD group had significantly higher OCD (P<0.001), psychotic disorder (P=0.048), past panic disorder (P=0.017), and suicidal risk (P<0.001). Suicidal risk was found in 32.1% of patients. Patients with suicidal risk had more comorbid anxiety disorder of any type (P=0.019) and psychotic disorder (P=0.032). Several comorbidities were associated with MDD. Patients with active MDD had higher comorbid OCD, psychotic disorder, past panic disorder, and suicidal risk. Patients with suicide risk had higher comorbid anxiety and

Role of Estrogen and Other Sex Hormones in Brain Aging. Neuroprotection and DNA Repair

PubMed Central

Zárate, Sandra; Stevnsner, Tinna; Gredilla, Ricardo

2017-01-01

Aging is an inevitable biological process characterized by a progressive decline in physiological function and increased susceptibility to disease. The detrimental effects of aging are observed in all tissues, the brain being the most important one due to its main role in the homeostasis of the organism. As our knowledge about the underlying mechanisms of brain aging increases, potential approaches to preserve brain function rise significantly. Accumulating evidence suggests that loss of genomic maintenance may contribute to aging, especially in the central nervous system (CNS) owing to its low DNA repair capacity. Sex hormones, particularly estrogens, possess potent antioxidant properties and play important roles in maintaining normal reproductive and non-reproductive functions. They exert neuroprotective actions and their loss during aging and natural or surgical menopause is associated with mitochondrial dysfunction, neuroinflammation, synaptic decline, cognitive impairment and increased risk of age-related disorders. Moreover, loss of sex hormones has been suggested to promote an accelerated aging phenotype eventually leading to the development of brain hypometabolism, a feature often observed in menopausal women and prodromal Alzheimer’s disease (AD). Although data on the relation between sex hormones and DNA repair mechanisms in the brain is still limited, various investigations have linked sex hormone levels with different DNA repair enzymes. Here, we review estrogen anti-aging and neuroprotective mechanisms, which are currently an area of intense study, together with the effect they may have on the DNA repair capacity in the brain. PMID:29311911

[Lead intakes by different age-sex population groups from Chinese total diet study in 2000].

PubMed

Zhang, Lei; Gao, Junquan; Li, Xiaowei

2007-07-01

To estimate the dietary lead intakes by different age-sex population groups in China. The lead concentrations of food sample from 3rd Chinese total diet study were determined, and then were combined with the food consumption by population of ten age-sex groups, The lead intakes, and its distribution and dietary sources were obtained. It was found that the mean and median concentrations of lead in all food samples were 0.118 and 0.052mg/kg, respectively. The highest concentration of individual sample and mean concentrations of lead in preserved egg were 8.964mg/kg and 2.577mg/kg, respectively. The vegetable samples in Hubei Province were heavily contaminated. The lead intakes by different age-sex groups were estimated to be 54.9-112.7microg/day. The average dietary lead intakes by 2-7 years old group could reach 86.1% of PTWI, and individual lead intakes by about 30% children in this group exceed PTWI. But the average dietary lead intakes of other age-sex population groups ranged from 42.8% to 86.1% of PTWI. The main sources of dietary lead were cereals and vegetables in ten age-sex population groups, and could reach 72%-80% of total lead intakes. Although the dietary lead intakes by different age-sex population groups are all lower than PTWI, it should be decreased to a lower level. Moreover, the dietary exposures to lead are higher enough for 2-7 years old children and population in some provinces to be considered seriously.

Syphilis among middle-aged female sex workers in China: a three-site cross-sectional study.

PubMed

Liu, Hongjie; Dumenci, Levent; Morisky, Donald E; Xu, Yongfang; Li, Xiaojing; Jiang, Baofa

2016-05-10

This study addresses the lack of empirical studies about the epidemic of syphilis among middle-aged female sex workers (FSWs). The objectives of this study were to investigate prevalence of syphilis, and its potential risk factors among middle-aged FSWs in China. A cross-sectional study with respondent-driven sampling (RDS). A multisite study conducted at three Chinese cites (Nanning, Hefei, and Qingdao) with different levels of sexually transmitted diseases in 2014. 1245 middle-aged female sex workers who were over 35 years old (about 400 per study site). Unprotected commercial sex, and syphilis and HIV infection were biologically tested and measured. The RDS-adjusted prevalence of active syphilis was 17.3% in Hefei, 9.9% in Qingdao, and 5.4% in Nanning. The RDS-adjusted prevalence of prevalent syphilis was between 6.8% and 33.6% in the three cities. The proportion of unprotected sex in the past 48 h verified by the prostate-specific antigen test (PSA) was between 27.8% and 42.4%. Multiple log-binomial regression analyses indicate that middle-aged FSWs who had 5 or more clients in the past week prior to interviews and engaged in unprotected sex were more likely to be active syphilitic cases. Middle-aged FSWs who had rural residency were less likely to be active syphilitic cases. In contrast with previous studies that reported low prevalence of syphilis and high prevalence of protected sex among FSWs in China, both the prevalence of syphilis and unprotected sex were high among middle-aged FSWs. Evidence-based intervention programmes should be developed and evaluated among this vulnerable population in China and other countries with similar settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Estimating Small-area Populations by Age and Sex Using Spatial Interpolation and Statistical Inference Methods

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qai, Qiang; Rushton, Gerald; Bhaduri, Budhendra L

The objective of this research is to compute population estimates by age and sex for small areas whose boundaries are different from those for which the population counts were made. In our approach, population surfaces and age-sex proportion surfaces are separately estimated. Age-sex population estimates for small areas and their confidence intervals are then computed using a binomial model with the two surfaces as inputs. The approach was implemented for Iowa using a 90 m resolution population grid (LandScan USA) and U.S. Census 2000 population. Three spatial interpolation methods, the areal weighting (AW) method, the ordinary kriging (OK) method, andmore » a modification of the pycnophylactic method, were used on Census Tract populations to estimate the age-sex proportion surfaces. To verify the model, age-sex population estimates were computed for paired Block Groups that straddled Census Tracts and therefore were spatially misaligned with them. The pycnophylactic method and the OK method were more accurate than the AW method. The approach is general and can be used to estimate subgroup-count types of variables from information in existing administrative areas for custom-defined areas used as the spatial basis of support in other applications.« less

Impact of comorbidity on survival by tumour location: Breast, colorectal and lung cancer (2000-2014).

PubMed

Parés-Badell, Oleguer; Banqué, Marta; Macià, Francesc; Castells, Xavier; Sala, Maria

2017-08-01

To assess the impact of comorbidity, measured by the Charlson Comorbidity Index (CCI), on survival in breast, colorectal and lung cancer. We identified 3455 breast cancer, 3336 colorectal cancer and 2654 lung cancer patients through the Hospital del Mar cancer registry. The prevalence of comorbidities according to the CCI was calculated. Kaplan-Meier curves and the log-rank test were used to compare survival curves for each cancer location. Cox regression was used to calculate survival hazard ratios and 1-, 3- and 5-year mortality rate ratios adjusted by age, sex, CCI, place of first consultation, stage, treatment and period of diagnosis. The overall unadjusted 5-year follow-up survival proportion was 82.6% for breast cancer, 55.7% for colorectal cancer, and 16.3% for lung cancer. Overall survival was associated with CCI≥3 in breast cancer (HR: 2.33 95%CI: 1.76-3.08), colorectal cancer (HR: 1.39; 95%CI: 1.13-1.70) and lung cancer (HR: 1.22; 95%CI: 1.06-1.40). In breast cancer, the higher the CCI, the higher the adjusted mortality rate ratio and differences were greater in 5-year than in 1-year follow-up survival. Comorbidity is a significant predictor of overall survival in cancer patients; however, it has a stronger impact on survival in breast cancer than in colorectal and lung cancer. Copyright © 2017 Elsevier Ltd. All rights reserved.

Variance in age-specific sex composition of Pacific halibut catches, and comparison of statistical and genetic methods for reconstructing sex ratios

NASA Astrophysics Data System (ADS)

Loher, Timothy; Woods, Monica A.; Jimenez-Hidalgo, Isadora; Hauser, Lorenz

2016-01-01

Declines in size at age of Pacific halibut Hippoglossus stenolepis, in concert with sexually-dimorphic growth and a constant minimum commercial size limit, have led to the expectation that the sex composition of commercial catches should be increasingly female-biased. Sensitivity analyses suggest that variance in sex composition of landings may be the most influential source of uncertainty affecting current understanding of spawning stock biomass. However, there is no reliable way to determine sex at landing because all halibut are eviscerated at sea. In 2014, a statistical method based on survey data was developed to estimate the probability that fish of any given length at age (LAA) would be female, derived from the fundamental observation that large, young fish are likely female whereas small, old fish have a high probability of being male. Here, we examine variability in age-specific sex composition using at-sea commercial and closed-season survey catches, and compare the accuracy of the survey-based LAA technique to genetic markers for reconstructing the sex composition of catches. Sexing by LAA performed best for summer-collected samples, consistent with the hypothesis that the ability to characterize catches can be influenced by seasonal demographic shifts. Additionally, differences between survey and commercial selectivity that allow fishers to harvest larger fish within cohorts may generate important mismatch between survey and commercial datasets. Length-at-age-based estimates ranged from 4.7% underestimation of female proportion to 12.0% overestimation, with mean error of 5.8 ± 1.5%. Ratios determined by genetics were closer to true sample proportions and displayed less variability; estimation to within < 1% of true ratios was limited to genetics. Genetic estimation of female proportions ranged from 4.9% underestimation to 2.5% overestimation, with a mean absolute error of 1.2 ± 1.2%. Males were generally more difficult to assign than females: 6.7% of

The impact of comorbidity on cancer and its treatment.

PubMed

Sarfati, Diana; Koczwara, Bogda; Jackson, Christopher

2016-07-01

Answer questions and earn CME/CNE Comorbidity is common among cancer patients and, with an aging population, is becoming more so. Comorbidity potentially affects the development, stage at diagnosis, treatment, and outcomes of people with cancer. Despite the intimate relationship between comorbidity and cancer, there is limited consensus on how to record, interpret, or manage comorbidity in the context of cancer, with the result that patients who have comorbidity are less likely to receive treatment with curative intent. Evidence in this area is lacking because of the frequent exclusion of patients with comorbidity from randomized controlled trials. There is evidence that some patients with comorbidity have potentially curative treatment unnecessarily modified, compromising optimal care. Patients with comorbidity have poorer survival, poorer quality of life, and higher health care costs. Strategies to address these issues include improving the evidence base for patients with comorbidity, further development of clinical tools to assist decision making, improved integration and coordination of care, and skill development for clinicians. CA Cancer J Clin 2016;66:337-350. © 2016 American Cancer Society. © 2016 American Cancer Society, Inc.

Age- and sex-related differences in the anthropometry and neuromuscular fitness of competitive taekwondo athletes.

PubMed

Nikolaidis, Pantelis Theodoros; Buśko, Krzysztof; Clemente, Filipe Manuel; Tasiopoulos, Ioannis; Knechtle, Beat

2016-01-01

Anthropometry and neuromuscular fitness have been shown to relate with taekwondo (TKD) performance; however, little information is available on the variation of these fitness components by sex and age in athletes practicing this sport. The aim of the present study was to examine the anthropometry and neuromuscular fitness of TKD athletes by sex and age. A total of 393 athletes (7-48 years old), separated into six age groups (7-9, 10-11, 12-13, 14-17, 18-32, and 33+), were examined for anthropometry and performed a series of neuromuscular fitness tests (flexibility, agility, muscle power, and isometric strength). An age × sex interaction on body mass, body height, and body fat percentage (BF, p ≤0.003, η 2 ≥0.045), but not on body mass index ( p =0.172, η 2 =0.020), was shown, where a larger increase in body mass and body height from 12-13 to 14-17 groups was observed in males than in females, and the sex difference in BF increased from 12-13 to 14-17 age group. An age × sex interaction on sit-and-reach (SAR) test, mean power output in the Bosco test, and Abalakov jump ( p ≤0.038, η 2 ≥0.031) was observed with larger differences between 12-13 and 18-32 groups in males than in females. In SAR, it was remarkable that the male athletes achieved similar scores as female athletes in the 18-32 group. An age × sex group interaction on measures of isometric muscle strength (right and left handgrip, trunk, and legs) was also shown ( p ≤0.002, η 2 ≥0.068), where larger differences in male than female athletes were observed between the 12-13 and 14-17 groups. From a practical perspective, coaches can use these findings as reference for the evaluation of their athletes. Because the anthropometric characteristics and neuromuscular fitness varied by sex (i.e., highest scores in males, except flexibility) and age (i.e., highest scores in the 18-32 age group) with unique sport-specific patterns in TKD athletes, these findings would be important for the

Impact of Gender, Age at Onset, and Lifetime Tic Disorders on the Clinical Presentation and Comorbidity Pattern of Obsessive-Compulsive Disorder in Children and Adolescents

PubMed Central

Adaletli, Hilal; Gunes, Hatice; Kilicoglu, Ali Guven; Mutlu, Caner; Bahali, Mustafa Kayhan; Aytemiz, Tugce; Uneri, Ozden Sukran

2015-01-01

Abstract Background: Obsessive–compulsive disorder (OCD) is a heterogeneous disorder; therefore, there is a need for identifying more homogeneous subtypes. This study aimed to examine the clinical characteristics and comorbidity pattern of a large sample of pediatric OCD subjects, and to examine the impact of gender, age at onset, and lifetime tic disorders on the clinical presentation and comorbidity pattern. Methods: A total of 110 children and adolescents diagnosed with OCD were assessed using the Kiddle Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL) for psychiatric comorbidity, and a clinical data form was filled out. The cutoff for differentiating prepubertal from adolescent onset was 11 years of age. Results: A total of 83.6% of the subjects had at least one comorbid psychiatric disorder. Oppositional defiant disorder and contamination/somatic obsessions were significantly higher in males (p=0.036 and p=0.03, respectively) than in females. Depressive disorders and religious obsessions were significantly higher in the adolescent-onset group (p=0.02, p=0.05, respectively) whereas disruptive behavior disorders were higher in the prepubertal-onset group (p=0.037). Disruptive behavior disorders were significantly more frequent in the tic (+) group than in tic (-) group (p=0.021). Conclusions: There were differences in the comorbidity pattern and clinical expression between genders and between prepubertal and adolescent-onset cases. Findings of this study supported the introduction of tic-related OCD as a specifier in Diagnostic and Statistical Manual of Mental Disorders, 5th ed. (DSM-5), and the necessity of a detailed assessment of other psychiatric disorders in youth with OCD. PMID:26091196

Epilepsy as a systemic condition: Link with somatic comorbidities.

PubMed

Novy, J; Bell, G S; Peacock, J L; Sisodiya, S M; Sander, J W

2017-10-01

People with epilepsy have more concomitant medical conditions than the general population; these comorbidities play an important role in premature mortality. We sought to generate explanatory hypotheses about the co-occurrence of somatic comorbidities and epilepsy, avoiding causal and treatment-resultant biases. We collected clinical, demographic and somatic comorbidity data for 2016 consecutive adults with epilepsy undergoing assessment at a tertiary centre and in 1278 people with epilepsy in the community. Underlying causes of epilepsy were not classed as comorbidities. Somatic comorbidities were more frequent in the referral centre (49%) where people more frequently had active epilepsy than in the community (36%). Consistent risk factors for comorbidities were found in both cohorts. Using multivariable ordinal regression adjusted for age, longer epilepsy duration and an underlying brain lesion were independently associated with a smaller burden of somatic conditions. The treatment burden, measured by the number of drugs to which people were exposed, was not an independent predictor. Shorter epilepsy duration was a predictor for conditions that conceivably harbour significant mortality risks. Somatic comorbidities do not occur randomly in relation to epilepsy; having more severe epilepsy seems to be a risk factor. Independently from age, the early period after epilepsy onset appears to be at particular risk, although it is not clear whether this relates to an early mortality or to a later decrease in the burden of comorbidities. These results suggest that, for some people, epilepsy should be considered a systemic condition not limited to the CNS. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Phenomenology and comorbidity of dysthymic disorder in 100 consecutively referred children and adolescents: beyond DSM-IV.

PubMed

Masi, Gabriele; Millepiedi, Stefania; Mucci, Maria; Pascale, Rosa Rita; Perugi, Giulio; Akiskal, Hagop S

2003-03-01

Diagnostic criteria and nosological boundaries of juvenile dysthymic disorder (DD) are under-researched. Two different sets of diagnostic criteria are still discussed in the DSM-IV, the first giving major weight to somatic and vegetative symptoms and the second, included in the appendix, to more affective and cognitive symptoms. The aim of this study was to describe prototypical symptomatology and comorbidity of DD, according to DSM-IV criteria, in a consecutive series of referred children and adolescents, as a function of age and sex. One hundred inpatients and outpatients (36 children and 64 adolescents, 57 males, 43 females, age range 7 to 18 years, mean age 13.3 years) received a diagnosis of DD without comorbid major depressive disorder (MDD), using historical information, the Diagnostic Interview for Children and Adolescents-Revised (DICA-R), and symptoms ratings according to the DSM-IV criteria. Irritability, low self-esteem, fatigue or loss of energy, depressed mood, guilt, concentration difficulties, anhedonia, and hopelessness were present in more than 50% of subjects. Differences in symptomatic profile between male and female patients were not significant. Anxiety disorders were commonly comorbid with DD, mainly generalized anxiety disorder, simple phobias, and in prepuberal children, separation anxiety disorder. Externalizing disorders were reported in 35% of the patients, with higher prevalence in male patients. Adolescents showed more suicidal thoughts and anhedonia than children. The clinical picture of early-onset DD we found, based entirely on a pure sample without current and past MDD, is not totally congruent with the diagnostic criteria according to DSM-IV. A more precise definition of the clinical picture may help early diagnosis and prevention of superimposed mental disorders.

How sex and age affect immune responses, susceptibility to infections, and response to vaccination

PubMed Central

Giefing-Kröll, Carmen; Berger, Peter; Lepperdinger, Günter; Grubeck-Loebenstein, Beatrix

2015-01-01

Do men die young and sick, or do women live long and healthy? By trying to explain the sexual dimorphism in life expectancy, both biological and environmental aspects are presently being addressed. Besides age-related changes, both the immune and the endocrine system exhibit significant sex-specific differences. This review deals with the aging immune system and its interplay with sex steroid hormones. Together, they impact on the etiopathology of many infectious diseases, which are still the major causes of morbidity and mortality in people at old age. Among men, susceptibilities toward many infectious diseases and the corresponding mortality rates are higher. Responses to various types of vaccination are often higher among women thereby also mounting stronger humoral responses. Women appear immune-privileged. The major sex steroid hormones exhibit opposing effects on cells of both the adaptive and the innate immune system: estradiol being mainly enhancing, testosterone by and large suppressive. However, levels of sex hormones change with age. At menopause transition, dropping estradiol potentially enhances immunosenescence effects posing postmenopausal women at additional, yet specific risks. Conclusively during aging, interventions, which distinctively consider the changing level of individual hormones, shall provide potent options in maintaining optimal immune functions. PMID:25720438

Cholesterol Curves to Identify Population Norms by Age and Sex in Healthy Weight Children

PubMed Central

Skinner, Asheley Cockrell; Steiner, Michael J.; Chung, Arlene E.; Perrin, Eliana M.

2012-01-01

Objective Develop clinically applicable charts of lipid values illustrating fluctuations throughout childhood and by sex among healthy weight children. Methods The National Health and Nutrition Examination Survey (1999–2008) was used to estimate total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides by age and sex in healthy weight children age 3 to 17 years. Using LMS procedures, the authors created smoothed curves demonstrating population-based 50th percentile for age and the 75th and 95th percentiles. Results The curves were based on 7681 children meeting inclusion criteria. Total cholesterol, HDL, and LDL demonstrated peaks at approximately 8 to 12 years for boys. Similar peaks were evident for girls at slightly younger ages, approximately 7 to 11 years. Triglycerides showed peaks for girls, but values were similar across ages for boys. Conclusions The use of fixed lipid value cutoffs in established guidelines regardless of age or sex likely mislabels many children as abnormal. The authors’ charts may allow for a more nuanced interpretation based on population norms. PMID:22157422

Comorbidities in adults with asthma: Population-based cross-sectional analysis of 1.4 million adults in Scotland.

PubMed

Weatherburn, C J; Guthrie, B; Mercer, S W; Morales, D R

2017-10-01

Comorbidity in people with asthma can significantly increase asthma morbidity and lower adherence to asthma guidelines. The objective of this study was to comprehensively measure the prevalence of physical and mental health comorbidities in adults with asthma using a large nationally representative population. Cross-sectional analysis of routine primary care electronic medical records for 1 424 378 adults in the UK, examining the prevalence of 39 comorbidities in people with and without asthma, before and after adjustment for age, sex, social deprivation and smoking status using logistic regression. Of 39 comorbidities measured, 36 (92%) were significantly more common in adults with asthma; 62.6% of adults with asthma had ≥1 comorbidity vs 46.2% of those without, and 16.3% had ≥4 comorbidities vs 8.7% of those without. Comorbidities with the largest absolute increase in prevalence in adults with asthma were as follows: chronic obstructive pulmonary disease (COPD) (13.4% vs 3.1%), depression (17.3% vs 9.1%), painful conditions (15.4% vs 8.4%) and dyspepsia (10.9% vs 5.2%). Comorbidities with the largest relative difference in adults with asthma compared to those without were as follows: COPD (adjusted odds ratio [aOR] 5.65, 95% CI 5.52-5.79), bronchiectasis (aOR 4.65, 95% CI 4.26-5.08), eczema/psoriasis (aOR 3.30, 95% CI 3.14-3.48), dyspepsia (aOR 2.20, 95% CI 2.15-2.25) and chronic sinusitis (aOR 2.12, 95% CI 1.99-2.26). Depression and anxiety were more common in adults with asthma (aOR 1.60, 95% CI 1.57-1.63, and aOR 1.53, 95% CI 1.48-1.57, respectively). Physical and mental health comorbidities are the norm in adults with asthma. Appropriate recognition and management should form part of routine asthma care. © 2017 John Wiley & Sons Ltd.

Sex- and age-based variation in transfusion practices among patients undergoing major surgery.

PubMed

Valero-Elizondo, Javier; Spolverato, Gaya; Kim, Yuhree; Wagner, Doris; Ejaz, Aslam; Frank, Steven M; Pawlik, Timothy M

2015-11-01

Data on hemoglobin (Hb) threshold levels for "appropriate" packed red blood cell (PRBC) transfusions have not taken into account patient-specific variables such as sex and age. We sought to define differences in perioperative transfusion practices based on patient sex and age among patients undergoing complex gastrointestinal (GI) and cardiothoracic-vascular (CT-V) surgical procedures. All patients undergoing any major GI or CT-V procedures between January 2010 and April 2014 at the Johns Hopkins Hospital were identified. Data on sex, age, as well as other clinicopathologic and procedures were collected and analyzed relative to transfusion practices (restrictive: transfusion at blood Hb < 7 vs liberal transfusion at Hb ≥ 7 g/dL). Among the 10,772 patients included in the study cohort, 4,689 (44.0%) were transfused with ≥ 1 PRBC. Median preoperative Hb was lower among women (12.3 vs 13.4 g/dL in men) and the aged (<65 years, 13.1 vs ≥ 65 years, 12.7 g/dL) patients (both P < .05). On adjusted analysis, male sex (odds ratio [OR], 1.13; 95% CI, 1.02-1.26; P = .03) and age ≥ 65 (OR, 1.77; 95% CI, 1.35-2.33; P < .001) were associated independently with an increased odds of receipt of ≥ 1 PRBC. Although sex did not seem to impact transfusion strategy, patient age did impact the relative trigger used by providers for a transfusion. Specifically, patients 65-74 years (OR, 2.87; 95% CI, 1.93-4.26) and those ≥ 74 years (OR, 3.42; 95% CI, 2.28-5.14) were at a much greater odds of being transfused liberally compared with patients <65 years old (both P < .05). The proportion of patients who had a potentially avoidable transfusion (ie, both trigger ≥ 7 and target ≥ 9 g/dL) was greater among aged patients (50%) compared with nonaged patients (41%; P < .001). Of note, a restrictive transfusion strategy did not increase the risk of overall morbidity among women (OR, 0.76; 95% CI, 0.59-0.99; P = .04) or aged (OR, 1.13; 95% CI, 0.87-1.47; P = .37) patients. Sex and age

Comorbidities in rotator cuff disease: a case-control study.

PubMed

Titchener, Andrew G; White, Jonathan J E; Hinchliffe, Sally R; Tambe, Amol A; Hubbard, Richard B; Clark, David I

2014-09-01

Rotator cuff disease is a common condition in the general population, but relatively little is known about its associated risk factors. We have undertaken a large case-control study using The Health Improvement Network database to assess and to quantify the relative contributions of some constitutional and environmental risk factors for rotator cuff disease in the community. Our data set included 5000 patients with rotator cuff disease who were individually matched with a single control by age, sex, and general practice (primary care practice). The median age at diagnosis was 55 years (interquartile range, 44-65 years). Multivariate analysis showed that the risk factors associated with rotator cuff disease were Achilles tendinitis (odds ratio [OR] = 1.78), trigger finger (OR = 1.99), lateral epicondylitis (OR = 1.71), and carpal tunnel syndrome (OR = 1.55). Oral corticosteroid therapy (OR = 2.03), oral antidiabetic use (OR = 1.66), insulin use (OR = 1.77), and "overweight" body mass index of 25.1 to 30 (OR = 1.15) were also significantly associated. Current or previous smoking history, body mass index of greater than 30, any alcohol intake, medial epicondylitis, de Quervain syndrome, cubital tunnel syndrome, and rheumatoid arthritis were not found to be associated with rotator cuff disease. We have identified a number of comorbidities and risk factors for rotator cuff disease. These include lateral epicondylitis, carpal tunnel syndrome, trigger finger, Achilles tendinitis, oral corticosteroid use, and diabetes mellitus. The findings should alert the clinician to comorbid pathologic processes and guide future research into the etiology of this condition. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Sex differences in the effects of juvenile and adult diet on age-dependent reproductive effort.

PubMed

Houslay, T M; Hunt, J; Tinsley, M C; Bussière, L F

2015-05-01

Sexual selection should cause sex differences in patterns of resource allocation. When current and future reproductive effort trade off, variation in resource acquisition might further cause sex differences in age-dependent investment, or in sensitivity to changes in resource availability over time. However, the nature and prevalence of sex differences in age-dependent investment remain unclear. We manipulated resource acquisition at juvenile and adult stages in decorated crickets, Gryllodes sigillatus, and assessed effects on sex-specific allocation to age-dependent reproductive effort (calling in males, fecundity in females) and longevity. We predicted that the resource and time demands of egg production would result in relatively consistent female strategies across treatments, whereas male investment should depend sharply on diet. Contrary to expectations, female age-dependent reproductive effort diverged substantially across treatments, with resource-limited females showing much lower and later investment in reproduction; the highest fecundity was associated with intermediate lifespans. In contrast, long-lived males always signalled more than short-lived males, and male age-dependent reproductive effort did not depend on diet. We found consistently positive covariance between male reproductive effort and lifespan, whereas diet altered this covariance in females, revealing sex differences in the benefits of allocation to longevity. Our results support sex-specific selection on allocation patterns, but also suggest a simpler alternative: males may use social feedback to make allocation decisions and preferentially store resources as energetic reserves in its absence. Increased calling effort with age therefore could be caused by gradual resource accumulation, heightened mortality risk over time, and a lack of feedback from available mates. © 2015 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2015 European Society For Evolutionary

Influence of female sex and fertile age on neuromyelitis optica spectrum disorders.

PubMed

Borisow, Nadja; Kleiter, Ingo; Gahlen, Anna; Fischer, Katrin; Wernecke, Klaus-Dieter; Pache, Florence; Ruprecht, Klemens; Havla, Joachim; Krumbholz, Markus; Kümpfel, Tania; Aktas, Orhan; Ringelstein, Marius; Geis, Christian; Kleinschnitz, Christoph; Berthele, Achim; Hemmer, Bernhard; Angstwurm, Klemens; Weissert, Robert; Stellmann, Jan-Patrick; Schuster, Simon; Stangel, Martin; Lauda, Florian; Tumani, Hayrettin; Mayer, Christoph; Zeltner, Lena; Ziemann, Ulf; Linker, Ralf A; Schwab, Matthias; Marziniak, Martin; Then Bergh, Florian; Hofstadt-van Oy, Ulrich; Neuhaus, Oliver; Winkelmann, Alexander; Marouf, Wael; Rückriem, Lioba; Faiss, Jürgen; Wildemann, Brigitte; Paul, Friedemann; Jarius, Sven; Trebst, Corinna; Hellwig, Kerstin

2017-07-01

Gender and age at onset are important epidemiological factors influencing prevalence, clinical presentation, and treatment response in autoimmune diseases. To evaluate the impact of female sex and fertile age on aquaporin-4-antibody (AQP4-ab) status, attack localization, and response to attack treatment in patients with neuromyelitis optica (NMO) and its spectrum disorders (neuromyelitis optica spectrum disorder (NMOSD)). Female-to-male ratios, diagnosis at last visit (NMO vs NMOSD), attack localization, attack treatment, and outcome were compared according to sex and age at disease or attack onset. A total of 186 NMO/SD patients (82% female) were included. In AQP4-ab-positive patients, female predominance was most pronounced during fertile age (female-to-male ratio 23:1). Female patients were more likely to be positive for AQP4-abs (92% vs 55%; p < 0.001). Interval between onset and diagnosis of NMO/SD was longer in women than in men (mean 54 vs 27 months; p = 0.023). In women, attacks occurring ⩽40 years of age were more likely to show complete remission ( p = 0.003) and better response to high-dose intravenous steroids ( p = 0.005) compared to woman at >40 years. Our data suggest an influence of sex and age on susceptibility to AQP4-ab-positive NMO/SD. Genetic and hormonal factors might contribute to pathophysiology of NMO/SD.

Preschoolers' Beliefs about Sex and Age Differences in Emotionality.

ERIC Educational Resources Information Center

Karbon, Mariss; And Others

1992-01-01

Assesses beliefs of 32 male and 35 female middle-class preschool children about the frequency and intensity with which girls, boys, women, and men experience anger, sadness, and happiness. Children's beliefs are complex; they vary as a function of the target person's age and sex and of the specific emotion. (SLD)

[Chinese Total Diet Study in 2000. Cadium intakes by different age-sex population groups].

PubMed

Zhang, Lei; Gao, Junquan; Li, Xiaowei

2008-05-01

To estimate the dietary cadium intakes by different age-sex groups in China. The cadium concentrations of food sample from 3rd Chinese total diet study were determined, and then combine these data with the food consumption by population of ten age-sex groups, The cadium intakes, and its distribution and dietary sources were obtained. It was found that the mean and median concentrations of cadium in all food samples were 0.046 and 0.006 mg/kg, respectively. The cadium contents in shellfish and liver were far higher than other food staffs. The cadium intakes by different age-sex groups were estimated to be 12.0 - 25.9 microg/day, ranged from 30.3% to 67.0% of PTWI. The individual dietary cadium intakes by 14% children in 2 - 7 years old group exceed PTWI. Cereals, vegetables and seafood were the main sources of cadium exposure, and contributed about 80% of total intakes. Although the dietary cadium intakes by different age-sex groups are all lower than PTWI, they are increased in the past decade. Moreover, in some provinces, the cadium burden of people is heavy.

Relationship between cortisol reactivity to psychosocial stress and declarative memory decline during aging: Impact of age and sex.

PubMed

Dos Santos, Aline Talita; Leyendecker, Dayse Maria D; Costa, Ana Lucia Siqueira; de Souza-Talarico, Juliana Nery

2018-01-01

To analyze the relationship between memory performance and the neuroendocrine and cardiovascular response to acute psychosocial stress in healthy older people, and the sex and age impact in this relationship. We randomly selected 100 literate older adults, without cognitive or functional impairment. The neuroendocrine stress response was evaluated by measuring the concentration of salivary cortisol, whereas cardiovascular reactions were determined based on blood pressure and heart rate measures taken before, during and after participant exposure to an acute psychosocial stressor (the Trier social stress test [TSST]). Memory performance was evaluated by applying the word pairs test before and after the TSST. A significant reduction in the word pair test scores was observed after the TSST, and a negative correlation between cortisol concentration and immediate and delayed recall of the word pair. Cortisol concentration associated with age, sex and education explained memory performance variability before and after the TSST. The results showed that the influence of acute stress on memory performance during aging might vary according to age and sex, highlighting potential differences in the vulnerability of older individuals to the neurotoxic effects of stress exposure on memory and consequently on the development of cognitive disorders. Geriatr Gerontol Int 2018; 18: 169-176. © 2017 Japan Geriatrics Society.

Odour-Mediated Orientation of Beetles Is Influenced by Age, Sex and Morph

PubMed Central

Arnold, Sarah E. J.; Stevenson, Philip C.; Belmain, Steven R.

2012-01-01

The behaviour of insects is dictated by a combination of factors and may vary considerably between individuals, but small insects are often considered en masse and thus these differences can be overlooked. For example, the cowpea bruchid Callosobruchus maculatus F. exists naturally in two adult forms: the active (flight) form for dispersal, and the inactive (flightless), more fecund but shorter-lived form. Given that these morphs show dissimilar biology, it is possible that they differ in odour-mediated orientation and yet studies of this species frequently neglect to distinguish morph type, or are carried out only on the inactive morph. Along with sex and age of individual, adult morph could be an important variable determining the biology of this and similar species, informing studies on evolution, ecology and pest management. We used an olfactometer with motion-tracking to investigate whether the olfactory behaviour and orientation of C. maculatus towards infested and uninfested cowpeas and a plant-derived repellent compound, methyl salicylate, differed between morphs or sexes. We found significant differences between the behaviour of male and female beetles and beetles of different ages, as well as interactive effects of sex, morph and age, in response to both host and repellent odours. This study demonstrates that behavioural experiments on insects should control for sex and age, while also considering differences between adult morphs where present in insect species. This finding has broad implications for fundamental entomological research, particularly when exploring the relationships between physiology, behaviour and evolutionary biology, and the application of crop protection strategies. PMID:23145074

Age-related sex differences in language lateralization: A magnetoencephalography study in children.

PubMed

Yu, Vickie Y; MacDonald, Matt J; Oh, Anna; Hua, Gordon N; De Nil, Luc F; Pang, Elizabeth W

2014-09-01

It is well supported by behavioral and neuroimaging studies that typical language function is lateralized to the left hemisphere in the adult brain and this laterality is less well defined in children. The behavioral literature suggests there maybe be sex differences in language development, but this has not been examined systematically with neuroimaging. In this study, magnetoencephalography was used to investigate the spatiotemporal patterns of language lateralization as a function of age and sex. Eighty typically developing children (46 female, 34 male; 4-18 years) participated in an overt visual verb generation task. An analysis method called differential beamforming was used to analyze language-related changes in oscillatory activity referred to as low-gamma event-related desynchrony (ERD). The proportion of ERD over language areas relative to total ERD was calculated. We found different patterns of laterality between boys and girls. Boys showed left-hemisphere lateralization in the frontal and temporal language-related areas across age groups, whereas girls showed a more bilateral pattern, particularly in frontal language-related areas. Differences in patterns of ERD were most striking between boys and girls in the younger age groups, and these patterns became more similar with increasing age, specifically in the preteen years. Our findings show sex differences in language lateralization during childhood; however, these differences do not seem to persist into adulthood. We present possible explanations for these differences. We also discuss the implications of these findings for presurgical language mapping in children and highlight the importance of examining the question of sex-related language differences across development.

Differences in Prevalence of Symptomatic Zika Virus Infection, by Age and Sex-Puerto Rico, 2016.

PubMed

Lozier, Matthew J; Burke, Rachel M; Lopez, Juan; Acevedo, Veronica; Amador, Manuel; Read, Jennifer S; Jara, Amanda; Waterman, Stephen H; Barrera, Roberto; Muñoz-Jordan, Jorge; Rivera-Garcia, Brenda; Sharp, Tyler M

2018-05-05

During the outbreak of Zika virus (ZIKV) disease in Puerto Rico in 2016, nonpregnant women aged 20-39 years were disproportionately identified with ZIKV disease. We used household-based cluster investigations to determine whether this disparity was associated with age- or sex-dependent differences in the rate of ZIKV infection or reported symptoms. Participation was offered to residents of households within a 100-m radius of the residences of a convenience sample of 19 laboratory-confirmed ZIKV disease cases. Participants answered a questionnaire and provided specimens for diagnostic testing by reverse transcription-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). Among 367 study participants, 114 (31.1%) were laboratory positive for ZIKV infection, of whom 30% reported a recent illness (defined as self-reported rash or arthralgia) attributable to ZIKV infection. Age and sex were not associated with ZIKV infection. Female sex (adjusted prevalence ratio [aPR], 2.28; 95% confidence interval [CI], 1.40, 3.67), age <40 years (aPR, 2.39; 95% CI, 1.55, 3.70), and asthma (aPR, 1.63; 95% CI, 1.12, 2.37) were independently associated with symptomatic infection. Although neither female sex nor age were associated with an increased prevalence of ZIKV infection, both were associated with symptomatic infection. Further investigation to identify a potential mechanism of age- and sex-dependent differences in reporting symptomatic ZIKV infection is warranted.

Age- and sex-specific mortality and population structure in sea otters

USGS Publications Warehouse

Bodkin, James L.; Burdin, A.M.; Ryazanov, D.A.

2000-01-01

We used 742 beach-cast carcasses to characterize age- and sex-specific sea otter mortality during the winter of 1990-1991 at Bering Island, Russia. We also examined 363 carcasses recovered after the 1989 grounding of the T/V Exxon Valdez, to characterize age and sex composition in the living western Prince William Sound (WPWS) sea otter population. At Bering Island, mortality was male-biased (81%), and 75% were adults. The WPWS population was female-biased (59%) and most animals were subadult (79% of the males and 45% of the females). In the decade prior to 1990-1991 we found increasing sea otter densities (particularly among males), declining prey resources, and declining weights in adult male sea otters at Bering Island. Our findings suggest the increased mortality at Bering Island in 1990-1991 was a density-dependent population response. We propose male-maintained breeding territories and exclusion of juvenile females by adult females, providing a mechanism for maintaining densities in female areas below densities in male areas and for potentially moderating the effects of prey reductions on the female population. Increased adult male mortality at Bering Island in 1990-1991 likely modified the sex and age class structure there toward that observed in Prince William Sound.

Predicting excess cost for older inpatients with clinical complexity: A retrospective cohort study examining cognition, comorbidities and complications

PubMed Central

Draper, Brian; Berry, Helen; Karmel, Rosemary; Goss, John

2018-01-01

Background Hospital-acquired complications increase length of stay and contribute to poorer patient outcomes. Older adults are known to be at risk for four key hospital-acquired complications (pressure injuries, pneumonia, urinary tract infections and delirium). These complications have been identified as sensitive to nursing characteristics such as staffing levels and level of education. The cost of these complications compared to the cost of admission severity, dementia, other comorbidities or age has not been established. Method To investigate costs associated with nurse-sensitive hospital-acquired complications in an older patient population 157,178 overnight public hospital episodes for all patients over age 50 from one Australian state, 2006/07 were examined. A retrospective cohort study design with linear regression analysis provided modelling of length-of-stay costs. Explanatory variables included patient age, sex, comorbidities, admission severity, dementia status, surgical status and four complications. Extra costs were based on above-average length-of-stay for each patient’s Diagnosis Related Group from hospital discharge data. Results For adults over 50 who have length of stay longer than average for their diagnostic condition, comorbid dementia predicts an extra cost of A$874, (US$1,247); any one of four key complications predicts A$812 (US$1,159); each increase in admission severity score predicts A$295 ($US421); each additional comorbidity predicts A$259 (US$370), and for each year of age above 50 predicts A$20 (US$29) (all estimates significant at p<0.0001). Discussion Hospital-acquired complications and dementia cost more than other kinds of inpatient complexity, but admission severity is a better predictor of excess cost. Because complications are potentially preventable and dementia care in hospitals can be improved, risk-reduction strategies for common complications, particularly for patients with dementia could be cost effective. Conclusions

Smoking-Cessation Efforts by US Adult Smokers with Medical Comorbidities.

PubMed

Kalkhoran, Sara; Kruse, Gina R; Chang, Yuchiao; Rigotti, Nancy A

2018-03-01

Continued cigarette smoking by individuals with chronic medical diseases can adversely affect their symptoms, disease progression, and mortality. We assessed the association between medical comorbidities and smoking-cessation efforts among US adult smokers. We analyzed cross-sectional data from 12,494 past-year cigarette smokers aged ≥18 years from Wave 1 (2013-2014) of the nationally representative Population Assessment of Tobacco and Health study. We assessed the association between self-reported medical comorbidities and past-year quit attempts, use of evidence-based smoking-cessation treatment or electronic cigarettes, and successful smoking cessation using logistic regression, adjusting for sociodemographics, insurance status, geographic region, and having a past-year doctor visit. In the study sample, 39% were aged 18 to 34 years, 45% were female, 70% were non-Hispanic white, and 48% reported ≥1 comorbidity. Smokers with any comorbidity, compared with those without comorbidities, had higher odds of trying to quit (adjusted odds ratio, 1.19; 95% confidence interval, 1.08-1.30), but no higher likelihood of quitting success. Having more medical comorbidities was associated with increased odds of trying to quit. Smokers with a comorbidity used evidence-based treatment more often than smokers without comorbidities (43% vs 26%); use of e-cigarettes to quit was similar between smokers with and without comorbidities (27% vs 28%). Adult smokers with chronic medical diseases try to quit and use evidence-based tobacco-cessation treatment more often than smokers without comorbidities, but they are no more likely to quit, suggesting that their quit attempts are less likely to succeed. Smokers with medical comorbidities may require more intensive, prolonged, and repeated treatment to stop smoking. Copyright © 2018 Elsevier Inc. All rights reserved.

Common comorbidities in women and men with epilepsy and the relationship between number of comorbidities and health plan paid costs in 2010.

PubMed

Wilner, A N; Sharma, B K; Soucy, A; Thompson, A; Krueger, A

2014-03-01

The objectives of this observational study were to determine the prevalence of the most common comorbidities in women and men with epilepsy and to demonstrate the relationship of these comorbidities to health plan paid costs. Data for 6621 members with epilepsy (52% women, 48% men) from eight commercial health plans were analyzed. The presence of comorbidities in people with epilepsy was identified by searching health insurance claims for 29 prespecified comorbidity-specific diagnosis codes. More women (50%) than men (43%) with epilepsy had one or more of the 29 comorbidities (p<0.05). The top 10 comorbidities for women and their relative prevalences were psychiatric diagnosis (16%), hypertension (12%), asthma (11%), hyperlipidemia (11%), headache (7%), diabetes (6%), urinary tract infection (5%), hypothyroidism (5%), anemia (5%), and migraine (4%). For men, the top 10 comorbidities and their relative prevalences were psychiatric diagnosis (15%), hyperlipidemia (12%), hypertension (12%), asthma (8%), diabetes (5%), headache (4%), cancer (4%), coronary artery disease (3%), anemia (3%), and gastroesophageal reflux disease (3%). Seven of the top 10 comorbidities were common to both women and men. Psychiatric diagnosis was the only comorbidity among the top five comorbidities for all age groups. The presence of one comorbidity approximately tripled the health-care cost for that member compared with the cost for members who had no comorbidities. Additional comorbidities generally further increased costs. The increase in health-care cost per member per month ($) with increase in number of comorbidities was greater for men than for women (p<0.05). Copyright © 2014 Elsevier Inc. All rights reserved.

Sex, Aging, and Preexisting Cerebral Ischemic Disease in Patients With Aortic Stenosis

PubMed Central

Wang, Ping; Acker, Michael A.; Bilello, Michel; Melhem, Elias R.; Stambrook, Elizabeth; Ratcliffe, Sarah J.; Floyd, Thomas F.

2011-01-01

Background Patients undergoing cardiac surgery have a high frequency of preexisting cerebral ischemic lesions, the presence of which appears to predict cognitive sequelae. Patients undergoing aortic valve replacement for aortic stenosis (AS) incur an exceptionally high risk for perioperative cerebral ischemia. The extreme risk in this subgroup may arise from the preexisting burden of cerebral ischemic disease. We tested the hypotheses that increasing age, female sex, coronary artery disease, and the severity of AS are predictive of the severity of preexisting cerebral ischemic lesions. Methods A total of 95 subjects were included in this study. Subjects were imaged on 1.5 Tesla magnetic resonance imaging scanners to obtain multimodal image sets which were used for the automatic segmentation of cerebral lesion volume. The dependence of lesion volume upon age, sex, coronary artery disease, and the severity of AS were tested. Results The results demonstrate a strong correlation between aging, female sex, and white matter and ischemia-like lesion volume in patients with aortic stenosis. Conclusions Women and those of advanced age presenting for aortic valve replacement for AS may incur a particularly high risk for postoperative neurologic sequelae due to an exceptional preexisting burden of cerebral ischemic disease. PMID:20868818

Persistent Sex Disparities in Invasive Pneumococcal Diseases in the Conjugate Vaccine Era.

PubMed

de St Maurice, Annabelle; Schaffner, William; Griffin, Marie R; Halasa, Natasha; Grijalva, Carlos G

2016-09-01

Few studies have characterized the role of sex on the incidence of invasive pneumococcal disease (IPD). We examined sex differences in rates of IPD, and trends after the introduction of pneumococcal conjugate vaccines (PCVs). We used active population and laboratory-based IPD surveillance data from the Centers for Disease Control and Prevention Active Bacterial Core surveillance program (1998-2013) in Tennessee. Population-based rates of IPD by sex, race, age group, and PCV era were calculated. Rates were compared using incidence rate ratios. Throughout the study years, rates of IPD were higher in male than in female subjects, particularly in children <2 years and adults 40-64 years of age, with male subjects having IPD rates 1.5-2 times higher than female subjects. The proportions of comorbid conditions were similar in male and female subjects . Sex rate differences persisted after stratification by race. Although the introductions of 7-valent PCV (PCV7) and 13-valent PCV (PCV13) were associated with declines in IPD rates in both sexes, rates of IPD after PCV13 were still significantly higher in male than in female subjects among children and adults 40-64 and >74 years of age. Rates of IPD were generally higher in male than in female subjects. These sex differences were observed in different race groups and persisted after introduction of both PCVs. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Apolipoprotein E and Alzheimer disease: Genotype-specific risks by age and sex

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bickeboeller, H.; Babron, M.C.; Clerget-Darpoux, F.

1997-02-01

The distribution of apolipoprotein E (APOE) genotypes as a function of age and sex has been examined in a French population of 417 Alzheimer disease (AD) patients and 1,030 control subjects. When compared to the APOE {epsilon}3 allele, an increased risk associated with the APOE {epsilon}4 allele (odds ratio [OR] [{epsilon}4] = 2.7 with 95% confidence interval [CI] = 2.0-3.6; P < .001) and a protective effect of the APOE {epsilon}2 allele (OR[{epsilon}2] = 0.5 with 95% CI = 0.3-0.98; P = .012) were retrieved. An effect of the {epsilon}4 allele dosage on susceptibility was confirmed (OR[{epsilon}4/{epsilon}4] vs. the {epsilon}3/{epsilon}3more » genotype = 11.2 [95% CI = 4.0-31.6]; OR[{epsilon}3/{epsilon}4] vs. the {epsilon}3/{epsilon}3 genotype = 2.2 [95% Cl = 1.5-3.5]). The frequency of the {epsilon}4 allele was lower in male cases than in female cases, but, since a similar difference was found in controls, this does not lead to a difference in OR between sex. ORs for the {epsilon}4 allele versus the {epsilon}3 allele, OR({epsilon}4), were not equal in all age classes: OR({epsilon}4) in the extreme groups with onset at < 60 years or > 79 years were significantly lower than those from the age groups 60-79 years. In {epsilon}3/{epsilon}4 individuals, sex-specific lifetime risk estimates by age 85 years (i.e., sex-specific penetrances by age 85 years) were 0.14 (95% CI 0.04-0.30) for men and 0.17 (95% CI 0.09-0.28) for women. 53 refs., 1 fig., 3 tabs.« less

Trajectories of plasma IGF-1, IGFBP-3, and their ratio in the Mayo Clinic Study of Aging.

PubMed

Wennberg, Alexandra M V; Hagen, Clinton E; Petersen, Ronald C; Mielke, Michelle M

2018-06-01

Insulin-like growth factor 1 (IGF-1) has been associated with osteoporosis, cardiovascular disease, cancer, neurodegenerative diseases, and mortality in middle and older aged adults. Cross-sectionally, IGF-1 decreases with age and levels of IGF-1 are markedly different between individuals. However, little is known about intra-individual trajectories of IGF-1. We examined baseline and serial measures of plasma total IGF-1, IGF binding protein (IGFBP)-3, and their ratio, which is a proxy for bioavailable IGF-1, among 1618 adults, aged 50-95, enrolled in the Mayo Clinic Study of Aging. At baseline, IGF-1 and IGFBP-3 were strongly correlated (r = 0.62, p < 0.001). Total IGF-1 and IGFBP-3 decreased across age, while the ratio of IGF-1/IGFBP-3 increased across age. This pattern was consistent across ages at baseline and intra-individually over an average 2.3 years follow-up (range = 10 months-5.6 years). In age-adjusted linear regression models, baseline levels of total IGF-1, IGFBP-3, and IGF-1/IGFBP-3 varied by participant characteristics (sex, BMI, gait speed), medical comorbidities (Charlson comorbidity index score, hypertension, diabetes, and cardiovascular disease), and hormone replacement therapy use in women. High interclass correlation coefficients (ICCs) suggest little intra-individual variability in levels of total IGF-1 (ICC = 0.84), IGFBP-3 (ICC = 0.88), and IGF-1/IGFBP-3 (ICC = 0.81) over time. In mixed effects models that specified age as a time scale, men showed greater decreases in total IGF-1 and IGFBP-3 with age, while more comorbidities and decreasing gait speed were associated with increasing IGFBP-3. In sex-stratified models, trajectories of total IGF-1, IGFBP-3, and IGF-1/IGFBP-3, as a function of participant demographics, health characteristics, and medical conditions, differed between men and women. These results suggest that change in levels of plasma total IGF-1, IGFBP-3, and IGF-1/IGFBP-3 are associated with

Racial/ethnic differences in obesity and comorbidities between safety-net- and non safety-net integrated health systems

PubMed Central

Balasubramanian, Bijal A.; Garcia, Michael P.; Corley, Douglas A.; Doubeni, Chyke A.; Haas, Jennifer S.; Kamineni, Aruna; Quinn, Virginia P.; Wernli, Karen; Zheng, Yingye; Skinner, Celette Sugg

2017-01-01

Abstract Previous research shows that patients in integrated health systems experience fewer racial disparities compared with more traditional healthcare systems. Little is known about patterns of racial/ethnic disparities between safety-net and non safety-net integrated health systems. We evaluated racial/ethnic differences in body mass index (BMI) and the Charlson comorbidity index from 3 non safety-net- and 1 safety-net integrated health systems in a cross-sectional study. Multinomial logistic regression modeled comorbidity and BMI on race/ethnicity and health care system type adjusting for age, sex, insurance, and zip-code-level income The study included 1.38 million patients. Higher proportions of safety-net versus non safety-net patients had comorbidity score of 3+ (11.1% vs. 5.0%) and BMI ≥35 (27.7% vs. 15.8%). In both types of systems, blacks and Hispanics were more likely than whites to have higher BMIs. Whites were more likely than blacks or Hispanics to have higher comorbidity scores in a safety net system, but less likely to have higher scores in the non safety-nets. The odds of comorbidity score 3+ and BMI 35+ in blacks relative to whites were significantly lower in safety-net than in non safety-net settings. Racial/ethnic differences were present within both safety-net and non safety-net integrated health systems, but patterns differed. Understanding patterns of racial/ethnic differences in health outcomes in safety-net and non safety-net integrated health systems is important to tailor interventions to eliminate racial/ethnic disparities in health and health care. PMID:28296752

Physician styles of decision-making for a complex condition: Type 2 diabetes with co-morbid mental illness.

PubMed

Trachtenberg, Felicia L; Pober, David M; Welch, Lisa C; McKinlay, John B

Variation in physician decisions may reflect personal styles of decision-making, as opposed to singular clinical actions and these styles may be applied differently depending on patient complexity. The objective of this study is to examine clusters of physician decision-making for type 2 diabetes, overall and in the presence of a mental health co-morbidity. This randomized balanced factorial experiment presented video vignettes of a "patient" with diagnosed, but uncontrolled type 2 diabetes. "Patients" were systematically varied by age, sex, race and co-morbidity (depression, schizophrenia with normal or bizarre affect, eczema as control). Two hundred and fifty-six primary care physicians, balanced by gender and experience level, completed a structured interview about clinical management. Cluster analysis identified 3 styles of diabetes management. "Minimalists" (n=84) performed fewer exams or tests compared to "middle of the road" physicians (n=84). "Interventionists" (n=88) suggested more medications and referrals. A second cluster analysis, without control for co-morbidities, identified an additional cluster of "information seekers" (n=15) who requested more additional information and referrals. Physicians ranking schizophrenia higher than diabetes on their problem list were more likely "minimalists" and none were "interventionists" or "information seekers". Variations in clinical management encompass multiple clinical actions and physicians subtly shift these decision-making styles depending on patient co-morbidities. Physicians' practice styles may help explain persistent differences in patient care. Training and continuing education efforts to encourage physicians to implement evidence-based clinical practice should account for general styles of decision-making and for how physicians process complicating comorbidities.

Unique sex- and age-dependent effects in protective pathways in acute kidney injury.

PubMed

Boddu, Ravindra; Fan, Chunlan; Rangarajan, Sunil; Sunil, Bhuvana; Bolisetty, Subhashini; Curtis, Lisa M

2017-09-01

Sex and age influence susceptibility to acute kidney injury (AKI), with young females exhibiting lowest incidence. In these studies, we investigated mechanisms which may underlie the sex/age-based dissimilarities. Cisplatin (Cp)-induced AKI resulted in morphological evidence of injury in all groups. A minimal rise in plasma creatinine (PCr) was seen in Young Females, whereas in Aged Females, PCr rose precipitously. Relative to Young Males, Aged Males showed significantly, but temporally, comparably elevated PCr. Notably, Aged Females showed significantly greater mortality, whereas Young Females exhibited none. Tissue KIM-1 and plasma NGAL were significantly lower in Young Females than all others. IGFBP7 levels were modestly increased in both Young groups. IGFBP7 levels in Aged Females were significantly elevated at baseline relative to Aged Males, and increased linearly through day 3 , when these levels were comparable in both Aged groups. Plasma cytokine levels similarly showed a pattern of protective effects preferentially in Young Females. Expression of the drug transporter MATE2 did not explain the sex/age distinctions. Heme oxygenase-1 (HO-1) levels (~28-kDa species) showed elevation at day 1 in all groups with highest levels seen in Young Males. Exclusively in Young Females, these levels returned to baseline on day 3 , suggestive of a more efficient recovery. In aggregate, we demonstrate, for the first time, a distinctive pattern of response to AKI in Young Females relative to males which appears to be significantly altered in aging. These distinctions may offer novel targets to exploit therapeutically in both females and males in the treatment of AKI.

Effects of genes, sex, age, and activity on BMC, bone size, and areal and volumetric BMD.

PubMed

Havill, Lorena M; Mahaney, Michael C; L Binkley, Teresa; Specker, Bonny L

2007-05-01

Quantitative genetic analyses of bone data for 710 inter-related individuals 8-85 yr of age found high heritability estimates for BMC, bone area, and areal and volumetric BMD that varied across bone sites. Activity levels, especially time in moderate plus vigorous activity, had notable effects on bone. In some cases, these effects were age and sex specific. Genetic and environmental factors play a complex role in determining BMC, bone size, and BMD. This study assessed the heritability of bone measures; characterized the effects of age, sex, and physical activity on bone; and tested for age- and sex-specific bone effects of activity. Measures of bone size and areal and volumetric density (aBMD and vBMD, respectively) were obtained by DXA and pQCT on 710 related individuals (466 women) 8-85 yr of age. Measures of activity included percent time in moderate + vigorous activity (%ModVig), stair flights climbed per day, and miles walked per day. Quantitative genetic analyses were conducted to model the effects of activity and covariates on bone outcomes. Accounting for effects of age, sex, and activity levels, genes explained 40-62% of the residual variation in BMC and BMD and 27-75% in bone size (all p<0.001). Decline in femoral neck (FN), hip, and spine aBMD with advancing age was greater among women than men (age-by-sex interaction; all p sex-by-activity interaction, both p

Age and sex selectivity in trapping mule deer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Garrott, R.A.; White, G.C.

1982-01-01

A mule deer (Odocoileus hemionus) trapping experiment is described using modified Clover traps in which changes in the placement of bait and height of the trap door modified the ratio of adult does to male and female fawns captured. The mechanisms responsible for the changes in age-sex capture ratios are discussed and indicate that modified Clover traps selectivity capture mule deer, thus introducing bias into population sampling. (JMT)

Frailty as a Novel Predictor of Mortality and Hospitalization in Hemodialysis Patients of All Ages

PubMed Central

McAdams-DeMarco, Mara A.; Law, Andrew; Salter, Megan L.; Boyarsky, Brian; Gimenez, Luis; Jaar, Bernard G.; Walston, Jeremy D.; Segev, Dorry L.

2013-01-01

Objectives To quantify the prevalence of frailty in adult patients of all ages undergoing chronic hemodialysis, its relationship to comorbidity and disability, and its association with adverse outcomes of mortality and hospitalization. Design Prospective cohort study. Setting Single hemodialysis center in Baltimore, Maryland. Participants 146 prevalent hemodialysis patients enrolled between January 2009 and March 2010 and followed through August 2012. Measurements Frailty, comorbidity, and disability on enrollment into the study and subsequent mortality and hospitalizations. Results At enrollment, 50.0% of older (age≥65) and 35.4% of younger (age<65) hemodialysis patients were frail; 35.9% and 29.3% were intermediately frail, respectively. The 3-year mortality was 16.2% for non frail, 34.4% for intermediately frail, and 40.2% for frail participants. Intermediate frailty and frailty were associated with a 2.68-fold (95% CI: 1.02-7.07, P=0.046) and 2.60-fold (95%CI: 1.04-6.49, P=0.041) higher risk of death independent of age, sex, comorbidity, and disability. In the year after enrollment, median number of hospitalizations was 1 (IQR 0-3). The proportion with 2 or more hospitalizations was 28.2% for non frail, 25.5% for intermediately frail, and 42.6% for frail participants. While intermediate frailty was not associated with the number of hospitalizations (RR=0.76, 95%CI:0.49-1.16, P=0.21), frailty was associated with a 1.43-fold (95%CI:1.00-2.03, P=0.049) higher number of hospitalizations independent of age, sex, comorbidity, and disability. The association of frailty with mortality and hospitalizations did not differ between older and younger participants (Interaction P=0.64 and P=0.14, respectively). Conclusions Adults of all ages undergoing hemodialysis have a very high prevalence of frailty, more than 5-fold higher than community dwelling older adults. In this population, regardless of age, frailtyis a strong, independent predictor of mortality and number of

Neuropsychological sex differences associated with age of initiated use among young adult cannabis users.

PubMed

Crane, Natania A; Schuster, Randi Melissa; Mermelstein, Robin J; Gonzalez, Raul

2015-01-01

Earlier initiation of cannabis use is associated with poorer neuropsychological functioning across several domains. Given well-documented sex differences in neuromaturation during adolescence, initiation of cannabis use during this time may affect neuropsychological functioning differently for males and females. In the current study, we examined sex differences in the relationship between age of initiated cannabis use and neuropsychological performance after controlling for amount of lifetime cannabis use in 44 male and 25 female young adult cannabis users. We found that an earlier age of initiated use was related to poorer episodic memory, especially immediate recall, in females, but not in males. On the other hand, we found that, surprisingly, an earlier age of initiated use was associated with better decision making overall. However, exploratory analyses found sex-specific factors associated with decision making and age of initiated use, specifically that attention-deficit/hyperactivity disorder (ADHD) symptoms in females may drive the relationship between an earlier age of initiated use and better decision making. Further, an earlier age of initiated use was associated with less education, a lower IQ, and fewer years of mother's education for females, but more lifetime cannabis use for males. Taken together, our findings suggest there are sex differences in the associations between age of initiated cannabis use and neuropsychological functioning. The current study provides preliminary evidence that males and females may have different neuropsychological vulnerabilities that place them at risk for initiating cannabis use and continued cannabis use, highlighting the importance of examining the impact of cannabis on neuropsychological functioning separately for males and females.

Sex-related differences in the wheel-running activity of mice decline with increasing age.

PubMed

Bartling, Babett; Al-Robaiy, Samiya; Lehnich, Holger; Binder, Leonore; Hiebl, Bernhard; Simm, Andreas

2017-01-01

Laboratory mice of both sexes having free access to running wheels are commonly used to study mechanisms underlying the beneficial effects of physical exercise on health and aging in human. However, comparative wheel-running activity profiles of male and female mice for a long period of time in which increasing age plays an additional role are unknown. Therefore, we permanently recorded the wheel-running activity (i.e., total distance, median velocity, time of breaks) of female and male mice until 9months of age. Our records indicated higher wheel-running distances for females than males which were highest in 2-month-old mice. This was mainly reached by higher running velocities of the females and not by longer running times. However, the sex-related differences declined in parallel to the age-associated reduction in wheel-running activities. Female mice also showed more variances between the weekly running distances than males, which were recorded most often for females being 4-6months old but not older. Additional records of 24-month-old mice of both sexes indicated highly reduced wheel-running activities at old age. Surprisingly, this reduction at old age resulted mainly from lower running velocities and not from shorter running times. Old mice also differed in their course of night activity which peaked later compared to younger mice. In summary, we demonstrated the influence of sex on the age-dependent activity profile of mice which is somewhat contrasting to humans, and this has to be considered when transferring exercise-mediated mechanism from mouse to human. Copyright © 2016. Published by Elsevier Inc.

Ideal resuscitation pressure for uncontrolled hemorrhagic shock in different ages and sexes of rats

PubMed Central

2013-01-01

Introduction Our previous studies demonstrated that 50-60 mmHg mean arterial blood pressure was the ideal target hypotension for uncontrolled hemorrhagic shock during the active hemorrhage in sexually mature rats. The ideal target resuscitation pressure for immature and older rats has not been determined. Methods To elucidate this issue, using uncontrolled hemorrhagic-shock rats of different ages and sexes (6 weeks, 14 weeks and 1.5 years representing pre-adult, adult and older rats, respectively), the resuscitation effects of different target pressures (40, 50, 60, 70 and 80 mmHg) on uncontrolled hemorrhagic shock during active hemorrhage and the age and sex differences were observed. Results Different target resuscitation pressures had different resuscitation outcomes for the same age and sex of rats. The optimal target resuscitation pressures for 6-week-old, 14-week-old and 1.5-year-old rats were 40 to 50 mmHg, 50 to 60 mmHg and 70 mmHg respectively. Ideal target resuscitation pressures were significantly superior to other resuscitation pressures in improving the hemodynamics, blood perfusion, organ function and animal survival of uncontrolled hemorrhagic-shock rats (P < 0.01). For same target resuscitation pressures, the beneficial effect on hemorrhagic shock had a significant age difference (P < 0.01) but no sex difference (P > 0.05). Different resuscitation pressures had no effect on coagulation function. Conclusion Hemorrhagic-shock rats at different ages have different target resuscitation pressures during active hemorrhage. The ideal target resuscitation hypotension for 6-week-old, 14-week-old and 1.5-year-old rats was 40 to 50 mmHg, 50 to 60 mmHg and 70 mmHg, respectively. Their resuscitation effects have significant age difference but had no sex difference. PMID:24020401

Comorbidities among patients with cancer who do and do not develop febrile neutropenia during the first chemotherapy cycle.

PubMed

Li, Xiaoyan; Luthra, Rakesh; Morrow, Phuong K; Fisher, Maxine D; Reiner, Maureen; Barron, Richard L; Langeberg, Wendy J

2016-10-01

Patients receiving myelosuppressive chemotherapy with certain comorbidities are at increased risk of febrile neutropenia. A comprehensive evaluation of febrile neutropenia-related comorbidities across cancers is needed. This study compared comorbidity prevalence among patients with cancer who did and did not develop febrile neutropenia during the first chemotherapy cycle. This case-control study used administrative claims from adult patients with non-Hodgkin lymphoma or breast, lung, colorectal, ovarian, or gastric cancer who received chemotherapy between 2007 and 2012. Each patient who developed febrile neutropenia (case) was matched with up to four patients without febrile neutropenia (controls) by cancer type, metastasis, chemotherapy regimen, age group, and sex. For each comorbidity (identified in the year before chemotherapy began), the adjusted odds ratio (aOR) for febrile neutropenia by cancer type was evaluated using conditional logistic regression models adjusted for potential confounding factors. Of 31,331 eligible patients, 672 developed febrile neutropenia in the first chemotherapy cycle. A total of 3312 febrile neutropenia cases and matched controls were analyzed. Across tumor types, comorbidity prevalence was higher in patients who developed febrile neutropenia than in those without febrile neutropenia. Among patients with breast cancer, osteoarthritis was more prevalent in patients with febrile neutropenia (aOR, 1.85; 95% CI, 1.07 to 3.18). Among patients with non-Hodgkin lymphoma, renal disease was more prevalent in patients with febrile neutropenia (aOR, 2.25; 95% CI, 1.23 to 4.11). Patients who developed febrile neutropenia in the first chemotherapy cycle presented with comorbidities more often than otherwise similar patients who did not develop febrile neutropenia. These findings warrant further investigation and support the inclusion of comorbidities into febrile neutropenia risk models. © The Author(s) 2015.

Impact of comorbid conditions on participation in an organised colorectal cancer screening programme: a cross-sectional study.

PubMed

Guiriguet, Carolina; Pera, Guillem; Castells, Antoni; Toran, Pere; Grau, Jaume; Rivero, Irene; Buron, Andrea; Macià, Francesc; Vela-Vallespín, Carmen; Vilarrubí-Estrella, Mercedes; Marzo-Castillejo, Mercedes

2017-08-07

There is controversy regarding how comorbidity impacts on colorectal cancer screening, especially in the context of organised programmes. The aim of this study is to assess the effect of comorbidities on participation in the Barcelona population-based colorectal cancer screening programme (BCCSP). Cross-sectional study carried out in ten primary care centres involved in the BCCSP. Individuals aged 50 to 69, at average risk of colorectal cancer, who were invited to participate in the first round of the faecal immunochemical test-based BCCSP were included (2011-2012). The main variable was participation in the BCCSP. Comorbidity was assessed by clinical risk group status. Other adjusting variables were age, sex, socioeconomic deprivation, visits to primary care, smoking, alcohol consumption and body mass index. Logistic regression models were used to test the association between participation in the programme and potential explanatory variables. The results were given as incidence rate ratios (IRR) and their 95% confidence intervals (CI). Of the 36,208 individuals included, 17,404 (48%) participated in the BCCSP. Participation was statistically significantly higher in women, individuals aged 60 to 64, patients with intermediate socioeconomic deprivation, and patients with more medical visits. There was a higher rate of current smoking, high-risk alcohol intake, obesity and individuals in the highest comorbidity categories in the non-participation group. In the adjusted analysis, only individuals with multiple minor chronic diseases were more likely to participate in the BCCSP (IRR 1.14; 95% CI [1.06 to 1.22]; p < 0.001). In contrast, having three or more dominant chronic diseases was associated with lower participation in the screening programme (IRR 0.76; 95% CI [0.65 to 0.89]; p = 0.001). Having three or more dominant chronic diseases, was associated with lower participation in a faecal immunochemical test-based colorectal cancer screening programme, whereas

Sex Differences in Obesity and Mental Health.

PubMed

Tronieri, Jena Shaw; Wurst, Courtney McCuen; Pearl, Rebecca L; Allison, Kelly C

2017-06-01

The purposes of this study were to examine the relationships between obesity and a wide range of mental health issues and to identify where sex differences exist and may vary across disorders. Research on sex differences in the relationship between obesity and psychiatric disorders is more abundant in some areas, such as depression and eating disorders, than others, such as anxiety, trauma, and substance use. However, for most of the disorders, their relationships with obesity and sex are complex and are usually moderated by additional variables. Thus, studies that find stronger relationships for women between depression and obesity cross-sectionally do not tell the whole story, as longitudinal studies suggest that this relationship may also be present among men, particularly when confounders are considered. For those with eating disorders, men and women with obesity are fairly equally affected, and weight and shape concerns may play a role in maintaining these behaviors for both sexes. Weight stigma, though, seems to have worse consequences for women than men with obesity. Sex differences exist in relation to the associations between mental health and obesity. However, these differences vary by disorder, with disorder-specific moderators playing a role, such as age for depressive disorders, comorbid depression for anxiety disorders, and weight and shape concerns for eating disorders. More work is needed to understand if sex differences play a role in the relationship between obesity and anxiety, trauma, and substance use disorders.

High probability of comorbidities in bronchial asthma in Germany.

PubMed

Heck, S; Al-Shobash, S; Rapp, D; Le, D D; Omlor, A; Bekhit, A; Flaig, M; Al-Kadah, B; Herian, W; Bals, R; Wagenpfeil, S; Dinh, Q T

2017-04-21

Clinical experience has shown that allergic and non-allergic respiratory, metabolic, mental, and cardiovascular disorders sometimes coexist with bronchial asthma. However, no study has been carried out that calculates the chance of manifestation of these disorders with bronchial asthma in Saarland and Rhineland-Palatinate, Germany. Using ICD10 diagnoses from health care institutions, the present study systematically analyzed the co-prevalence and odds ratios of comorbidities in the asthma population in Germany. The odds ratios were adjusted for age and sex for all comorbidities for patients with asthma vs. without asthma. Bronchial asthma was strongly associated with allergic and with a lesser extent to non-allergic comorbidities: OR 7.02 (95%CI:6.83-7.22) for allergic rhinitis; OR 4.98 (95%CI:4.67-5.32) allergic conjunctivitis; OR 2.41 (95%CI:2.33-2.52) atopic dermatitis; OR 2.47 (95%CI:2.16-2.82) food allergy, and OR 1.69 (95%CI:1.61-1.78) drug allergy. Interestingly, increased ORs were found for respiratory diseases: 2.06 (95%CI:1.64-2.58) vocal dysfunction; 1.83 (95%CI:1.74-1.92) pneumonia; 1.78 (95%CI:1.73-1.84) sinusitis; 1.71 (95%CI:1.65-1.78) rhinopharyngitis; 2.55 (95%CI:2.03-3.19) obstructive sleep apnea; 1.42 (95%CI:1.25-1.61) pulmonary embolism, and 3.75 (95%CI:1.64-8.53) bronchopulmonary aspergillosis. Asthmatics also suffer from psychiatric, metabolic, cardiac or other comorbidities. Myocardial infarction (OR 0.86, 95%CI:0.79-0.94) did not coexist with asthma. Based on the calculated chances of manifestation for these comorbidities, especially allergic and respiratory, to a lesser extent also metabolic, cardiovascular, and mental disorders should be taken into consideration in the diagnostic and treatment strategy of bronchial asthma. PREVALENCE OF CO-EXISTING DISEASES IN GERMANY: Patients in Germany with bronchial asthma are highly likely to suffer from co-existing diseases and their treatments should reflect this. Quoc Thai Dinh at Saarland

Gene-Environment Interplay in Depressive Symptoms: Moderation by Age, Sex, and Physical Illness

PubMed Central

Petkus, Andrew J.; Beam, Christopher R.; Johnson, Wendy; Kaprio, Jaakko; Korhonen, Tellervo; McGue, Matt; Neiderhiser, Jenae M.; Pedersen, Nancy L.; Reynolds, Chandra A.; Gatz, Margaret

2017-01-01

Background Numerous factors influence late-life depressive symptoms in adults, many not thoroughly characterized. We addressed whether genetic and environmental influences on depressive symptoms differed by age, sex, and physical illness. Methods The analysis sample included 24,436 twins aged 40 through 90 drawn from the Interplay of Genes and Environment across Multiple Studies (IGEMS) consortium. Biometric analyses tested age, sex, and physical illness moderation of genetic and environmental variance in depressive symptoms. Results Women reported greater depressive symptoms than men. After age 60, there was an accelerating increase in depressive symptom scores with age, but this did not appreciably affect genetic and environmental variances. Overlap in genetic influences between physical illness and depressive symptoms was greater in men than in women. Additionally, in men extent of overlap was greater with worse physical illness (the genetic correlation ranged from near .00 for the least physical illness to nearly .60 with physical illness two SD above the mean). For men and women, the same environmental factors that influenced depressive symptoms also influenced physical illness. Conclusions Findings suggested that genetic factors play a larger part in the association between depressive symptoms and physical illness for men than for women. For both sexes, across all ages, physical illness may similarly trigger social and health limitations that contribute to depressive symptoms. PMID:28202098

Gene-environment interplay in depressive symptoms: moderation by age, sex, and physical illness.

PubMed

Petkus, A J; Beam, C R; Johnson, W; Kaprio, J; Korhonen, T; McGue, M; Neiderhiser, J M; Pedersen, N L; Reynolds, C A; Gatz, M

2017-07-01

Numerous factors influence late-life depressive symptoms in adults, many not thoroughly characterized. We addressed whether genetic and environmental influences on depressive symptoms differed by age, sex, and physical illness. The analysis sample included 24 436 twins aged 40-90 years drawn from the Interplay of Genes and Environment across Multiple Studies (IGEMS) Consortium. Biometric analyses tested age, sex, and physical illness moderation of genetic and environmental variance in depressive symptoms. Women reported greater depressive symptoms than men. After age 60, there was an accelerating increase in depressive symptom scores with age, but this did not appreciably affect genetic and environmental variances. Overlap in genetic influences between physical illness and depressive symptoms was greater in men than in women. Additionally, in men extent of overlap was greater with worse physical illness (the genetic correlation ranged from near 0.00 for the least physical illness to nearly 0.60 with physical illness 2 s.d. above the mean). For men and women, the same environmental factors that influenced depressive symptoms also influenced physical illness. Findings suggested that genetic factors play a larger part in the association between depressive symptoms and physical illness for men than for women. For both sexes, across all ages, physical illness may similarly trigger social and health limitations that contribute to depressive symptoms.

The role of psychiatric, cardiometabolic, and musculoskeletal comorbidity in the recurrence of depression-related work disability.

PubMed

Ervasti, Jenni; Vahtera, Jussi; Pentti, Jaana; Oksanen, Tuula; Ahola, Kirsi; Kivekäs, Teija; Kivimäki, Mika; Virtanen, Marianna

2014-09-01

Comorbid psychiatric disorders, cardiovascular disease, chronic hypertension, diabetes, and musculoskeletal disorders are highly prevalent in depression. However, the extent to which these conditions affect the recurrence of depression-related work disability is unknown. The specific aims of the study were to investigate the extent to which comorbid other psychiatric disorders, cardiometabolic, and musculoskeletal conditions were associated with the recurrence of depression-related work disability among employees who had returned to work after a depression-related disability episode. A cohort study of Finnish public sector employees with at least one depression-related disability episode during 2005-2011 after which the employee had returned to work (14,172 depression-related work disability episodes derived from national health and disability registers for 9,946 individuals). We used Cox proportional hazard models for recurrent events. Depression-related work disability recurred in 35% of the episodes that had ended in return to work from a previous episode, totaling 4,927 recurrent episodes among 3,095 (31%) employees. After adjustment for sex, age, socioeconomic status, and type of employment contract, comorbid psychiatric disorder (hazard ratio = 1.82, 95% CI 1.68-1.97), cardiovascular disease (1.39, 95% CI 1.04-1.87), diabetes (1.43, 95% CI 1.11-1.85), chronic hypertension (1.33, 95% CI 1.11-1.58), and musculoskeletal disorder (1.17, 95% CI 1.06-1.28) were associated with an increased risk of a recurrent episode compared to those without these comorbid conditions. Recurrence of depression-related work disability is common. Employees with comorbid psychiatric, cardiometabolic, or musculoskeletal conditions are at an increased risk of recurrent depression-related work disability episodes. © 2014 Wiley Periodicals, Inc.

Competition and Habitat Quality Influence Age and Sex Distribution in Wintering Rusty Blackbirds

PubMed Central

Mettke-Hofmann, Claudia; Hamel, Paul B.; Hofmann, Gerhard; Zenzal Jr., Theodore J.; Pellegrini, Anne; Malpass, Jennifer; Garfinkel, Megan; Schiff, Nathan

2015-01-01

Bird habitat quality is often inferred from species abundance measures during the breeding and non-breeding season and used for conservation management decisions. However, during the non-breeding season age and sex classes often occupy different habitats which suggest a need for more habitat-specific data. Rusty Blackbird (Euphagus carolinus) is a forested wetland specialist wintering in bottomland hardwood forests in the south-eastern U. S. and belongs to the most steeply declining songbirds in the U.S. Little information is available to support priority birds such as the Rusty Blackbird wintering in this threatened habitat. We assessed age and sex distribution and body condition of Rusty Blackbirds among the three major habitats used by this species in the Lower Mississippi Alluvial Valley and also measured food availability. Overall, pecan groves had the highest biomass mainly driven by the amount of nuts. Invertebrate biomass was highest in forests but contributed only a small percentage to overall biomass. Age and sex classes were unevenly distributed among habitats with adult males primarily occupying pecan groves containing the highest nut biomass, females being found in forests which had the lowest nut biomass and young males primarily staying in forest fragments along creeks which had intermediate nut biomass. Males were in better body condition than females and were in slightly better condition in pecan groves. The results suggest that adult males occupy the highest quality habitat and may competitively exclude the other age and sex classes. PMID:25946335

Competition and habitat quality influence age and sex distribution in wintering rusty blackbirds.

PubMed

Mettke-Hofmann, Claudia; Hamel, Paul B; Hofmann, Gerhard; Zenzal, Theodore J; Pellegrini, Anne; Malpass, Jennifer; Garfinkel, Megan; Schiff, Nathan; Greenberg, Russell

2015-01-01

Bird habitat quality is often inferred from species abundance measures during the breeding and non-breeding season and used for conservation management decisions. However, during the non-breeding season age and sex classes often occupy different habitats which suggest a need for more habitat-specific data. Rusty Blackbird (Euphagus carolinus) is a forested wetland specialist wintering in bottomland hardwood forests in the south-eastern U. S. and belongs to the most steeply declining songbirds in the U.S. Little information is available to support priority birds such as the Rusty Blackbird wintering in this threatened habitat. We assessed age and sex distribution and body condition of Rusty Blackbirds among the three major habitats used by this species in the Lower Mississippi Alluvial Valley and also measured food availability. Overall, pecan groves had the highest biomass mainly driven by the amount of nuts. Invertebrate biomass was highest in forests but contributed only a small percentage to overall biomass. Age and sex classes were unevenly distributed among habitats with adult males primarily occupying pecan groves containing the highest nut biomass, females being found in forests which had the lowest nut biomass and young males primarily staying in forest fragments along creeks which had intermediate nut biomass. Males were in better body condition than females and were in slightly better condition in pecan groves. The results suggest that adult males occupy the highest quality habitat and may competitively exclude the other age and sex classes.

Sleep Disorders and Associated Medical Comorbidities in Active Duty Military Personnel

PubMed Central

Mysliwiec, Vincent; McGraw, Leigh; Pierce, Roslyn; Smith, Patrick; Trapp, Brandon; Roth, Bernard J.

2013-01-01

Study Objectives: Describe the prevalence of sleep disorders in military personnel referred for polysomnography and identify relationships between demographic characteristics, comorbid diagnoses, and specific sleep disorders. Design: Retrospective cross-sectional study. Setting: Military medical treatment facility. Participants: Active duty military personnel with diagnostic polysomnogram in 2010. Measurements: Primary sleep disorder rendered by review of polysomnogram and medical record by a board certified sleep medicine physician. Demographic characteristics and conditions of posttraumatic stress disorder (PTSD), mild traumatic brain injury (mTBI), anxiety, depression, and pain syndromes determined by medical record review. Results: Primary sleep diagnoses (n = 725) included: mild obstructive sleep apnea (OSA), 207 (27.2%); insomnia, 188 (24.7%); moderate-to-severe OSA, 183 (24.0 %); and paradoxical insomnia,39 (5.1%); behaviorally induced insufficient sleep syndrome, 68 (8.9%) and snoring, 40 (5.3%) comprised our control group. Short sleep duration (< 5 h) was reported by 41.8%. Overall 85.2% had deployed, with 58.1% having one or more comorbid diagnoses. Characteristics associated with moderate-to-severe OSA were age (adjusted odds ratio [OR], 1.03 [95% confidence interval {CI}, 1.0–1.05], sex (male) (adjusted OR, 19.97 [95% CI, 2.66–150.05], anxiety (adjusted OR, 0.58 [95% CI, 0.34–0.99]), and body mass index, BMI (adjusted OR 1.19 [95% CI, 1.13–1.25]; for insomnia, characteristics included PTSD (adjusted OR, 2.12 [95% CI, 1.31–3.44]), pain syndromes (adjusted OR, 1.48 [95%CI, 1.01–2.12]), sex (female) (adjusted OR, 0.22 [95% CI, 0.12–0.41]) and lower BMI (adjusted OR, 0.91 [95% CI, 0.87, 0.95]). Conclusions: Service-related illnesses are prevalent in military personnel who undergo polysomnography with significant associations between PTSD, pain syndromes, and insomnia. Despite having sleep disorders, almost half reported short sleep duration

Sleep disorders and associated medical comorbidities in active duty military personnel.

PubMed

Mysliwiec, Vincent; McGraw, Leigh; Pierce, Roslyn; Smith, Patrick; Trapp, Brandon; Roth, Bernard J

2013-02-01

Describe the prevalence of sleep disorders in military personnel referred for polysomnography and identify relationships between demographic characteristics, comorbid diagnoses, and specific sleep disorders. Retrospective cross-sectional study. Military medical treatment facility. Active duty military personnel with diagnostic polysomnogram in 2010. Primary sleep disorder rendered by review of polysomnogram and medical record by a board certified sleep medicine physician. Demographic characteristics and conditions of posttraumatic stress disorder (PTSD), mild traumatic brain injury (mTBI), anxiety, depression, and pain syndromes determined by medical record review. Primary sleep diagnoses (n = 725) included: mild obstructive sleep apnea (OSA), 207 (27.2%); insomnia, 188 (24.7%); moderate-to-severe OSA, 183 (24.0 %); and paradoxical insomnia,39 (5.1%); behaviorally induced insufficient sleep syndrome, 68 (8.9%) and snoring, 40 (5.3%) comprised our control group. Short sleep duration (< 5 h) was reported by 41.8%. Overall 85.2% had deployed, with 58.1% having one or more comorbid diagnoses. Characteristics associated with moderate-to-severe OSA were age (adjusted odds ratio [OR], 1.03 [95% confidence interval {CI}, 1.0-1.05], sex (male) (adjusted OR, 19.97 [95% CI, 2.66-150.05], anxiety (adjusted OR, 0.58 [95% CI, 0.34-0.99]), and body mass index, BMI (adjusted OR 1.19 [95% CI, 1.13-1.25]; for insomnia, characteristics included PTSD (adjusted OR, 2.12 [95% CI, 1.31-3.44]), pain syndromes (adjusted OR, 1.48 [95%CI, 1.01-2.12]), sex (female) (adjusted OR, 0.22 [95% CI, 0.12-0.41]) and lower BMI (adjusted OR, 0.91 [95% CI, 0.87, 0.95]). Service-related illnesses are prevalent in military personnel who undergo polysomnography with significant associations between PTSD, pain syndromes, and insomnia. Despite having sleep disorders, almost half reported short sleep duration. Multidisciplinary assessment and treatment of military personnel with sleep disorders and service

Variations in Dream Recall Frequency and Dream Theme Diversity by Age and Sex

PubMed Central

Nielsen, Tore

2012-01-01

We assessed dream recall frequency (DRF) and dream theme diversity (DTD) with an internet questionnaire among a cohort of 28,888 male and female participants aged 10–79 years in a cross-sectional design. DRF increased from adolescence (ages 10–19) to early adulthood (20–29) and then decreased again for the next 20 years. The nature of this decrease differed for males and females. For males, it began earlier (30–39), proceeded more gradually, and reached a nadir earlier (40–49) than it did for females. For females, it began later (40–49), dropped more abruptly, and reached nadir later (50–59). Marked sex differences were observed for age strata 10–19 through 40–49 and year-by-year analyses estimated the window for these differences to be more precisely from 14 to 44 years. DTD decreased linearly with age for both sexes up to 50–59 and then dropped even more sharply for 60–79. There was a sex difference favoring males on this measure but only for ages 10–19. Findings replicate, in a single sample, those from several previous studies showing an increase in DRF from adolescence to early adulthood, a subsequent decrease primarily in early and middle adulthood, and different patterns of age-related decrease in the two sexes. Age-related changes in sleep structure, such as decreasing %REM sleep which parallel the observed dream recall changes, might help explain these findings, but these sleep changes are much smaller and more gradual in nature. Changes in the phase and amplitude of circadian rhythms of REM propensity and generational differences in life experiences may also account for some part of the findings. That decreases in DTD parallel known age-related decreases in episodic and autobiographical memory may signify that this new diversity measure indexes an aspect of autobiographical memory that also influences dream recall. PMID:22783222

Binge-eating disorder in the Swedish national registers: Somatic comorbidity.

PubMed

Thornton, Laura M; Watson, Hunna J; Jangmo, Andreas; Welch, Elisabeth; Wiklund, Camilla; von Hausswolff-Juhlin, Yvonne; Norring, Claes; Herman, Barry K; Larsson, Henrik; Bulik, Cynthia M

2017-01-01

To evaluate associations between binge-eating disorder (BED) and somatic illnesses and determine whether medical comorbidities are more common in individuals who present with BED and comorbid obesity. Cases (n = 850) were individuals with a BED diagnosis in the Swedish eating disorders quality registers. Ten community controls were matched to each case on sex, and year, month, and county of birth. Associations of BED status with neurologic, immune, respiratory, gastrointestinal, skin, musculoskeletal, genitourinary, circulatory, and endocrine system diseases were evaluated using conditional logistic regression models. We further examined these associations by adjusting for lifetime psychiatric comorbidity. Amongst individuals with BED, we explored whether comorbid obesity was associated with risk of somatic disorders. BED was associated with most classes of diseases evaluated; strongest associations were with diabetes [odds ratio (95% confidence interval) = 5.7 (3.8; 8.7)] and circulatory systems [1.9 (1.3; 2.7)], likely indexing components of metabolic syndrome. Amongst individuals with BED, those with comorbid obesity were more likely to have a lifetime history of respiratory [1.5 (1.1; 2.1)] and gastrointestinal [2.6 (1.7; 4.1)] diseases than those without comorbid obesity. Increased risk of some somatic disease classes in individuals with BED was not simply due to obesity or other lifetime psychiatric comorbidity. The association of BED with many somatic illnesses highlights the morbidity experienced by individuals with BED. Clinicians treating patients with BED should be vigilant for medical comorbidities. Nonpsychiatric providers may be the first clinical contact for those with BED underscoring the importance of screening in primary care. © 2016 The Authors International Journal of Eating Disorders Published by Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:58-65). © 2016 The Authors International Journal of Eating Disorders Published by Wiley

Secular Changes in Clinical Features at Presentation of Rheumatoid Arthritis: Increase in Comorbidity But Improved Inflammatory States.

PubMed

Nikiphorou, Elena; Norton, Sam; Carpenter, Lewis; Dixey, Josh; Andrew Walsh, David; Kiely, Patrick; Young, Adam

2017-01-01

To examine secular trends in demographics, clinical manifestations, and comorbidity on first presentation of rheumatoid arthritis (RA) prior to disease-modifying antirheumatic drug treatment. A total of 2,701 patients were recruited over 25 years to 2 UK-based RA inception cohorts: the Early Rheumatoid Arthritis Study (9 centers; 1986-2001) and the Early Rheumatoid Arthritis Network (23 centers; 2002-2012). Trends in demographic and baseline clinical/laboratory and radiographic variables and comorbidities were estimated using mixed-effects models, including random effects for recruitment center. Age at onset increased from 53.2 to 57.7 years in 1990 and 2010, respectively (2.6 months/year; 95% confidence interval [95% CI] 1.2, 4.1). Sex ratio, the proportion living in deprived areas, and smoking status were unchanged (P > 0.05) and there were no changes in the proportion seropositive or erosive at baseline (P > 0.05). After controlling for treatment at the time of assessment, erythrocyte sedimentation rate decreased and hemoglobin increased over time (P > 0.05); however, the Health Assessment Questionnaire (HAQ), the Disease Activity Score (DAS), the DAS in 28 joints, and joint counts were unchanged (P > 0.05). The overall prevalence of comorbidity increased from 29.0% in 1990 to 50.7% in 2010, mainly due to cardiovascular and non-cardiac vascular conditions, including hypertension. There was a significant increase in body mass index (0.15 units/year; 95% CI 0.11, 0.18), resulting in an increase in the prevalence of obesity from 13.3% in 1990 to 33.6% in 2010. Age at onset and comorbidity burden, especially obesity, have increased at RA presentation over 25 years, reflecting wider demographic trends at the population level. In contrast, there were no accompanying changes in disease severity assessed by composite markers of disease activity, radiographic erosions, seropositivity, or HAQ at presentation. Treatment strategies in early RA should take

Age- and Sex-Specific Causal Effects of Adiposity on Cardiovascular Risk Factors

PubMed Central

Fall, Tove; Hägg, Sara; Ploner, Alexander; Mägi, Reedik; Fischer, Krista; Draisma, Harmen H.M.; Sarin, Antti-Pekka; Benyamin, Beben; Ladenvall, Claes; Åkerlund, Mikael; Kals, Mart; Esko, Tõnu; Nelson, Christopher P.; Kaakinen, Marika; Huikari, Ville; Mangino, Massimo; Meirhaeghe, Aline; Kristiansson, Kati; Nuotio, Marja-Liisa; Kobl, Michael; Grallert, Harald; Dehghan, Abbas; Kuningas, Maris; de Vries, Paul S.; de Bruijn, Renée F.A.G.; Willems, Sara M.; Heikkilä, Kauko; Silventoinen, Karri; Pietiläinen, Kirsi H.; Legry, Vanessa; Giedraitis, Vilmantas; Goumidi, Louisa; Syvänen, Ann-Christine; Strauch, Konstantin; Koenig, Wolfgang; Lichtner, Peter; Herder, Christian; Palotie, Aarno; Menni, Cristina; Uitterlinden, André G.; Kuulasmaa, Kari; Havulinna, Aki S.; Moreno, Luis A.; Gonzalez-Gross, Marcela; Evans, Alun; Tregouet, David-Alexandre; Yarnell, John W.G.; Virtamo, Jarmo; Ferrières, Jean; Veronesi, Giovanni; Perola, Markus; Arveiler, Dominique; Brambilla, Paolo; Lind, Lars; Kaprio, Jaakko; Hofman, Albert; Stricker, Bruno H.; van Duijn, Cornelia M.; Ikram, M. Arfan; Franco, Oscar H.; Cottel, Dominique; Dallongeville, Jean; Hall, Alistair S.; Jula, Antti; Tobin, Martin D.; Penninx, Brenda W.; Peters, Annette; Gieger, Christian; Samani, Nilesh J.; Montgomery, Grant W.; Whitfield, John B.; Martin, Nicholas G.; Groop, Leif; Spector, Tim D.; Magnusson, Patrik K.; Amouyel, Philippe; Boomsma, Dorret I.; Nilsson, Peter M.; Järvelin, Marjo-Riitta; Lyssenko, Valeriya; Metspalu, Andres; Strachan, David P.; Salomaa, Veikko; Ripatti, Samuli; Pedersen, Nancy L.; Prokopenko, Inga; McCarthy, Mark I.

2015-01-01

Observational studies have reported different effects of adiposity on cardiovascular risk factors across age and sex. Since cardiovascular risk factors are enriched in obese individuals, it has not been easy to dissect the effects of adiposity from those of other risk factors. We used a Mendelian randomization approach, applying a set of 32 genetic markers to estimate the causal effect of adiposity on blood pressure, glycemic indices, circulating lipid levels, and markers of inflammation and liver disease in up to 67,553 individuals. All analyses were stratified by age (cutoff 55 years of age) and sex. The genetic score was associated with BMI in both nonstratified analysis (P = 2.8 × 10−107) and stratified analyses (all P < 3.3 × 10−30). We found evidence of a causal effect of adiposity on blood pressure, fasting levels of insulin, C-reactive protein, interleukin-6, HDL cholesterol, and triglycerides in a nonstratified analysis and in the <55-year stratum. Further, we found evidence of a smaller causal effect on total cholesterol (P for difference = 0.015) in the ≥55-year stratum than in the <55-year stratum, a finding that could be explained by biology, survival bias, or differential medication. In conclusion, this study extends previous knowledge of the effects of adiposity by providing sex- and age-specific causal estimates on cardiovascular risk factors. PMID:25712996

Congenital Etiology is an Independent Risk Factor for Complications in Adolescents Undergoing Corrective Scoliosis Surgery: Comparison of In-hospital Comorbidities Using Nationwide KID's Inpatient Database.

PubMed

Poorman, Gregory W; Jalai, Cyrus M; Diebo, Bassel; Vira, Shaleen; Buza, John; Baker, Joe; Tishelman, Jared; Horn, Samantha; Bono, Olivia; Shenoy, Kartik; Hasan, Saqib; Paul, Justin; Isaacs, Evan; Kaye, Ian; Atanda, Abiola; Buckland, Aaron J; LaFage, Virginie; Errico, Thomas; Passias, Peter G

2017-04-24

Congenital scoliosis (CS) is associated with more rigid, complex deformities relative to adolescent idiopathic scoliosis (AIS) which theoretically increases surgical complications. Despite extensive literature studying AIS patients, few studies have been performed on CS patients. The purpose of this study was to evaluate complications associated with spinal fusions for CS and AIS. A retrospective review of the Kid's Inpatient Database (KID) years 2000 to 2009 was performed. Inclusion: patients under 20 years with ICD-9 diagnosis codes for idiopathic scoliosis (IS-without concomitant congenital anomalies) and CS, undergoing spinal fusion from the KID years 2000 to 2009. Two analyses were performed according to age below 10 years and 10 years and above. Univariate analysis described differences in demographics, comorbidities, intraoperative complications, and clinical values between groups. Binary logistic regression controlling for age, sex, race, and invasiveness predicted complications risk in CS (odds ratios; 95% confidence interval). In total, 25,131 patients included (IS, n=22443; CS, n=2688). For patients under age 10, CS patients underwent 1 level shorter fusions (P<0.001), had fewer comorbidities (P<0.001), and sustained similar complication incidence. In the 10 and over age analysis, CS patients similarly had shorter fusions, but greater comorbidities, and significantly more complications (odds ratio, 1.6; confidence interval, 1.4-1.8). CS patients have higher in-hospital complication rates. With more comorbidities, these patients have increased risk of sustaining procedure-related complications such as shock, infection, and Adult Respiratory Distress Syndrome. These data help to counsel patients and their families before spinal fusion. Level III-retrospective review of a prospectively collected database.

Manual control age and sex differences in 4 to 11 year old children.

PubMed

Flatters, Ian; Hill, Liam J B; Williams, Justin H G; Barber, Sally E; Mon-Williams, Mark

2014-01-01

To what degree does being male or female influence the development of manual skills in pre-pubescent children? This question is important because of the emphasis placed on developing important new manual skills during this period of a child's education (e.g. writing, drawing, using computers). We investigated age and sex-differences in the ability of 422 children to control a handheld stylus. A task battery deployed using tablet PC technology presented interactive visual targets on a computer screen whilst simultaneously recording participant's objective kinematic responses, via their interactions with the on-screen stimuli using the handheld stylus. The battery required children use the stylus to: (i) make a series of aiming movements, (ii) trace a series of abstract shapes and (iii) track a moving object. The tasks were not familiar to the children, allowing measurement of a general ability that might be meaningfully labelled 'manual control', whilst minimising culturally determined differences in experience (as much as possible). A reliable interaction between sex and age was found on the aiming task, with girls' movement times being faster than boys in younger age groups (e.g. 4-5 years) but with this pattern reversing in older children (10-11 years). The improved performance in older boys on the aiming task is consistent with prior evidence of a male advantage for gross-motor aiming tasks, which begins to emerge during adolescence. A small but reliable sex difference was found in tracing skill, with girls showing a slightly higher level of performance than boys irrespective of age. There were no reliable sex differences between boys and girls on the tracking task. Overall, the findings suggest that prepubescent girls are more likely to have superior manual control abilities for performing novel tasks. However, these small population differences do not suggest that the sexes require different educational support whilst developing their manual skills.

An evaluation of sex-age-kill (SAK) model performance

USGS Publications Warehouse

Millspaugh, Joshua J.; Skalski, John R.; Townsend, Richard L.; Diefenbach, Duane R.; Boyce, Mark S.; Hansen, Lonnie P.; Kammermeyer, Kent

2009-01-01

The sex-age-kill (SAK) model is widely used to estimate abundance of harvested large mammals, including white-tailed deer (Odocoileus virginianus). Despite a long history of use, few formal evaluations of SAK performance exist. We investigated how violations of the stable age distribution and stationary population assumption, changes to male or female harvest, stochastic effects (i.e., random fluctuations in recruitment and survival), and sampling efforts influenced SAK estimation. When the simulated population had a stable age distribution and λ > 1, the SAK model underestimated abundance. Conversely, when λ < 1, the SAK overestimated abundance. When changes to male harvest were introduced, SAK estimates were opposite the true population trend. In contrast, SAK estimates were robust to changes in female harvest rates. Stochastic effects caused SAK estimates to fluctuate about their equilibrium abundance, but the effect dampened as the size of the surveyed population increased. When we considered both stochastic effects and sampling error at a deer management unit scale the resultant abundance estimates were within ±121.9% of the true population level 95% of the time. These combined results demonstrate extreme sensitivity to model violations and scale of analysis. Without changes to model formulation, the SAK model will be biased when λ ≠ 1. Furthermore, any factor that alters the male harvest rate, such as changes to regulations or changes in hunter attitudes, will bias population estimates. Sex-age-kill estimates may be precise at large spatial scales, such as the state level, but less so at the individual management unit level. Alternative models, such as statistical age-at-harvest models, which require similar data types, might allow for more robust, broad-scale demographic assessments.

Prevalence, Correlates, Disability, and Comorbidity of DSM-IV Schizotypal Personality Disorder: Results From the Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions

PubMed Central

Pulay, Attila J.; Stinson, Frederick S.; Dawson, Deborah A.; Goldstein, Risë B.; Chou, S. Patricia; Huang, Boji; Saha, Tulshi D.; Smith, Sharon M.; Pickering, Roger P.; Ruan, W. June; Hasin, Deborah S.; Grant, Bridget F.

2009-01-01

Objective: To present nationally representative findings on the prevalence, correlates, and comorbidity of and disability associated with DSM-IV schizotypal personality disorder (SPD). Method: This study used the 2004–2005 Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions, which targeted a nationally representative sample of the adult civilian population of the United States aged 18 years and older and residing in households and group quarters. In Wave 2, attempts were made to conduct face-to-face reinterviews with all respondents to the Wave 1 interview. Results: Lifetime prevalence of SPD was 3.9%, with significantly greater rates among men (4.2%) than women (3.7%) (p < .01). Odds for SPD were significantly greater among black women, individuals with lower incomes, and those who were separated, divorced, or widowed; odds were significantly lower among Asian men (all p < .01). Schizotypal personality disorder was associated with substantial mental disability in both sexes. Co-occurrence rates of Axis I and other Axis II disorders among respondents with SPD were much higher than rates of co-occurrence of SPD among respondents with other disorders. After adjustment for sociodemographic characteristics and additional comorbidity, associations remained significant in both sexes between SPD and 12-month and lifetime bipolar I disorder, social and specific phobias, and posttraumatic stress disorder, as well as 12-month bipolar II disorder, lifetime generalized anxiety disorder, and borderline and narcissistic personality disorders (all p < .01). Conclusions: Common and unique factors may underlie associations of SPD with narcissistic and borderline personality disorders, whereas much of the comorbidity between SPD and most mood and anxiety disorders appears to reflect factors common to these disorders. Some of the associations with SPD were sex specific. Schizotypal personality disorder and dependent, avoidant, and borderline personality disorders

Prevalence, comorbidities and mortality of toxic shock syndrome in children and adults in the USA.

PubMed

Strom, Mark A; Hsu, Derek Y; Silverberg, Jonathan I

2017-11-01

Toxic Shock Syndrome (TSS), a superantigen-mediated illness, is characterized by rash, hypotension and multi-organ dysfunction. Predictors of TSS and related morbidity and mortality are poorly defined. In this study, data on 61,959,084 hospitalizations from the 2003-2012 Nationwide Inpatient Sample, a 20% stratified sample of US hospitalizations, were analyzed and ICD-9-CM coding used to identify 4491 hospitalizations with a diagnosis of TSS. Incidence, in-hospital mortality rate, comorbidities, length of stay and costs of care attributable to TSS were determined. In multivariate survey logistic regression models, TSS was associated with female sex (adjusted odds ratio [95% confidence interval], 1.54 [1.48-1.60]), younger age (0-17 years, 2.17 [2.06-2.29]; 40-59: 0.53 [0.50-0.56]; 60-79: 0.28 [0.26-0.30]; 80+: 0.13 [0.11-0.14] compared with 18-39) and race/ethnicity (black, 0.63 [0.59-0.67]; Hispanic: 0.60 [0.56-0.64]; Asian, 1.11 [1.00-1.11]; and other, 0.83 [0.75-0.92] compared with white). Patients with TSS had a three-fold greater cost of care (mean: $36,656 ± 942) and length of stay (LOS) (mean: 10.65 ± 0.23 days) than patients without TSS. Shared predictors of increased LOS and costs in patients with TSS were male sex; age 40-79 years; Black, Hispanic, Asian and other race/ethnicity; and more than one chronic condition. Predictors of in-hospital mortality included respiratory failure (13.66 [11.37-16.43]), liver disease/failure (3.36 [2.59-4.34]), chickenpox (91.26 [27.74-300.25]), coagulopathy (2.14 [1.85-2.48]), and higher age. In conclusion, there are significant racial/ethnic, socioeconomic, and comorbid disparities in the incidence and mortality of TSS in adults and children in the USA. © 2017 The Societies and John Wiley & Sons Australia, Ltd.

Do Advanced Glycation End Products (AGEs) Contribute to the Comorbidities of Polycystic Ovary Syndrome (PCOS)?

PubMed

Rutkowska, Aleksandra Zofia; Diamanti-Kandarakis, Evanthia

2016-01-01

Advanced glycation end products (AGEs) are formed both during the endogenous and exogenous reactions and are implicated in the process of ageing, pathogenesis of diabetes, atherosclerosis, female fertility, and cancers. Food and smoking are the most important sources of exogenous AGEs in daily life. The biochemical composition of meal, cooking methods, time and temperature of food preparation may impact AGEs formation, therefore Western-type diet, rich in animal-derived products as well as in fast foods seems to be the main source of AGEs. Both, endogenous and exogenous AGEs can act intracellularly or during serum interaction with cell surface receptors called RAGE influencing variety of molecular pathways. Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age. The aetiology of this disorder remains unclear, however the environmental and genetic factors may play an important role in its pathogenesis. Nevertheless, PCOS women have increased factors for reproductive and cardiometabolic comorbidities. AGEs can contribute to the pathogenesis of PCOS as well as its consequences. It has been shown that chronic inflammation and increased oxidative stress may be a link between the mechanisms of AGEs action and the metabolic and reproductive consequences of PCOS. This review highlights that high dietary AGEs intake promotes deteriorating biological effects in women with PCOS, whereas AGEs restriction seems to have beneficial impact on women health. Better understanding AGEs formation and biochemistry as well as AGE-mediated pathophysiological mechanisms may open new therapeutic avenues converging to the achievement of the complete treatment of PCOS and its consequences.

Sex- and age-dependent gene expression in human liver: An implication for drug-metabolizing enzymes.

PubMed

Uno, Yasuhiro; Takata, Ryo; Kito, Go; Yamazaki, Hiroshi; Nakagawa, Kazuko; Nakamura, Yusuke; Kamataki, Tetsuya; Katagiri, Toyomasa

2017-02-01

Sex and age differences in hepatic expression of drug-metabolizing enzyme genes could cause variations in drug metabolism, but has not been fully elucidated, especially in Asian population. In this study, the global expression of human hepatic genes was analyzed by microarrays in 40 Japanese subjects (27 males and 13 females). Thirty-five sex-biased genes were identified (P < 0.005). Whereas, 60 age-biased genes in two age groups, <60 years and ≥70 years (P < 0.001), were identified in males. By Gene Ontology analysis, the sex-biased genes were related to protein catabolism and modification, while the age-biased genes were related to transcription regulation and cell death. Quantitative polymerase chain reaction confirmed the female-biased expression of drug-metabolizing enzyme genes BChE, CYP4X1, and SULT1E1 (≥1.5-fold, P < 0.05). Further analysis of drug-metabolizing enzyme genes indicated that expression of CYP2A6 and CYP3A4 in females in the ≥70 age group was less than in the <60 age group (≥1.5-fold, P < 0.05), and this trend was also observed for PXR expression in males (≥1.5-fold, P < 0.05). The results presented provide important insights into hepatic physiology and function, especially drug metabolism, with respect to sex and age. Copyright © 2016 The Japanese Society for the Study of Xenobiotics. Published by Elsevier Ltd. All rights reserved.

The morphology of human hyoid bone in relation to sex, age and body proportions.

PubMed

Urbanová, P; Hejna, P; Zátopková, L; Šafr, M

2013-06-01

Morphological aspects of the human hyoid bone are, like many other skeletal elements in human body, greatly affected by individual's sex, age and body proportions. Still, the known sex-dependent bimodality of a number of body size characteristics overshadows the true within-group patterns. Given the ambiguity of the causal effects of age, sex and body size upon hyoid morphology the present study puts the relationship between shape of human hyoid bone and body proportions (height and weight) under scrutiny of a morphological study. Using 211 hyoid bones and landmark-based methods of geometric morphometrics, it was shown that the size of hyoid bones correlated positively with measured body dimensions but showed no correlation if the individual's sex was controlled for. For shape variables, our results revealed that hyoid morphology is clearly related to body size as expressed in terms of the height and weight. Yet, the hyoid shape was shown to result primarily from the sex-related bimodal distribution of studied body size descriptors which, in the case of the height-dependent model, exhibited opposite trends for males and females. Apart from the global hyoid shape given by spatial arrangements of the greater horns, body size dependency was translated into size and position of the hyoid body. None of the body size characters had any impact on hyoid asymmetry. Ultimately, sexually dimorphic variation was revealed for age-dependent changes in both size and shape of hyoid bones as male hyoids tend to be more susceptible to modifications with age than female bones. Copyright © 2013 Elsevier GmbH. All rights reserved.

Effect of age and sex on lacosamide pharmacokinetics in healthy adult subjects and adults with focal epilepsy.

PubMed

Schaefer, Carina; Cawello, Willi; Waitzinger, Josef; Elshoff, Jan-Peer

2015-04-01

Age- and sex-related differences in body composition could affect the pharmacokinetic parameters of administered drugs. The purpose of this post hoc analysis was to investigate the influences of age and sex on the pharmacokinetics of lacosamide. This post hoc analysis used pharmacokinetic data taken at steady state from (i) two phase I studies of oral lacosamide in healthy adult subjects (n = 66), and (ii) a population pharmacokinetic analysis carried out using data from two phase III studies of adjunctive oral lacosamide in adults (n = 565) with focal epilepsy taking 1-3 concomitant anti-epileptic drugs. Phase I data were stratified by age and sex as 'younger female' (aged 18-40 years), 'younger male' (aged 18-45 years) or 'elderly male/female' (aged ≥65 years), then normalized by body weight (lean body weight or fat-free mass), height or volume of distribution, and analysed using non-compartmental analysis. Population pharmacokinetic data were stratified by sex and analysed using a one-compartment model. Minor numerical differences between lacosamide exposure [the area under the concentration-time curve at steady state over the dosage interval (AUCτ,ss)] and the maximum plasma concentration at steady state (C max,ss) in subjects of different ages or sexes were noted. The differences could be explained by a scaling factor between the drug applied and the plasma concentration. Following normalization by lean body weight or volume of distribution, an analysis of relative bioavailability resulted in 90 % confidence intervals of the ratios for AUCτ,ss and C max,ss for age (elderly to younger) or sex (male to female) falling within the range accepted for equivalence (80-125 %); without normalization, the 90 % confidence intervals were outside this range. Minor numerical differences in lacosamide plasma concentrations were noted in the comparison between male and female patients (aged 16-71 years) with focal epilepsy. Simulations using different body weights

Vocational interests in the United States: Sex, age, ethnicity, and year effects.

PubMed

Morris, Michael L

2016-10-01

Vocational interests predict educational and career choices, job performance, and career success (Rounds & Su, 2014). Although sex differences in vocational interests have long been observed (Thorndike, 1911), an appropriate overall measure has been lacking from the literature. Using a cross-sectional sample of United States residents aged 14 to 63 who completed the Strong Interest Inventory assessment between 2005 and 2014 (N = 1,283,110), I examined sex, age, ethnicity, and year effects on work related interest levels using both multivariate and univariate effect size estimates of individual dimensions (Holland's Realistic, Investigative, Artistic, Social, Enterprising, and Conventional). Men scored higher on Realistic (d = -1.14), Investigative (d = -.32), Enterprising (d = -.22), and Conventional (d = -.23), while women scored higher on Artistic (d = .19) and Social (d = .38), mostly replicating previous univariate findings. Multivariate, overall sex differences were very large (disattenuated Mahalanobis' D = 1.61; 27% overlap). Interest levels were slightly lower and overall sex differences larger in younger samples. Overall sex differences have narrowed slightly for 18-22 year-olds in more recent samples. Generally very small ethnicity effects included relatively higher Investigative and Enterprising scores for Asians, Indians, and Middle Easterners, lower Realistic scores for Blacks and Native Americans, higher Realistic, Artistic, and Social scores for Pacific Islanders, and lower Conventional scores for Whites. Using Prediger's (1982) model, women were more interested in people (d = 1.01) and ideas (d = .18), while men were more interested in things and data. These results, consistent with previous reviews showing large sex differences and small year effects, suggest that large sex differences in work related interests will continue to be observed for decades. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Age of Sexual Debut and Physical Dating Violence Victimization: Sex Differences among US High School Students

ERIC Educational Resources Information Center

Ihongbe, Timothy O.; Cha, Susan; Masho, Saba W.

2017-01-01

Background: Research has shown that early age of sexual debut is associated with physical dating violence (PDV), but sex-specific associations are sparse. We estimated the prevalence of PDV victimization in high school students who have initiated sexual intercourse and examined sex-specific association between age of sexual debut and PDV…

The relationship of age-adjusted Charlson comorbidity ındex and diurnal variation of blood pressure.

PubMed

Kalaycı, Belma; Erten, Yunus Turgay; Akgün, Tunahan; Karabag, Turgut; Kokturk, Furuzan

2018-03-05

Charlson Comorbidity index (CCI) is a scoring system to predict prognosis and mortality. It exhibits better utility when combined with age, age-adjusted Charlson Comorbidity Index (ACCI). The aim of this study was to evaluate the relationship between ACCI and diurnal variation of blood pressure parameters in hypertensive patients and normotensive patients. We enrolled 236 patients. All patients underwent a 24-h ambulatory blood pressure monitoring (ABPM) for evaluation of dipper or non-dipper pattern. We searched the correlation between ACCI and dipper or non-dipper pattern and other ABPM parameters. To further investigate the role of these parameters in predicting survival, a multivariate analysis using the Cox proportional hazard model was performed. 167 patients were in the hypertensive group (87 patients in non-dipper status) and 69 patients were in the normotensive group (41 patients in non-dipper status) of all study patients. We found a significant difference and negative correlation between AACI and 24-h diastolic blood pressure (DBP), awake DBP, awake mean blood pressure (MBP) and 24-h MBP and awake systolic blood pressure(SBP). Night decrease ratio of blood pressure had also a negative correlation with ACCI (p = 0.003, r = -0.233). However, we found a relationship with non-dipper pattern and ACCI in the hypertensive patients (p = 0.050). In multivariate Cox analysis sleep MBP was found related to mortality like ACCI (p = 0.023, HR = 1.086, %95 CI 1.012-1.165) Conclusion: ACCI was statistically significantly higher in non-dipper hypertensive patients than dipper hypertensive patients while ACCI had a negative correlation with blood pressure. Sleep MBP may predict mortality.

Mental health disorders among homeless, substance-dependent men who have sex with men.

PubMed

Fletcher, Jesse B; Reback, Cathy J

2017-07-01

Homelessness is associated with increased prevalence of mental health disorders, substance use disorders and mental health/substance use disorder comorbidity in the United States of America. Gay, bisexual and other men who have sex with men (MSM) living in the United States are at increased risk for homelessness, and have also evidenced elevated mental health and substance use disorder prevalence relative to their non-MSM male counterparts. Secondary analysis of data from a randomised controlled trial estimating the diagnostic prevalence of substance use/mental health disorder comorbidity among a sample of homeless, substance-dependent MSM (DSM-IV verified; n = 131). The most prevalent substance use/mental health disorder comorbidities were stimulant dependence comorbid with at least one depressive disorder (28%), alcohol dependence comorbid with at least one depressive disorder (26%) and stimulant dependence comorbid with antisocial personality disorder (25%). Diagnostic depression and antisocial personality disorder both demonstrated high rates of prevalence among homeless, substance-dependent (particularly stimulant and alcohol dependent) MSM. [Fletcher JB, Reback CJ. Mental health disorders among homeless, substance-dependent men who have sex with men. Drug Alcohol Rev 2016;36:555-559]. © 2016 Australasian Professional Society on Alcohol and other Drugs.

Cognitive function and associated factors among older people in Taiwan: age and sex differences.

PubMed

Li, Cheng-Lun; Hsu, Hui-Chuan

2015-01-01

The aim of this study was to examine cognitive function and the risk and the protective factors by age and sex among Taiwanese older people. The data were from a nation-representative panel of older people in Taiwan. The participants completing both the 2003 and 2007 waves were included for analysis in this study (n=3228). Descriptive analysis and generalized linear model were applied, and the samples were stratified by age groups and by sex. The factors related to higher cognitive function at the intercept included being younger, male, higher education, and doing unpaid work. At the time slope, the age effect and physical function difficulties would reduce the cognitive function across time, while education and providing informational support would increase the cognitive function across time. There were age- and sex-differences in the factors related to cognitive function, particularly on the working status and social participation. Different health promotion strategies to target these populations should be accordingly developed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Differential resting-state EEG patterns associated with comorbid depression in Internet addiction.

PubMed

Lee, Jaewon; Hwang, Jae Yeon; Park, Su Mi; Jung, Hee Yeon; Choi, Sam-Wook; Kim, Dai Jin; Lee, Jun-Young; Choi, Jung-Seok

2014-04-03

Many researchers have reported a relationship between Internet addiction and depression. In the present study, we compared the resting-state quantitative electroencephalography (QEEG) activity of treatment-seeking patients with comorbid Internet addiction and depression with those of treatment-seeking patients with Internet addiction without depression, and healthy controls to investigate the neurobiological markers that differentiate pure Internet addiction from Internet addiction with comorbid depression. Thirty-five patients diagnosed with Internet addiction and 34 age-, sex-, and IQ-matched healthy controls were enrolled in this study. Patients with Internet addiction were divided into two groups according to the presence (N=18) or absence (N=17) of depression. Resting-state, eye-closed QEEG was recorded, and the absolute and relative power of the brain were analyzed. The Internet addiction group without depression had decreased absolute delta and beta powers in all brain regions, whereas the Internet addiction group with depression had increased relative theta and decreased relative alpha power in all regions. These neurophysiological changes were not related to clinical variables. The current findings reflect differential resting-state QEEG patterns between both groups of participants with Internet addiction and healthy controls and also suggest that decreased absolute delta and beta powers are neurobiological markers of Internet addiction. Copyright © 2013 Elsevier Inc. All rights reserved.

Performance Development in Adolescent Track and Field Athletes According to Age, Sex and Sport Discipline

PubMed Central

Tønnessen, Espen; Svendsen, Ida Siobhan; Olsen, Inge Christoffer; Guttormsen, Atle; Haugen, Thomas

2015-01-01

Introduction Sex-specific differences that arise during puberty have a pronounced effect on the training process. However, the consequences this should have for goal-setting, planning and implementation of training for boys and girls of different ages remains poorly understood. The aim of this study was to quantify performance developments in athletic running and jumping disciplines in the age range 11-18 and identify progression differences as a function of age, discipline and sex. Methods The 100 all-time best Norwegian male and female 60-m, 800-m, long jump and high jump athletes in each age category from 11 to 18 years were analysed using mixed models with random intercept according to athlete. Results Male and female athletes perform almost equally in running and jumping events up to the age of 12. Beyond this age, males outperform females. Relative annual performance development in females gradually decreases throughout the analyzed age period. In males, annual relative performance development accelerates up to the age of 13 (for running events) or 14 (for jumping events) and then gradually declines when approaching 18 years of age. The relative improvement from age 11 to 18 was twice as high in jumping events compared to running events. For all of the analyzed disciplines, overall improvement rates were >50% higher for males than for females. The performance sex difference evolves from < 5% to 10-18% in all the analyzed disciplines from age 11 to 18 yr. Conclusion To the authors’ knowledge, this is the first study to present absolute and relative annual performance developments in running and jumping events for competitive athletes from early to late adolescence. These results allow coaches and athletes to set realistic goals and prescribe conditioning programs that take into account sex-specific differences in the rate of performance development at different stages of maturation. PMID:26043192

Influence of age, sex, and strength training on human muscle gene expression determined by microarray

PubMed Central

ROTH, STEPHEN M.; FERRELL, ROBERT E.; PETERS, DAVID G.; METTER, E. JEFFREY; HURLEY, BEN F.; ROGERS, MARC A.

2010-01-01

The purpose of this study was to determine the influence of age, sex, and strength training (ST) on large-scale gene expression patterns in vastus lateralis muscle biopsies using high-density cDNA microarrays and quantitative PCR. Muscle samples from sedentary young (20–30 yr) and older (65–75 yr) men and women (5 per group) were obtained before and after a 9-wk unilateral heavy resistance ST program. RNA was hybridized to cDNA filter microarrays representing ~4,000 known human genes and comparisons were made among arrays to determine differential gene expression as a result of age and sex differences, and/or response to ST. Sex had the strongest influence on muscle gene expression, with differential expression (>1.7-fold) observed for ~200 genes between men and women (~75% with higher expression in men). Age contributed to differential expression as well, as ~50 genes were identified as differentially expressed (>1.7-fold) in relation to age, representing structural, metabolic, and regulatory gene classes. Sixty-nine genes were identified as being differentially expressed (>1.7-fold) in all groups in response to ST, and the majority of these were downregulated. Quantitative PCR was employed to validate expression levels for caldesmon, SWI/SNF (BAF60b), and four-and-a-half LIM domains 1. These significant differences suggest that in the analysis of skeletal muscle gene expression issues of sex, age, and habitual physical activity must be addressed, with sex being the most critical variable. PMID:12209020

Prevalence and associated factors of tuberculosis and diabetes mellitus comorbidity: A systematic review

PubMed Central

Bjune, Gunnar Aksel; Yimer, Solomon Abebe

2017-01-01

Introduction The dual burden of tuberculosis (TB) and diabetes mellitus (DM) has become a major global public health concern. There is mounting evidence from different countries on the burden of TB and DM comorbidity. The objective of this systematic review was to summarize the existing evidence on prevalence and associated/risk factors of TBDM comorbidity at global and regional levels. Methods Ovid Medline, Embase, Global health, Cochrane library, Web of science and Scopus Elsevier databases were searched to identify eligible articles for the systematic review. Data were extracted using standardized excel form and pilot tested. Median with interquartile range (IQR) was used to estimate prevalence of TBDM comorbidity. Associated/risk factors that were identified from individual studies were thematically analyzed and described. Results The prevalence of DM among TB patients ranged from 1.9% to 45%. The overall median global prevalence was 16% (IQR 9.0%-25.3%) Similarly, the prevalence of TB among DM patients ranged from 0.38% to 14% and the overall median global prevalence was 4.1% (IQR 1.8%-6.2%). The highest prevalence of DM among TB patients is observed in the studied countries of Asia, North America and Oceania. On the contrary, the prevalence of TB among DM patients is low globally, but relatively higher in the studied countries of Asia and the African continents. Sex, older age, urban residence, tobacco smoking, sedentary lifestyle, poor glycemic control, having family history of DM and TB illness were among the variables identified as associated/risk factors for TBDM comorbidity. Conclusion This systematic review revealed that there is a high burden of DM among TB patients at global level. On the contrary, the global prevalence of TB among DM patients is low. Assessing the magnitude and risk/associated factors of TBDM comorbidity at country/local level is crucial before making decisions to undertake TBDM integrated services. PMID:28430796

Local-global interference is modulated by age, sex and anterior corpus callosum size

PubMed Central

Müller-Oehring, Eva M.; Schulte, Tilman; Raassi, Carla; Pfefferbaum, Adolf; Sullivan, Edith V.

2007-01-01

To identify attentional and neural mechanisms affecting global and local feature extraction, we devised a global-local hierarchical letter paradigm to test the hypothesis that aging reduces functional cerebral lateralization through corpus callosum (CC) degradation. Participants (37 men and women, 26–79 years) performed a task requiring global, local, or global+local attention and underwent structural MRI for CC measurement. Although reaction time (RT) slowed with age, all participants had faster RTs to local than global targets. This local precedence effect together with greater interference from incongruent local information and greater response conflict from local targets each correlated with older age and smaller callosal genu (anterior) areas. These findings support the hypothesis that the CC mediates lateralized local-global processes by inhibition of task-irrelevant information under selective attention conditions. Further, with advancing age smaller genu size leads to less robust inhibition, thereby reducing cerebral lateralization and permitting interference to influence processing. Sex was an additional modifier of interference, in that callosum-interference relationships were evident in women but not in men. Regardless of age, smaller splenium (posterior) areas correlated with less response facilitation from repetition priming of global targets in men, but with greater response facilitation from repetition priming of local targets in women. Our data indicate the following dissociation: Anterior callosal structure was associated with inhibitory processes (i.e., interference from incongruency and response conflict), which are vulnerable to the effects of age and sex, whereas posterior callosal structure was associated with facilitation processes from repetition priming dependent on sex and independent of age. PMID:17335783

Local-global interference is modulated by age, sex and anterior corpus callosum size.

PubMed

Müller-Oehring, Eva M; Schulte, Tilman; Raassi, Carla; Pfefferbaum, Adolf; Sullivan, Edith V

2007-04-20

To identify attentional and neural mechanisms affecting global and local feature extraction, we devised a global-local hierarchical letter paradigm to test the hypothesis that aging reduces functional cerebral lateralization through corpus callosum (CC) degradation. Participants (37 men and women, 26-79 years) performed a task requiring global, local, or global+local attention and underwent structural MRI for CC measurement. Although reaction time (RT) slowed with age, all participants had faster RTs to local than global targets. This local precedence effect together with greater interference from incongruent local information and greater response conflict from local targets each correlated with older age and smaller callosal genu (anterior) areas. These findings support the hypothesis that the CC mediates lateralized local-global processes by inhibition of task-irrelevant information under selective attention conditions. Further, with advancing age smaller genu size leads to less robust inhibition, thereby reducing cerebral lateralization and permitting interference to influence processing. Sex was an additional modifier of interference, in that callosum-interference relationships were evident in women but not in men. Regardless of age, smaller splenium (posterior) areas correlated with less response facilitation from repetition priming of global targets in men, but with greater response facilitation from repetition priming of local targets in women. Our data indicate the following dissociation: anterior callosal structure was associated with inhibitory processes (i.e., interference from incongruency and response conflict), which are vulnerable to the effects of age and sex, whereas posterior callosal structure was associated with facilitation processes from repetition priming dependent on sex and independent of age.

Cranium asymmetry in a modern Greek population sample of known age and sex.

PubMed

Chovalopoulou, Maria-Eleni; Papageorgopoulou, Christina; Bertsatos, Andreas

2017-05-01

The aim of this paper is to evaluate and quantify cranium asymmetry, sexual differences in the set of individual asymmetry scores, and the relationship between fluctuating asymmetry and age, in a modern Greek population sample. In addition, we test for the developmental origins of health and disease hypothesis by assessing the correlation between fluctuating asymmetry and cause of death. The study sample consisted of 173 crania of known sex and adult age (92 males, 81 females) belonging to individuals who lived in Greece during the twentieth century. The three-dimensional coordinates of 77 ectocranial landmarks were digitized using a Microscribe 3DX contact digitizer and landmark configurations were analyzed using the generalized least-squares Procrustes method. Regarding directional asymmetry, the results show that the human skull has a tendency for a left-side excess for the Greek population. No significant directional asymmetry differences between the sexes are found. The highest levels of fluctuating asymmetry for both sexes are located on the skull base. The levels of fluctuating asymmetry in all cranial regions appear higher for males than females. Nevertheless, these differences do not present any statistical significance between sexes. Additionally, there is no relationship between fluctuating asymmetry scores and age for both males and females. Finally, the results of this study could not confirm that early development has a significant impact on adult health outcomes.

Sex Differences in the Biology and Pathology of the Aging Heart.

PubMed

Keller, Kaitlyn M; Howlett, Susan E

2016-09-01

The knowledge that advanced age is a major risk factor for cardiovascular disease (CVD) has stimulated interest in cardiac aging. Understanding how the heart remodels with age can help us appreciate why older individuals are more likely to acquire heart disease. Growing evidence in both humans and animals shows that the heart exhibits distinct structural and functional changes as a consequence of age. These changes occur even in the absence of overt cardiovascular disease and are often maladaptive. For example, atrial hypertrophy and fibrosis may increase susceptibility to atrial fibrillation in older adults. Age-dependent increases in left ventricular fibrosis, stiffness, and wall thickness promote diastolic dysfunction, predisposing to heart failure with preserved ejection fraction. The influence of age on the heart is evident at rest but is even more prominent during exercise. There is also evidence for sex-specific variation in age-associated remodelling. For instance, there is some evidence that the number of ventricular myocytes declines with age through apoptosis in men but not in women. This helps explain why older men are more likely than women to experience heart failure with reduced ejection fraction. Emerging evidence from preclinical studies suggests that frailty rather than chronological age promotes adverse cardiac remodelling. Mechanisms implicated in cardiac aging include impaired calcium handling, excessive activation of the ß-adrenergic and renin-angiotensin systems, and mitochondrial dysfunction. Further research into cardiac aging in both sexes is needed, because it may be possible to modify disease treatment if the substrate upon which the disease first develops is better understood. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Sex-related differences in outcomes among men and women under 55 years of age with acute coronary syndrome undergoing percutaneous coronary intervention: Results from the PROMETHEUS study.

PubMed

Chandrasekhar, Jaya; Baber, Usman; Sartori, Samantha; Faggioni, Michela; Aquino, Melissa; Kini, Annapoorna; Weintraub, William; Rao, Sunil; Kapadia, Samir; Weiss, Sandra; Strauss, Craig; Toma, Catalin; Muhlestein, Brent; DeFranco, Anthony; Effron, Mark; Keller, Stuart; Baker, Brian; Pocock, Stuart; Henry, Timothy; Mehran, Roxana

2017-03-01

Young women undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) experience greater adverse events than men, potentially due to under-treatment. We sought to compare the 1-year outcomes by sex in patients ≤55 years of age from a contemporary PCI cohort. PROMETHEUS was a retrospective multicenter observational US study comparing outcomes in clopidogrel and prasugrel treated patients following ACS PCI. MACE was defined as a composite of death, myocardial infarction, stroke or unplanned revascularization. Clinically significant bleeding was defined as bleeding requiring transfusion or hospitalization. Hazard ratios were generated using multivariable Cox proportional hazards regression. The study cohort included 4,851 patients of which 1,162 (24.0%) were women and 3,689 (76.0%) were men. In this cohort, the prevalence of diabetes (41.0 vs. 27.9%) and chronic kidney disease (12.7 vs. 7.2%) was higher among women compared with men. Irrespective of sex, prasugrel was used in less than one-third of patients (31.8% in men vs. 28.1% in women, P = 0.01). Unadjusted, 1-year MACE (21.1% vs. 16.2%, P < 0.001) and bleeding (3.6% vs. 2.2%, P = 0.01) was significantly higher in women compared with men, but these results were no longer significant after adjustment for risk (HR 1.13, 95% CI 0.94-1.36 for MACE and HR 1.31, 95% CI 0.85-2.04 for bleeding). Women ≤ 55 years of age undergoing ACS PCI have significantly greater comorbidities than young men. Despite a higher risk clinical phenotype in women, prasugrel use was significantly lower in women than men. Female sex was associated with a significantly higher risk of 1-year MACE and bleeding than male sex, findings that are attributable to baseline differences. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Effects of age, education, and sex on response bias in a recognition task.

PubMed

Marquié, J C; Baracat, B

2000-09-01

This study examined age-related differences in decision criteria and the extent to which inconsistencies in earlier findings could be due to sampling artifacts, especially the underlying effects of educational level and sex. Male and female participants (N = 3,059) from 4 age groups (32, 42, 52, and 62 years) and a wide range of educational levels performed a word recognition task. Response bias was assessed with a nonparametric index derived from signal detection theory. The analyses revealed no age differences except for the most educated subjects, for whom increased age was associated with stricter decision criteria. Lower levels of education and men as compared with women were associated with a more conservative bias. Controlling for the level of sensitivity did not significantly change this pattern of results. This finding stresses the need for caution in generalizing age differences obtained from samples that are only partly representative or imbalanced with respect to education and sex.

Impact of aging and comorbidity on the efficacy of low-intensity shock wave therapy for erectile dysfunction.

PubMed

Hisasue, Shin-ichi; China, Toshiyuki; Horiuchi, Akira; Kimura, Masaki; Saito, Keisuke; Isotani, Shuji; Ide, Hisamitsu; Muto, Satoru; Yamaguchi, Raizo; Horie, Shigeo

2016-01-01

To evaluate the efficacy of low-intensity shock wave therapy and to identify the predictive factors of its efficacy in Japanese patients with erectile dysfunction. The present study included 57 patients with erectile dysfunction who satisfied all the following conditions: more than 6-months history of erectile dysfunction, sexual health inventory for men score of ≤ 12 without phosphodiesterase type-5 inhibitor, erection hardness score grade 1 or 2, mean penile circumferential change by erectometer assessing sleep related erection of < 25 mm and non-neurological pathology. Patients were treated by a low-energy shock waves generator (ED1000; Medispec, Gaithersburg, MD, USA). A total of 12 shock wave treatments were applied. Sexual health inventory for men score, erection hardness score with or without phosphodiesterase type-5 inhibitor, and mean penile circumferential change were assessed at baseline, 1, 3 and 6 months after the termination of low-intensity shock wave therapy. Of 57 patients who were assigned for the low-intensity shock wave therapy trial, 56 patients were analyzed. Patients had a median age of 64 years. The sexual health inventory for men and erection hardness score (with and without phosphodiesterase type-5 inhibitor) were significantly increased (P < 0.001) at each time-point. The mean penile circumferential change was also increased from 13.1 to 20.2 mm after low-intensity shock wave therapy (P < 0.001). In the multivariate analysis, age and the number of concomitant comorbidities were statistically significant predictors for the efficacy. Low-intensity shock wave therapy seems to be an effective physical therapy for erectile dysfunction. Age and comorbidities are negative predictive factors of therapeutic response. © 2015 The Japanese Urological Association.

Prevalence and associations of anisometropia with spherical ametropia, cylindrical power, age, and sex in refractive surgery candidates.

PubMed

Linke, Stephan J; Richard, Gisbert; Katz, Toam

2011-09-29

To analyze the prevalence and associations of anisometropia with spherical ametropia, astigmatism, age, and sex in a refractive surgery population. Medical records of 27,070 eyes of 13,535 refractive surgery candidates were reviewed. Anisometropia, defined as the absolute difference in mean spherical equivalent powers between right and left eyes, was analyzed for subjective (A(subj)) and cycloplegic refraction (A(cycl)). Correlations between anisometropia (>1 diopter) and spherical ametropia, cylindrical power, age, and sex, were analyzed using χ² and nonparametric Kruskal-Wallis or Mann-Whitney tests and binomial logistic regression analyses. Power vector analysis was applied for further analysis of cylindrical power. Prevalence of A(subj) was 18.5% and of A(cycl) was 19.3%. In hyperopes, logistic regression analysis revealed that only spherical refractive error (odds ratio [OR], 0.72) and age (OR, 0.97) were independently associated with anisometropia. A(subj) decreased with increasing spherical ametropia and advancing age. Cylindrical power and sex did not significantly affect A(subj). In myopes all explanatory variables (spherical power OR, 0.93; cylindrical power OR, 0.75; age OR, 1.02; sex OR, 0.8) were independently associated with anisometropia. Cylindrical power was most strongly associated with anisometropia. Advancing age and increasing spherical/cylindrical power correlated positively with increasing anisometropia in myopic subjects. Female sex was more closely associated with anisometropia. This large-scale retrospective analysis confirmed an independent association between anisometropia and both spherical ametropia and age in refractive surgery candidates. Notably, an inverse relationship between these parameters in hyperopes was observed. Cylindrical power and female sex were independently associated with anisometropia in myopes.

Remote memory as a function of age and sex.

PubMed

Storandt, M; Grant, E A; Gordon, B C

1978-10-01

Memory for events which occurred between 1910 and 1969 was examined in individuals ranging in age from 20 to 80 years. Two types of events were included: Those which represented happenings of historical significance and those which dealt with the entertainment world of the past. Men were found to recall historical items significantly better than women, while entertainment items were equally well recalled by the two sexes. Age of peak memory for past events from the entertainment world increased with the age of the item; individuals seemed to remember best those events which occurred in their youth or young adulthood. This pattern was not replicated with respect to the historical current events items; however, these items may be a biased test of remote memory in women.

Hematological parameters in relation to age, sex and biochemical values for mute swans (Cygnus olor).

PubMed

Dolka, B; Włodarczyk, R; Zbikowski, A; Dolka, I; Szeleszczuk, P; Kluciński, W

2014-06-01

The knowledge of the correct morphological and biochemical parameters in mute swans is an important indicator of their health status, body condition, adaptation to habitat and useful diagnostic tools in veterinary practice and ecological research. The aim of the study was to obtain hematological parameters in relation to age, sex and serum biochemistry values in wild-living mute swans. We found the significant differences in the erythrocyte count, hematocrit, hemoglobin concentration and erythrocyte sedimentation rate in relation to age of mute swans. There were no differences in hematological values between males and females. The leukogram and H/L ratio did not vary by age and sex in swans. Among of biochemical parameters the slightly increased AST, ALP, CK, K, urea, decreased CHOL and TG values were recorded. As far as we know, this is the first study in which the morphometric parameters of blood cells in mute swans were presented. We found extremely low concentration of lead in blood (at subthreshold level). No blood parasites were found in blood smears. The analysis of body mass and biometric parameters revealed a significant differences dependent on age and sex. No differences in the scaled mass index were found. Our results represent a normal hematologic and blood chemistry values and age-sex related changes, as reference values for the mute swan.

High sex ratios in rural China: declining well-being with age in never-married men.

PubMed

Zhou, Xudong; Hesketh, Therese

2017-09-19

In parts of rural China male-biased sex ratios at birth, combined with out-migration of women, have led to highly male-biased adult sex ratios, resulting in large numbers of men being unable to marry, in a culture where marriage and reproduction are an expectation. The aim of this study was to test the hypotheses that older unmarried men are more predisposed to depression, low self-esteem and aggression than both those who are married, and those who are younger and unmarried. Self-completion questionnaires were administered among men aged 20-40 in 48 villages in rural Guizhou province, southwestern China. Tools used included the Beck Depression Inventory, the Rosenberg's Self-esteem Scale and the Bryant-Smith Aggression Questionnaire. Regression models assessed psychological wellbeing while adjusting for socio-demographic variables. Completed questionnaires were obtained from 957 never-married men, 535 married men aged 30-40, 394 partnered men and 382 unpartnered men aged 20-29. After adjusting for socio-demographic variables, never-married men were more predisposed to depression ( p < 0.05), aggression ( p < 0.01), low self-esteem ( p < 0.05) and suicidal tendencies ( p < 0.001). All the psychological measures deteriorated with age in never-married men. In contrast, married men remained stable on these dimensions with age. Never-married men are a psychologically highly vulnerable group in a society where marriage is an expectation. Since the highest birth sex-ratio cohorts have not yet reached reproductive age, the social tragedy of these men will last for at least another generation.This article is part of the themed issue 'Adult sex ratios and reproductive decisions: a critical re-examination of sex differences in human and animal societies'. © 2017 The Authors.

Age-related sex differences in body condition and telomere dynamics of red-sided garter snakes

PubMed Central

Rollings, Nicky; Uhrig, Emily J.; Krohmer, Randolph W.; Waye, Heather L.; Mason, Robert T.; Olsson, Mats; Whittington, Camilla M.

2017-01-01

Life-history strategies vary dramatically between the sexes, which may drive divergence in sex-specific senescence and mortality rates. Telomeres are tandem nucleotide repeats that protect the ends of chromosomes from erosion during cell division. Telomeres have been implicated in senescence and mortality because they tend to shorten with stress, growth and age. We investigated age-specific telomere length in female and male red-sided garter snakes, Thamnophis sirtalis parietalis. We hypothesized that age-specific telomere length would differ between males and females given their divergent reproductive strategies. Male garter snakes emerge from hibernation with high levels of corticosterone, which facilitates energy mobilization to fuel mate-searching, courtship and mating behaviours during a two to four week aphagous breeding period at the den site. Conversely, females remain at the dens for only about 4 days and seem to invest more energy in growth and cellular maintenance, as they usually reproduce biennially. As male investment in reproduction involves a yearly bout of physiologically stressful activities, while females prioritize self-maintenance, we predicted male snakes would experience more age-specific telomere loss than females. We investigated this prediction using skeletochronology to determine the ages of individuals and qPCR to determine telomere length in a cross-sectional study. For both sexes, telomere length was positively related to body condition. Telomere length decreased with age in male garter snakes, but remained stable in female snakes. There was no correlation between telomere length and growth in either sex, suggesting that our results are a consequence of divergent selection on life histories of males and females. Different selection on the sexes may be the physiological consequence of the sexual dimorphism and mating system dynamics displayed by this species. PMID:28381620

Age-related sex differences in body condition and telomere dynamics of red-sided garter snakes.

PubMed

Rollings, Nicky; Uhrig, Emily J; Krohmer, Randolph W; Waye, Heather L; Mason, Robert T; Olsson, Mats; Whittington, Camilla M; Friesen, Christopher R

2017-04-12

Life-history strategies vary dramatically between the sexes, which may drive divergence in sex-specific senescence and mortality rates. Telomeres are tandem nucleotide repeats that protect the ends of chromosomes from erosion during cell division. Telomeres have been implicated in senescence and mortality because they tend to shorten with stress, growth and age. We investigated age-specific telomere length in female and male red-sided garter snakes, Thamnophis sirtalis parietalis We hypothesized that age-specific telomere length would differ between males and females given their divergent reproductive strategies. Male garter snakes emerge from hibernation with high levels of corticosterone, which facilitates energy mobilization to fuel mate-searching, courtship and mating behaviours during a two to four week aphagous breeding period at the den site. Conversely, females remain at the dens for only about 4 days and seem to invest more energy in growth and cellular maintenance, as they usually reproduce biennially. As male investment in reproduction involves a yearly bout of physiologically stressful activities, while females prioritize self-maintenance, we predicted male snakes would experience more age-specific telomere loss than females. We investigated this prediction using skeletochronology to determine the ages of individuals and qPCR to determine telomere length in a cross-sectional study. For both sexes, telomere length was positively related to body condition. Telomere length decreased with age in male garter snakes, but remained stable in female snakes. There was no correlation between telomere length and growth in either sex, suggesting that our results are a consequence of divergent selection on life histories of males and females. Different selection on the sexes may be the physiological consequence of the sexual dimorphism and mating system dynamics displayed by this species. © 2017 The Author(s).

Oxidative stress and the evolution of sex differences in life span and ageing in the decorated cricket, Gryllodes sigillatus.

PubMed

Archer, Catharine R; Sakaluk, Scott K; Selman, Colin; Royle, Nick J; Hunt, John

2013-03-01

The Free Radical Theory of Ageing (FRTA) predicts that oxidative stress, induced when levels of reactive oxygen species exceed the capacity of antioxidant defenses, causes ageing. Recently, it has also been argued that oxidative damage may mediate important life-history trade-offs. Here, we use inbred lines of the decorated cricket, Gryllodes sigillatus, to estimate the genetic (co)variance between age-dependent reproductive effort, life span, ageing, oxidative damage, and total antioxidant capacity within and between the sexes. The FRTA predicts that oxidative damage should accumulate with age and negatively correlate with life span. We find that protein oxidation is greater in the shorter lived sex (females) and negatively genetically correlated with life span in both sexes. However, oxidative damage did not accumulate with age in either sex. Previously we have shown antagonistic pleiotropy between the genes for early-life reproductive effort and ageing rate in both sexes, although this was stronger in females. In females, we find that elevated fecundity early in life is associated with greater protein oxidation later in life, which is in turn positively correlated with the rate of ageing. Our results provide mixed support for the FRTA but suggest that oxidative stress may mediate sex-specific life-history strategies in G. sigillatus. © 2012 The Author(s). Evolution© 2012 The Society for the Study of Evolution.

Outcome of anesthesia in elective surgical patients with comorbidities.

PubMed

Eyelade, Olayinka; Sanusi, Arinola; Adigun, Tinuola; Adejumo, Olufemi

2016-01-01

Presence of comorbidity in surgical patients may be associated with adverse perioperative events and increased the risk of morbidity and mortality. This audit was conducted to determine the frequencies of comorbidities in elective surgical patients and the outcome of anesthesia in a Tertiary Hospital in Nigeria. Observational study of a cross-section of adult patients scheduled for elective surgery over a 6-month period. A standardized questionnaire was used to document patients' demographics, the presence of comorbidity and type, surgical diagnosis, anesthetic technique, intraoperative adverse events, and outcome of anesthesia. The questionnaire was administered pre- and post-operatively to determine the effects of the comorbidities on the outcome of anesthesia. One hundred and sixty-five adult patients aged between 18 and 84 years were studied. There were 89 (53.9%) females and 76 (46.1%) males. Forty-five (27.3%) have at least one comorbidity. Hypertension was the most common (48.8%) associated illness. Other comorbidities identified include anemia (17.8%), asthma (8.9%), diabetes mellitus (6.7%), chronic renal disease (6.7%), and others. The perioperative period was uneventful in majority of patients (80.6%) despite the presence of comorbidities. Intraoperative adverse events include hypotension, hypertension, shivering, and vomiting. No mortality was reported. Hypertension was the most common comorbidity in this cohort of patients. The presence of comorbidity did not significantly affect the outcome of anesthesia in elective surgical patients.

Distinctive roles of age, sex, and genetics in shaping transcriptional variation of human immune responses to microbial challenges.

PubMed

Piasecka, Barbara; Duffy, Darragh; Urrutia, Alejandra; Quach, Hélène; Patin, Etienne; Posseme, Céline; Bergstedt, Jacob; Charbit, Bruno; Rouilly, Vincent; MacPherson, Cameron R; Hasan, Milena; Albaud, Benoit; Gentien, David; Fellay, Jacques; Albert, Matthew L; Quintana-Murci, Lluis

2018-01-16

The contribution of host genetic and nongenetic factors to immunological differences in humans remains largely undefined. Here, we generated bacterial-, fungal-, and viral-induced immune transcriptional profiles in an age- and sex-balanced cohort of 1,000 healthy individuals and searched for the determinants of immune response variation. We found that age and sex affected the transcriptional response of most immune-related genes, with age effects being more stimulus-specific relative to sex effects, which were largely shared across conditions. Although specific cell populations mediated the effects of age and sex on gene expression, including CD8 + T cells for age and CD4 + T cells and monocytes for sex, we detected a direct effect of these intrinsic factors for the majority of immune genes. The mapping of expression quantitative trait loci (eQTLs) revealed that genetic factors had a stronger effect on immune gene regulation than age and sex, yet they affected a smaller number of genes. Importantly, we identified numerous genetic variants that manifested their regulatory effects exclusively on immune stimulation, including a Candida albicans -specific master regulator at the CR1 locus. These response eQTLs were enriched in disease-associated variants, particularly for autoimmune and inflammatory disorders, indicating that differences in disease risk may result from regulatory variants exerting their effects only in the presence of immune stress. Together, this study quantifies the respective effects of age, sex, genetics, and cellular heterogeneity on the interindividual variability of immune responses and constitutes a valuable resource for further exploration in the context of different infection risks or disease outcomes. Copyright © 2018 the Author(s). Published by PNAS.

Sex- and age-dependent patterns of survival and breeding success in a long-lived endangered avian scavenger

NASA Astrophysics Data System (ADS)

Sanz-Aguilar, Ana; Cortés-Avizanda, Ainara; Serrano, David; Blanco, Guillermo; Ceballos, Olga; Grande, Juan M.; Tella, José L.; Donázar, José A.

2017-01-01

In long-lived species, the age-, stage- and/or sex-dependent patterns of survival and reproduction determine the evolution of life history strategies, the shape of the reproductive value, and ultimately population dynamics. We evaluate the combined effects of age and sex in recruitment, breeder survival and breeding success of the globally endangered Egyptian vulture (Neophron percnopterus), using 31-years of exhaustive data on marked individuals in Spain. Mean age of first reproduction was 7-yrs for both sexes, but females showed an earlier median and a larger variance than males. We found an age-related improvement in breeding success at the population level responding to the selective appearance and disappearance of phenotypes of different quality but unrelated to within-individual aging effects. Old males (≥8 yrs) showed a higher survival than both young males (≤7 yrs) and females, these later in turn not showing aging effects. Evolutionary trade-offs between age of recruitment and fitness (probably related to costs of territory acquisition and defense) as well as human-related mortality may explain these findings. Sex- and age-related differences in foraging strategies and susceptibility to toxics could be behind the relatively low survival of females and young males, adding a new concern for the conservation of this endangered species.

Self-concept of academic ability as a function of sex, age, and academic achievement among African adolescents.

PubMed

Mboya, M M

1998-08-01

This study examined (a) sex and age variations for scores on Self-concept of Academic Ability and academic achievement among 244 African adolescents attending a coeducational high school and (b) correlations between scores on Self-concept of Academic Ability and academic achievement by sex and age. No significant sex differences were found, but there were significant age differences on the Self-concept scores and measures of English, science, and history but not in mathematics. A significant positive correlation was found between Self-concept scores and academic achievement for boys and girls and in all age groups, but the magnitude of the correlations with achievement in mathematics was stronger among boys than among girls.

Age and sex differences in paranormal beliefs: a response to Vitulli, Tipton, and Rowe (1999)

PubMed

Irwin, H J

2000-04-01

Vitulli, Tipton, and Rowe (1999) report evidence of age and sex differences in the strength of paranormal beliefs. An alternative interpretation of their data is offered in terms of differential item functioning. It is suggested that respondents' interpretation of paranormal belief test items may vary with age and sex, and that such differences in the strength with which such beliefs are endorsed has not been conclusively established by Vitulli, et al.

Sex-based memory advantages and cognitive aging: a challenge to the cognitive reserve construct?

PubMed

Caselli, Richard J; Dueck, Amylou C; Locke, Dona E C; Baxter, Leslie C; Woodruff, Bryan K; Geda, Yonas E

2015-02-01

Education and related proxies for cognitive reserve (CR) are confounded by associations with environmental factors that correlate with cerebrovascular disease possibly explaining discrepancies between studies examining their relationships to cognitive aging and dementia. In contrast, sex-related memory differences may be a better proxy. Since they arise developmentally, they are less likely to reflect environmental confounds. Women outperform men on verbal and men generally outperform women on visuospatial memory tasks. Furthermore, memory declines during the preclinical stage of AD, when it is clinically indistinguishable from normal aging. To determine whether CR mitigates age-related memory decline, we examined the effects of gender and APOE genotype on longitudinal memory performances. Memory decline was assessed in a cohort of healthy men and women enriched for APOE ɛ4 who completed two verbal [Rey Auditory Verbal Learning Test (AVLT), Buschke Selective Reminding Test (SRT)] and two visuospatial [Rey-Osterrieth Complex Figure Test (CFT), and Benton Visual Retention Test (VRT)] memory tests, as well as in a separate larger and older cohort [National Alzheimer's Coordinating Center (NACC)] who completed a verbal memory test (Logical Memory). Age-related memory decline was accelerated in APOE ɛ4 carriers on all verbal memory measures (AVLT, p=.03; SRT p<.001; logical memory p<.001) and on the VRT p=.006. Baseline sex associated differences were retained over time, but no sex differences in rate of decline were found for any measure in either cohort. Sex-based memory advantage does not mitigate age-related memory decline in either APOE ɛ4 carriers or non-carriers.

Effects of age and sex on hormonal responses to weightlessness simulation

NASA Technical Reports Server (NTRS)

Larochelle, F.; Leach, C.; Vernikos-Danellis, J.

1982-01-01

The effects of horizontal bedrest on the excretion of catecholamines, aldosterone, and cortisol by human subjects grouped by age and sex are examined. The responses are assessed by assays of 24-hr urine samples collected throughout the studies. In 36-45-yr-olds, the excretion of epinephrine increases, whereas it decreases in the 46-55- and 56-65-yr-old groups. Norepinephrine excretion decreases (5-27%) in all groups during bedrest. Aldosterone excretion increases in the younger two groups of both males (19 and 6%) and females (47 and 9%). A slight decrease is observed in 56-65-yr-old males (6%), whereas excretion in females is unchanged. Cortisol excretion increases in the youngest groups of both men (12%) and women (13%) but decreases in the 56-65-yr-old groups (6 and 5%). For the two groups of intermediate age (46-55 yr), excretion in females decreases (15%), whereas in males it increases (19%). It is believed that hormone measurements may be of value in explaining variation in stress tolerance due to age and/or sex during space flight.

Prediction modelling for trauma using comorbidity and 'true' 30-day outcome.

PubMed

Bouamra, Omar; Jacques, Richard; Edwards, Antoinette; Yates, David W; Lawrence, Thomas; Jenks, Tom; Woodford, Maralyn; Lecky, Fiona

2015-12-01

Prediction models for trauma outcome routinely control for age but there is uncertainty about the need to control for comorbidity and whether the two interact. This paper describes recent revisions to the Trauma Audit and Research Network (TARN) risk adjustment model designed to take account of age and comorbidities. In addition linkage between TARN and the Office of National Statistics (ONS) database allows patient's outcome to be accurately identified up to 30 days after injury. Outcome at discharge within 30 days was previously used. Prospectively collected data between 2010 and 2013 from the TARN database were analysed. The data for modelling consisted of 129 786 hospital trauma admissions. Three models were compared using the area under the receiver operating curve (AuROC) for assessing the ability of the models to predict outcome, the Akaike information criteria to measure the quality between models and test for goodness-of-fit and calibration. Model 1 is the current TARN model, Model 2 is Model 1 augmented by a modified Charlson comorbidity index and Model 3 is Model 2 with ONS data on 30 day outcome. The values of the AuROC curve for Model 1 were 0.896 (95% CI 0.893 to 0.899), for Model 2 were 0.904 (0.900 to 0.907) and for Model 3 0.897 (0.896 to 0.902). No significant interaction was found between age and comorbidity in Model 2 or in Model 3. The new model includes comorbidity and this has improved outcome prediction. There was no interaction between age and comorbidity, suggesting that both independently increase vulnerability to mortality after injury. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Sex-Related and Age-Related Differences in Knee Strength of Basketball Players Ages 11–17 Years

PubMed Central

Vardaxis, Vassilios G.

2003-01-01

Objective: To assess hamstrings and quadriceps strength of basketball players ages 11–13 and 15–17 years. Design and Setting: This cross-sectional study occurred during the 2000 American Youth Basketball Tour National Tournament. We investigated whether sex- or age-related strength differences existed among study participants. Subjects: Forty-one tournament participants (22 girls, 19 boys; 11–13 or 15–17 years old) who reported no history of knee sprain or surgery were recruited. Measurements: We used a Cybex II dynamometer to obtain isokinetic concentric peak torques relative to body mass (Nm/kg) at 60°/s for hamstrings and quadriceps bilaterally. From average peak torques, we determined ipsilateral hamstrings:quadriceps and homologous muscle-group ratios. Results: Correlations between hamstrings and quadriceps strength measures ranged from 0.78 to 0.97. Players 15–17 years old had greater relative hamstrings and quadriceps strength than 11- to 13-year-old athletes. Age and sex interacted significantly for quadriceps strength. The quadriceps strength of 15- to 17-year-old girls did not differ from that of 11- to 13-year-old girls, whereas 15- to 17-year-old boys had stronger quadriceps than 11- to 13-year-old boys. Boys 15–17 years old had greater quadriceps strength than girls 15–17 years old. Conclusions: This study is unique in providing normative data for the hamstrings and quadriceps strength of basketball players 11–13 and 15–17 years old. Age-related strength differences did not occur consistently between the sexes, as girls 11–13 and 15–17 years old had similar relative quadriceps strength. PMID:14608433

Age, Comorbidity, and Breast Cancer Severity: Impact on Receipt of Definitive Local Therapy and Rate of Recurrence among Older Women with Early Stage Breast Cancer

PubMed Central

Field, Terry S; Bosco, Jaclyn LF; Prout, Marianne N; Gold, Heather T; Cutrona, Sarah; Pawloski, Pamala A; Yood, Marianne Ulcickas; Quinn, Virginia P; Thwin, Soe Soe; Silliman, Rebecca A

2011-01-01

Background The definitive local therapy options for early stage breast cancer are 1) mastectomy and 2) breast conserving surgery followed by radiation therapy. Older women and those with comorbidities frequently receive breast conserving surgery alone. The interaction of age and comorbidity with breast cancer severity and their impact on receipt of definitive therapy have not been well studied Study Design In a cohort of 1837 women age≥65 years receiving treatment for early stage breast cancer in 6 integrated healthcare delivery systems in 1990–1994 and followed for 10 years, we examined predictors of receiving non-definitive local therapy and assessed the impact on breast cancer recurrence within levels of severity, defined as level of risk for recurrence. Results Age and comorbidity were associated with receipt of non-definitive therapy. Compared to those at low risk, women at the highest risk were less likely to receive non-definitive therapy (odds ratio (OR) 0.32, 95% confidence interval (CI) 0.22, 0.47) while women at moderate risk were about half as likely (OR 0.54, CI 0.35, 0.84). Non-definitive local therapy was associated with higher rates of recurrence among women at moderate (HR 5.1, CI 1.9, 13.5) and low risk (HR 3.2, CI 1.1, 8.9). The association among women at high risk was weak (HR 1.3, CI 0.75, 2.1). Conclusions Among these older women with early stage breast cancer, decisions about therapy partially balanced breast cancer severity against age and comorbidity. However, even among women at low risk, omitting definitive local therapy was associated with increased recurrence. PMID:22014658

Managing comorbidities in idiopathic pulmonary fibrosis