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Association between socioeconomic status and the development of mental and physical health conditions in adulthood: a multi-cohort study.

https://arctichealth.org/en/permalink/ahliterature307090
Source
Lancet Public Health. 2020 03; 5(3):e140-e149
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Date
03-2020
Author
Mika Kivimäki
G David Batty
Jaana Pentti
Martin J Shipley
Pyry N Sipilä
Solja T Nyberg
Sakari B Suominen
Tuula Oksanen
Sari Stenholm
Marianna Virtanen
Michael G Marmot
Archana Singh-Manoux
Eric J Brunner
Joni V Lindbohm
Jane E Ferrie
Jussi Vahtera
Author Affiliation
Department of Epidemiology and Public Health, University College London, London, UK. Electronic address: m.kivimaki@ucl.ac.uk.
Source
Lancet Public Health. 2020 03; 5(3):e140-e149
Date
03-2020
Language
English
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Aged
Female
Finland - epidemiology
Health Status Disparities
Humans
Male
Middle Aged
Prospective Studies
Risk factors
Social Class
Young Adult
Abstract
Socioeconomic disadvantage is a risk factor for many diseases. We characterised cascades of these conditions by using a data-driven approach to examine the association between socioeconomic status and temporal sequences in the development of 56 common diseases and health conditions.
In this multi-cohort study, we used data from two Finnish prospective cohort studies: the Health and Social Support study and the Finnish Public Sector study. Our pooled prospective primary analysis data comprised 109?246 Finnish adults aged 17-77 years at study entry. We captured socioeconomic status using area deprivation and education at baseline (1998-2013). Participants were followed up for health conditions diagnosed according to the WHO International Classification of Diseases until 2016 using linkage to national health records. We tested the generalisability of our findings with an independent UK cohort study-the Whitehall II study (9838 people, baseline in 1997, follow-up to 2017)-using a further socioeconomic status indicator, occupational position.
During 1?110?831 person-years at risk, we recorded 245?573 hospitalisations in the Finnish cohorts; the corresponding numbers in the UK study were 60?946 hospitalisations in 186?572 person-years. Across the three socioeconomic position indicators and after adjustment for lifestyle factors, compared with more advantaged groups, low socioeconomic status was associated with increased risk for 18 (32·1%) of the 56 conditions. 16 diseases formed a cascade of inter-related health conditions with a hazard ratio greater than 5. This sequence began with psychiatric disorders, substance abuse, and self-harm, which were associated with later liver and renal diseases, ischaemic heart disease, cerebral infarction, chronic obstructive bronchitis, lung cancer, and dementia.
Our findings highlight the importance of mental health and behavioural problems in setting in motion the development of a range of socioeconomically patterned physical illnesses. Policy and health-care practice addressing psychological health issues in social context and early in the life course could be effective strategies for reducing health inequalities.
UK Medical Research Council, US National Institute on Aging, NordForsk, British Heart Foundation, Academy of Finland, and Helsinki Institute of Life Science.
Notes
CommentIn: Lancet Public Health. 2020 Mar;5(3):e127 PMID 32113514
PubMed ID
32007134 View in PubMed
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Association of Alcohol-Induced Loss of Consciousness and Overall Alcohol Consumption With Risk for Dementia.

https://arctichealth.org/en/permalink/ahliterature304855
Source
JAMA Netw Open. 2020 09 01; 3(9):e2016084
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Date
09-01-2020
Author
Mika Kivimäki
Archana Singh-Manoux
G David Batty
Séverine Sabia
Andrew Sommerlad
Sarah Floud
Markus Jokela
Jussi Vahtera
May A Beydoun
Sakari B Suominen
Aki Koskinen
Ari Väänänen
Marcel Goldberg
Marie Zins
Lars Alfredsson
Peter J M Westerholm
Anders Knutsson
Solja T Nyberg
Pyry N Sipilä
Joni V Lindbohm
Jaana Pentti
Gill Livingston
Jane E Ferrie
Timo Strandberg
Author Affiliation
Department of Epidemiology and Public Health, University College London, London, United Kingdom.
Source
JAMA Netw Open. 2020 09 01; 3(9):e2016084
Date
09-01-2020
Language
English
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Keywords
Adolescent
Adult
Aged
Alcoholism - classification - complications - epidemiology
Cohort Studies
Dementia - epidemiology - etiology - physiopathology
Ethanol - analysis - classification
Female
Finland - epidemiology
France - epidemiology
Humans
Male
Middle Aged
Proportional Hazards Models
Risk factors
Sweden - epidemiology
Unconsciousness - epidemiology - etiology - physiopathology
United Kingdom - epidemiology
Abstract
Evidence on alcohol consumption as a risk factor for dementia usually relates to overall consumption. The role of alcohol-induced loss of consciousness is uncertain.
To examine the risk of future dementia associated with overall alcohol consumption and alcohol-induced loss of consciousness in a population of current drinkers.
Seven cohort studies from the UK, France, Sweden, and Finland (IPD-Work consortium) including 131?415 participants were examined. At baseline (1986-2012), participants were aged 18 to 77 years, reported alcohol consumption, and were free of diagnosed dementia. Dementia was examined during a mean follow-up of 14.4 years (range, 12.3-30.1). Data analysis was conducted from November 17, 2019, to May 23, 2020.
Self-reported overall consumption and loss of consciousness due to alcohol consumption were assessed at baseline. Two thresholds were used to define heavy overall consumption: greater than 14 units (U) (UK definition) and greater than 21 U (US definition) per week.
Dementia and alcohol-related disorders to 2016 were ascertained from linked electronic health records.
Of the 131?415 participants (mean [SD] age, 43.0 [10.4] years; 80?344 [61.1%] women), 1081 individuals (0.8%) developed dementia. After adjustment for potential confounders, the hazard ratio (HR) was 1.16 (95% CI, 0.98-1.37) for consuming greater than 14 vs 1 to 14 U of alcohol per week and 1.22 (95% CI, 1.01-1.48) for greater than 21 vs 1 to 21 U/wk. Of the 96?591 participants with data on loss of consciousness, 10?004 individuals (10.4%) reported having lost consciousness due to alcohol consumption in the past 12 months. The association between loss of consciousness and dementia was observed in men (HR, 2.86; 95% CI, 1.77-4.63) and women (HR, 2.09; 95% CI, 1.34-3.25) during the first 10 years of follow-up (HR, 2.72; 95% CI, 1.78-4.15), after excluding the first 10 years of follow-up (HR, 1.86; 95% CI, 1.16-2.99), and for early-onset (
PubMed ID
32902651 View in PubMed
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DSM-5 eating disorders among adolescents and young adults in Finland: A public health concern.

https://arctichealth.org/en/permalink/ahliterature307121
Source
Int J Eat Disord. 2020 05; 53(5):520-531
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
05-2020
Author
Yasmina Silén
Pyry N Sipilä
Anu Raevuori
Linda Mustelin
Mauri Marttunen
Jaakko Kaprio
Anna Keski-Rahkonen
Author Affiliation
Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland.
Source
Int J Eat Disord. 2020 05; 53(5):520-531
Date
05-2020
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Child
Diagnostic and Statistical Manual of Mental Disorders
Feeding and Eating Disorders - epidemiology
Female
Finland
Humans
Incidence
Male
Prevalence
Prospective Studies
Public Health
Surveys and Questionnaires
Abstract
We aimed to assess the lifetime prevalence, 10-year incidence, and peak periods of onset for eating disorders as defined by the Fifth Diagnostic and Statistical Manual of Mental Disorders (DSM-5) among adolescents and young adults born in the 1980s in Finland.
Virtually all Finnish twins born in 1983-1987 (n = 5,600) were followed prospectively from the age of 12?years. A subsample of participants (n = 1,347) was interviewed using a semi-structured diagnostic interview in their early twenties.
The prevalence of lifetime DSM-5 eating disorders was 17.9% for females and 2.4% for males (pooled across genders, 10.5%). The estimated lifetime prevalences for females and males, respectively, were 6.2 and 0.3% for anorexia nervosa (AN), 2.4 and 0.16% for bulimia nervosa (BN), 0.6 and 0.3% for binge-eating disorder (BED), 4.5 and 0.16% for other specified feeding or eating disorder (OSFED), and 4.5 and 1.6% for unspecified feeding or eating disorder (UFED). Among females, the prevalence of OSFED subcategories was as follows: atypical AN 2.1%, purging disorder 1.3%, BED of low frequency/limited duration 0.7%, and BN of low frequency/limited duration 0.4%. The 10-year incidence rate of eating disorders was 1,700 per 100,000 person-years among females (peak age of onset 16-19?years) and 220 per 100,000 person-years among males.
Eating disorders are a common public health concern among youth and young adults, affecting one in six females and one in 40 males. Adequate screening efforts, prevention, and interventions are urgently needed.
PubMed ID
31999001 View in PubMed
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Fever in travelers returning from malaria-endemic areas: don't look for malaria only.

https://arctichealth.org/en/permalink/ahliterature133263
Source
J Travel Med. 2011 Jul-Aug;18(4):239-44
Publication Type
Article
Author
Heli M Siikamäki
Pia S Kivelä
Pyry N Sipilä
Annikaisa Kettunen
M Katariina Kainulainen
Jukka P Ollgren
Anu Kantele
Author Affiliation
Division of Infectious Diseases, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. heli.siikamaki@hus.fi
Source
J Travel Med. 2011 Jul-Aug;18(4):239-44
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Communicable Diseases - diagnosis - epidemiology
Diagnosis, Differential
Endemic Diseases
Female
Fever - complications
Finland - epidemiology
Humans
Malaria - complications - diagnosis - epidemiology
Male
Middle Aged
Retrospective Studies
Risk factors
Travel
Young Adult
Abstract
Returning travelers with fever pose challenges for clinicians because of the multitude of diagnostic alternatives. Case data in a Finnish tertiary hospital were analyzed in order to define the causes of fever in returned travelers and to evaluate the current diagnostic approach.
A retrospective study of patient records comprised 462 febrile adults who, after traveling in malaria-endemic areas, were admitted to the Helsinki University Central Hospital (HUCH) emergency room from 2005 to 2009. These patients were identified through requests for malaria smear.
The most common groups of diagnoses were acute diarrheal disease (126 patients/27%), systemic febrile illness (95/21%), and respiratory illness (69/15%). The most common specific main diagnosis was Campylobacter infection (40/9%). Malaria was diagnosed in 4% (20/462). Blood culture was positive for bacteria in 5% of those tested (21/428). Eight patients were diagnosed with influenza. HIV-antibodies were tested in 174 patients (38%) and proved positive in 3% of them (5/174, 1% of all patients). The cause of fever was noninfectious in 12 (3%), remaining unknown in 116 (25%). Potentially life-threatening illnesses were diagnosed in 118 patients (26%), the strongest risk factors were baseline C-reactive protein (CRP) =100 (OR 3.6; 95% CI 2.0-6.4) and platelet count =140 (OR 3.8; 95% CI 2.0-7.3). Nine patients (2%) were treated in high dependency or intensive care units; one died of septicemia. Forty-five patients (10%) had more than one diagnosis.
The high proportion of patients with more than one diagnosis proves the importance of careful diagnostics. Every fourth returning traveler with fever had a potentially life-threatening illness. Septicemia was as common as malaria. The proportion of HIV cases exceeded the prevalence in population for which Centers for Disease Control and Prevention, USA (CDC) recommends routine HIV testing. Both blood cultures and HIV tests should be considered in febrile travelers.
PubMed ID
21722234 View in PubMed
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FinnTwin16: A Longitudinal Study from Age 16 of a Population-Based Finnish Twin Cohort.

https://arctichealth.org/en/permalink/ahliterature307886
Source
Twin Res Hum Genet. 2019 12; 22(6):530-539
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review
Date
12-2019
Author
Milla Kaidesoja
Sari Aaltonen
Leonie H Bogl
Kauko Heikkilä
Sara Kaartinen
Urho M Kujala
Ulla Kärkkäinen
Guiomar Masip
Linda Mustelin
Teemu Palviainen
Kirsi H Pietiläinen
Mirva Rottensteiner
Pyry N Sipilä
Richard J Rose
Anna Keski-Rahkonen
Jaakko Kaprio
Author Affiliation
Department of Public Health, University of Helsinki, Helsinki, Finland.
Source
Twin Res Hum Genet. 2019 12; 22(6):530-539
Date
12-2019
Language
English
Publication Type
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review
Keywords
Alcohol Drinking - physiopathology
Alcoholism - physiopathology
Diseases in Twins - epidemiology - genetics - psychology
Finland - epidemiology
Humans
Incidence
Longitudinal Studies
Mental Disorders - epidemiology - genetics - psychology
Registries - statistics & numerical data
Smoking - physiopathology
Twin Studies as Topic - methods
Twins - genetics - psychology - statistics & numerical data
Abstract
The purpose of this review is to provide a detailed and updated description of the FinnTwin16 (FT16) study and its future directions. The Finnish Twin Cohort comprises three different cohorts: the Older Twin Cohort established in the 1970s and the FinnTwin12 and FT16 initiated in the 1990s. FT16 was initiated in 1991 to identify the genetic and environmental precursors of alcoholism, but later the scope of the project expanded to studying the determinants of various health-related behaviors and diseases in different stages of life. The main areas addressed are alcohol use and its consequences, smoking, physical activity, overall physical health, eating behaviors and eating disorders, weight development, obesity, life satisfaction and personality. To date, five waves of data collection have been completed and the sixth is now planned. Data from the FT16 cohort have contributed to several hundred studies and many substudies, with more detailed phenotyping and collection of omics data completed or underway. FT16 has also contributed to many national and international collaborations.
PubMed ID
31796134 View in PubMed
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