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A comparison over 2 decades of disability-free life expectancy at age 65 years for those with long-term conditions in England: Analysis of the 2 longitudinal Cognitive Function and Ageing Studies
by Holly Q. Bennett, Andrew Kingston, Ilianna Lourida, Louise Robinson, Lynne Corner, Carol Brayne, Fiona E. Matthews, Carol Jagger, the Cognitive Function and Ageing Studies Collaboration BackgroundPrevious research has examined the improvements in healthy years if different health conditions are eliminated, but often with cross-sectional data, or for a limited number of conditions. We used longitudinal data to estimate disability-free life expectancy (DFLE) trends for older people with a broad number of health conditions, identify the conditions that would result in the greatest improvement in DFLE, and describe the cont...
Source: PLoS Medicine - March 15, 2022 Category: Internal Medicine Authors: Holly Q. Bennett Source Type: research

Association of ischemic stroke onset time with presenting severity, acute progression, and long-term outcome: A cohort study
ConclusionsNight-onset strokes, compared with day-onset strokes, are associated with higher presenting neurologic severity, more frequent END, and worse 3-month functional outcome. These findings suggest that circadian time of onset is an important additional variable for inclusion in epidemiologic natural history studies and in treatment trials of neuroprotective and reperfusion agents for acute ischemic stroke.
Source: PLoS Medicine - February 4, 2022 Category: Internal Medicine Authors: Wi-Sun Ryu Source Type: research

Consumption of coffee and tea and risk of developing stroke, dementia, and poststroke dementia: A cohort study in the UK Biobank
by Yuan Zhang, Hongxi Yang, Shu Li, Wei-dong Li, Yaogang Wang BackgroundPrevious studies have revealed the involvement of coffee and tea in the development of stroke and dementia. However, little is known about the association between the combination of coffee and tea and the risk of stroke, dementia, and poststroke dementia. Therefore, we aimed to investigate the associations of coffee and tea separately and in combination with the risk of developing stroke and dementia. Methods and findingsThis prospective cohort study included 365,682 participants (50 to 74 years old) from the UK Biobank. Participants joined the study f...
Source: PLoS Medicine - November 16, 2021 Category: Internal Medicine Authors: Yuan Zhang Source Type: research

Food biodiversity and total and cause-specific mortality in 9 European countries: An analysis of a prospective cohort study
We examined the associations between DSR and subsequent total and cause-specific mortality among 451,390 adults enrolled in the European Prospective Investigation into Cancer and Nutrition (EPIC) study (1992 to 2014, median follow-up: 17 years), free of cancer, diabetes, heart attack, or stroke at baseline. Usual dietary intakes were assessed at recruitment with country-specific dietary questionnaires (DQs). DSR of an individual ’s yearly diet was calculated based on the absolute number of unique biological species in each (composite) food and drink. Associations were assessed by fitting multivariable-adjusted Cox propor...
Source: PLoS Medicine - October 18, 2021 Category: Internal Medicine Authors: Giles T. Hanley-Cook Source Type: research

Intrinsic capacity and its associations with incident dependence and mortality in 10/66 Dementia Research Group studies in Latin America, India, and China: A population-based cohort study
ConclusionsIn this study we observed a high prevalence of DICs, particularly in older age groups. Those affected had substantially increased risks of dependence and death. Most needs for care arose in those with DIC yet to become frail. Our findings provide some support for the strategy of optimising intrinsic capacity in pursuit of healthy ageing. Implementation at scale requires community-based screening and assessment, and a stepped-care intervention approach, with redefined roles for community healthcare workers and efforts to engage, train, and support them in these tasks. ICOPE might be usefully integrated into commu...
Source: PLoS Medicine - September 14, 2021 Category: Internal Medicine Authors: Martin J. Prince Source Type: research

Telmisartan use and risk of dementia in type 2 diabetes patients with hypertension: A population-based cohort study
by Chi-Hung Liu, Pi-Shan Sung, Yan-Rong Li, Wen-Kuan Huang, Tay-Wey Lee, Chin-Chang Huang, Tsong-Hai Lee, Tien-Hsing Chen, Yi-Chia Wei BackgroundAngiotensin receptor blockers (ARBs) may have protective effects against dementia occurrence in patients with hypertension (HTN). However, whether telmisartan, an ARB with peroxisome proliferator-activated receptor γ (PPAR-γ)–modulating effects, has additional benefits compared to other ARBs remains unclear. Methods and findingsBetween 1997 and 2013, 2,166,944 type 2 diabetes mellitus (T2DM) patients were identified from the National Health Insurance Research Database of Taiwa...
Source: PLoS Medicine - July 19, 2021 Category: Internal Medicine Authors: Chi-Hung Liu Source Type: research

Evaluation of a package of risk-based pharmaceutical and lifestyle interventions in patients with hypertension and/or diabetes in rural China: A pragmatic cluster randomised controlled trial
by Xiaolin Wei, Zhitong Zhang, Marc K. C. Chong, Joseph P. Hicks, Weiwei Gong, Guanyang Zou, Jieming Zhong, John D. Walley, Ross E. G. Upshur, Min Yu BackgroundPrimary prevention of cardiovascular disease (CVD) requires adequate control of hypertension and diabetes. We designed and implemented pharmaceutical and healthy lifestyle interventions for patients with diabetes and/or hypertension in rural primary care, and assessed their effectiveness at reducing severe CVD events. Methods and findingsWe used a pragmatic, parallel group, 2-arm, controlled, superiority, cluster trial design. We randomised 67 township hospitals in ...
Source: PLoS Medicine - July 1, 2021 Category: Internal Medicine Authors: Xiaolin Wei Source Type: research

Development and validation of a model for predicting incident type 2 diabetes using quantitative clinical data and a Bayesian logistic model: A nationwide cohort and modeling study
ConclusionsOur results show that a Bayesian logistic model using full-information continuous predictors has high predictive discrimination, and can be used to quantify race- and sex-specific T2D risk, providing a new, powerful predictive tool. This tool can be used for T2D prevention efforts including weight loss therapy by allowing clinicians to target high-risk individuals in a manner that could be used to optimize outcomes.
Source: PLoS Medicine - August 6, 2020 Category: Internal Medicine Authors: Lua Wilkinson Source Type: research

The global burden of disease attributable to high body mass index in 195 countries and territories, 1990 –2017: An analysis of the Global Burden of Disease Study
ConclusionsIn this study, we observed that the number of global deaths and DALYs attributable to high BMI has substantially increased between 1990 and 2017. Successful population-wide initiatives targeting high BMI may mitigate the burden of a wide range of diseases. Given the large variations in high-BMI-related burden of disease by SDI, future strategies to prevent and reduce the burden should be developed and implemented based on country-specific development status.
Source: PLoS Medicine - July 27, 2020 Category: Internal Medicine Authors: Haijiang Dai Source Type: research

Opportunistic screening for atrial fibrillation by clinical pharmacists in UK general practice during the influenza vaccination season: A cross-sectional feasibility study
ConclusionsThis study demonstrates that AF screening performed by GP practice –based pharmacists was feasible, economically viable, and positively endorsed by participants. Furthermore, diagnosis of AF by the clinical pharmacist using anSLECG was more sensitive and more specific than the use of pulse palpation alone. Future research should explore the key barriers preventing the adoption of national screening programmes.
Source: PLoS Medicine - July 16, 2020 Category: Internal Medicine Authors: Vilius Savickas Source Type: research

Cardiometabolic disease costs associated with suboptimal diet in the United States: A cost analysis based on a microsimulation model
ConclusionsSuboptimal diet of 10 dietary factors accounts for 18.2% of all ischemic heart disease, stroke, and type 2 diabetes costs in the US, highlighting that timely implementation of diet policies could address these health and economic burdens.
Source: PLoS Medicine - December 16, 2019 Category: Internal Medicine Authors: Thiago Veiga Jardim Source Type: research

Variation of all-cause and cause-specific mortality with body mass index in one million Swedish parent-son pairs: An instrumental variable analysis
ConclusionsConsistent with previous large-scale meta-analyses and reviews, results supported the causal role of higher BMI in increasing the risk of several common causes of death, including cancers with increasing global incidence. We also found positive effects of BMI on mortality from respiratory disease, prostate cancer, and lung cancer, which has been inconsistently reported in the literature, suggesting that the causal role of higher BMI in mortality from these diseases may be underestimated. Furthermore, we expect different patterns of bias in the current observational and IV analyses; therefore, the similarities be...
Source: PLoS Medicine - August 8, 2019 Category: Internal Medicine Authors: Kaitlin H. Wade Source Type: research

Determinants of cognitive performance and decline in 20 diverse ethno-regional groups: A COSMIC collaboration cohort study
This study investigated associations between risk factors and late-life cognitive decline on a global scale, including comparisons between ethno-regional groups. Methods and findingsWe harmonized longitudinal data from 20 population-based cohorts from 15 countries over 5 continents, including 48,522 individuals (58.4% women) aged 54 –105 (mean = 72.7) years and without dementia at baseline. Studies had 2–15 years of follow-up. The risk factors investigated were age, sex, education, alcohol consumption, anxiety, apolipoprotein E ε4 allele (APOE*4) status, atrial fibrillation, blood pressure and pulse pressure, body mas...
Source: PLoS Medicine - July 22, 2019 Category: Internal Medicine Authors: Darren M. Lipnicki Source Type: research

Lifetime risk and multimorbidity of non-communicable diseases and disease-free life expectancy in the general population: A population-based cohort study
ConclusionsOur study suggests that in this western European community, 9 out of 10 individuals aged 45 years and older develop an NCD during their remaining lifetime. Among those individuals who develop an NCD, at least a third are subsequently diagnosed with multiple NCDs. Absence of 3 common shared risk factors is associated with compression of morbidity of NCDs. These findings underscore the importance of avoidance of these common shared risk factors to reduce the premature morbidity and mortality attributable to NCDs.
Source: PLoS Medicine - February 4, 2019 Category: Internal Medicine Authors: Silvan Licher Source Type: research

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