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BACKGROUND: modifiable behavioural risk factors including smoking and alcohol consumption are major contributing or actual causes of mortality. OBJECTIVE: to examine the effect of alcohol intake on all-cause mortality in older adults. Design and SETTING: prospective population-based cohort study of residents of a California, United States retirement community. SUBJECTS: 8,877 women and 5,101 men (median age, 74 years) who in the early 1980s completed a postal health srvey incluing details on alcohol consumption. METHODS: participants were followed for 23 years (1981-2004) including two follow-up questionnaires (in 1992 and 1998) asking about current alcohol intake. Age-adjusted and multivariate-adjusted risk ratios of death and 95% confidence intervals were calculated separately for men and women, using proportional hazard regression. RESULTS: of the 8,644 women and 4,980 men with complete information on the variables of interest and potential confounders, 6,930 women and 4,456 men had died (median age, 87 years). Both men and women who drank alcohol had decreased mortality compared with non-drinkers. Those who drank two or more drinks per day had a 15% reduced risk of death. The reduced risk was not limited to one type of alcohol. Stable drinkers (those who reported drinking both at baseline and follow-up) had a significantly decreased risk of death compared with stable non-drinkers. Those who started drinking at follow-up also had a significantly lower risk. Women who quit drinking were at increased risk of death. CONCLUSION: in elderly men and women, moderate alcohol intake exhibits a beneficial effect on mortality. Those who quit may do so for health reasons that affect mortality. 相似文献
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A M Levine G D Overturf R F Field D Holdorf A Paganini-Hill D I Feinstein 《Blood》1979,54(5):1171-1175
Fulminant bacterial sepsis has been described in patients with Hodgkin disease who have undergone splenectomy for staging purposes. The organisms commonly associated with sepsis in this setting include Streptococcus pneumoniae and Haemophilus influenzae. Polyvalent pneumococcal vaccine (Merck) has recently been licensed and has been suggested for use in patients with Hodgkin disease who are at risk for postsplenectomy sepsis. We administered 14-valent pneumococcal vaccine to 24 patients with Hodgkin disease and 24 normal controls, and measured antibody response to 13 antigens at time of immunization and at 3 wk and 3 mo following immunization. Our results indicate that patients who have been previously treated for Hodgkin disease, with chemotherapy, radiotherapy, or both, have severe impairment of antibody response. Untreated patients, however, respond in a manner similar to normal controls. 相似文献
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María M. Corrada Kathleen M. Hayden Annlia Paganini-Hill Szofia S. Bullain Jaime DeMoss Colette Aguirre Ron Brookmeyer Claudia H. Kawas 《Alzheimer's & dementia》2017,13(2):103-110
Introduction
We investigated the association between age of onset of hypertension and dementia risk in an oldest-old cohort.Methods
Participants are from The 90+ Study, a population-based longitudinal study of people aged 90+ who are survivors from the Leisure World Cohort Study. We estimated hypertension onset age using self-reported information from The 90+ Study and Leisure World Cohort Study, collected about 20 years earlier. A total of 559 participants without dementia were followed every 6 months for up to 10 years.Results
A total of 224 participants developed dementia during follow-up (mean = 2.8 years). Compared with those without hypertension, participants whose hypertension onset age was 80 to 89 years had a lower dementia risk (hazard ratio = 0.58, P = .04) and participants with an onset age of 90+ years had the lowest risk (hazard ratio = 0.37, P = .004).Discussion
Developing hypertension at older ages may protect against dementia. Understanding the mechanisms for this lower risk is important for determining ways to prevent dementia in the very elderly. 相似文献6.
Decreased mortality in users of estrogen replacement therapy 总被引:15,自引:0,他引:15
In a prospective study of 8881 postmenopausal female residents of a retirement community in southern California, we evaluated in detail the relationship between estrogen use and overall mortality. After 7 1/2 years of follow-up, there had been 1447 deaths. Women with a history of estrogen use had 20% lower age-adjusted, all-cause mortality than lifetime nonusers (95% confidence interval, 0.70 to 0.87). Mortality decreased with increasing duration of use and was lower among current users than among women who used estrogens only in the distant past. Current users with more than 15 years of estrogen use had a 40% reduction in their overall mortality. Among oral estrogen users, relative risks of death could not be distinguished by specific dosages of the oral estrogen taken for the longest time. Women who had used estrogen replacement therapy had a reduced mortality from all categories of acute and chronic arteriosclerotic disease and cerebrovascular disease. This group of women had a reduced mortality from cancer, although this reduction was not statistically significant. The mortality from all remaining causes combined was the same in estrogen users and lifetime nonusers. 相似文献
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Smoking and mortality among residents of a California retirement community. 总被引:2,自引:1,他引:1 下载免费PDF全文
Smoking cessation decreases mortality among the elderly. Participants in the Leisure World Cohort Study initiated in 1981 were followed until death or January 1, 1991. The 8869 women and 4999 men (median age = 73 years at initial survey) contributed 105,952 person-years of follow-up; 4002 had died. All-cause mortality rates were highest among current smokers; compared with never smokers the age-adjusted relative risks (and 95% confidence intervals) were 1.67 (1.46, 1.92) for women and 1.95 (1.66, 2.30) for men. Current smokers had increased risks of coronary heart disease, other cardiovascular disease, and cancer. Risk of death from smoking-related cancers continued to be high among former smokers, although lower than the risk among current smokers. Relative risks of mortality from cancer and cardiovascular disease increased with the number of cigarettes smoked per day and with a decreasing number of years since cessation of smoking. 相似文献
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John S. Witte Giske Ursin Jack Siemiatycki W. Douglas Thompson Annali Paganini-Hill Robert W. Haile 《Breast cancer research and treatment》1997,42(3):243-251
We investigated associations between diet and premenopausal bilateral breast cancer in a familial matched case-control study. We studied 140 cases from population-based registries in Los Angeles County (California) and Connecticut, and from the major hospitals in the southern parts of the Province of Quebec. Unaffected sisters of the cases served as matched controls (222 total). Dietary intake were assessed with a food frequency questionnaire. Total fat, monounsaturated fat, polyunsaturated fat, oleic acid, and linoleic acid intake was inversely associated with premenopausal bilateral breast cancer risk. Consumption of carbohydrates (and sweetened beverages) was associated with an increased risk. We observed no associations for dietary fiber, antioxidants, or major food groupings, but we did observe inverse associations for intake of low fat dairy products and tofu. These findings suggest that monounsaturated and polyunsaturated fats, as well as soy foods, might reduce the risk of premenopausal bilateral breast cancer. 相似文献