Do reports of sleep disturbance relate to coronary and aortic calcification in healthy middle-aged women?: Study of Women’s Health Across the Nation

BackgroundPoor sleep may be associated with the cardiovascular disease (CVD) morbidity and mortality. It is less clear if poor sleep is associated with subclinical CVD. We evaluated cross-sectional associations between self-reported sleep disturbance and duration and calcification in the coronary arteries (CAC) and aorta (AC) in healthy mid-life women.Methods512 black and white women enrolled in the SWAN Heart Study, underwent a computed tomography protocol for measurement of CAC and AC and completed questionnaires about their sleep. Linear and partial proportional logit regression analyses adjusted for site, race, age, body mass index, and the Framingham risk score (model 1). Additional covariates of education, perceived health, hypnotic medication and alcohol use were evaluated (model 2), plus depressive symptoms (model 3).ResultsAC was related to higher levels of trouble falling asleep, waking earlier than planned, overall poor sleep quality, and cough/snoring and shorter sleep duration in linear regression analyses (model 1). Adjustments for additional covariates showed that poor sleep quality and waking earlier than planned remained associated with higher AC (models 2 and 3). CAC was unrelated to sleep characteristics.ConclusionsPoor sleep quality is related to AC in middle-aged women. Sleep quality should routinely be assessed in mid-life women.     

Nutrition and the risk for Parkinson’s disease: review of the literature

The etiology of Parkinson's disease (PD), the second most common movement disorder, is still unclear. A genetic vulnerability, even in idiopathic PD seems likely. Additional factors like endo- and exotoxins are proposed to contribute to the induction and in some cases possibly acceleration of the disorder. Among the epidemiological risk factors dietary components are being broadly discussed. Moreover, there is a growing awareness of the population concerning possibly preventive dietary habits. However, dietary factors are difficult to assess. This review gives an overview on epidemiological studies addressing a possible relation of dietary compounds and the risk for PD.     

Age of onset of hypertension and risk of dementia in the oldest-old: The 90+ Study

Introduction

We investigated the association between age of onset of hypertension and dementia risk in an oldest-old cohort.

High prevalence of mental disorders and comorbidity in the Geneva Gay Men’s Health Study

Background Several large surveys have suggested high prevalence of psychiatric disorders among gay men and other men who have sex with men. Methods In 2002, a comprehensive health survey was conducted among 571 gay men in Geneva, Switzerland, using probability-based time-space sampling. The Composite International Diagnostic Interview Short-Form (CIDI-SF) was used to assess 12-month prevalence of major depression, specific phobia, social phobia, alcohol dependence, and drug dependence. Results Nearly half (43.7%, 95% CI=39.0–48.4) of the sample fulfilled the criteria for at least one of the five DSM-IV disorders: 19.2% had major depression, 21.9% had specific and/or social phobia, and 16.7% had an alcohol and/or drug dependence disorder in the past 12 months. Over one quarter of the cases were comorbid with another kind of disorder, and 35.7% of cases consulted a health care professional in the past 12 months for mental health. Like cases, screen-positives for mood and/or anxiety disorders (24.7%) also reported significantly greater disability and lower quality of life. Conclusions Nearly two-thirds of this community sample of gay men was affected by psychiatric morbidity with new evidence for comorbidity, subthreshold disorders, and low levels of awareness of psychiatric disorders and their treatment. This population needs to be a priority in psychiatric epidemiology and mental public health.     

Anthropometric measures and cognition in middle-aged HIV-infected and uninfected women. The Women’s Interagency HIV Study

This study aimed to explore the relationship of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) with cognition in women with (HIV+) and without HIV (HIV?) infection. One thousand six hundred ninety participants (1,196 HIV+, 494 HIV?) in the Women’s Interagency HIV Study (WIHS) with data available on anthropometric measures comprise the analytical sample. Cross-sectional analyses using linear regression models estimated the relationship between anthropometric variables and Trails A, Trails B, Stroop interference time, Stroop word recall, Stroop color naming and reading, and Symbol Digit Modalities Test (SDMT) with consideration for age, HIV infection status, Wide Range Achievement Test score, CD4 count, insulin resistance, drug use, and race/ethnicity. Among HIV+ women, BMI?<?18.5 kg/m² was associated with poorer cognitive performance evidenced by longer Trails A and Trails B and shorter SDMT completion times. An obese BMI (30 kg/m² or higher) was related to better performance on Trails B and worse performance on the Stroop interference test. Among HIV? women, an obese BMI was related to worse performance on the Stroop color naming test. Few and inconsistent associations were observed between WC, WHR, and cognition. Among women at mid-life with chronic (at least 10 years) HIV infection, common anthropometric measures, primarily BMI, were differentially related to cognitive test performance by cognitive domain. Higher levels of BMI were associated with better cognitive function. In this era of antiretroviral therapies, restoration of health evidenced as higher BMI due to effective antiretroviral therapies, may improve cognitive function in middle-aged HIV-infected women.     

Breastfeeding and risk of febrile seizures in infants: The Japan Environment and Children’s Study

ObjectiveOur study was conducted to examine the association between breastfeeding and febrile seizures (FS) in the first year of life.MethodsWe used data from a birth cohort study, the Japan Environment and Children’s Study (JECS). In a self-administered questionnaire, we asked participants the duration of breastfeeding and whether their children were diagnosed as having FS during their first 12 months. We estimated the association of duration and exclusiveness of breastfeeding with the FS by using multiple logistic regression analysis.ResultsOf 84,082 children, 995 (1.2%) were diagnosed as having FS by the age of 12 months. The prevalence of FS was higher in children who were breastfed for shorter duration. Multiple logistic regression analysis showed that, compared with children breastfed for less than 1 month, those breastfed for 4–6 months and 7–12 months had lower risks of FS (adjusted odds ratio [aOR], 0.65 [95% confidence interval {CI}, 0.42–0.99]; aOR, 0.66 [95% CI: 0.45–0.96], respectively). Moreover, compared with infants who received both breast milk and formula milk for 6 months, infants who were breastfed exclusively for 6 months had lower risk of FS (aOR: 0.78 [95% CI: 0.64–0.95]).ConclusionsOur results suggest that breastfeeding has a protective effect against FS in the first year of life.     

Relationship Between Children’s Sleep and Mental Health in Mothers of Children with and Without Autism

The study employed 90 children with autism spectrum disorders (ASDs) who were matched to 90 typically developing children on age, gender, and ethnicity. Using structural equation modeling, maternal sleep and maternal stress mediated the relationship between children’s sleep and mothers’ mental health for mothers of children with and without ASDs. Mothers of children with ASDs reported more problems related to children’s sleep, their own sleep, greater stress, and poorer mental health; however, children’s sleep and maternal sleep were more closely related to maternal stress for mothers of typically developing children. Implications of these findings and future directions for research are discussed.     

Daytime sleepiness and risk of coronary heart disease and stroke: results from the Nurses’ Health Study II

ObjectiveThe objective of this study was to determine whether daytime sleepiness is independently associated with coronary heart disease (CHD) and stroke or whether the positive association is explained by short sleep duration, disturbed sleep, and circadian disruption, conditions that are associated with cardiometabolic risk factors for vascular events.MethodsLongitudinal analyses of data from the Nurses’ Health Study II comprising 84,003 female registered nurses aged 37–54 at baseline were conducted in 2001 with follow-up until 2009. Multivariate Cox regression was used to explore the relationship between reported daytime sleepiness and the incidence of either CHD or stroke (n = 500 cases).ResultsWomen who reported daytime sleepiness almost every day, compared with rarely/never, had an elevated adjusted risk of cardiovascular disease (CVD) (hazard ratio (HR) = 1.58, 95% confidence interval (CI) 1.15–2.17). Controlling for sleep variables (sleep duration, snoring, shift work, and sleep adequacy) or potential metabolic biological mediators of disrupted sleep (diabetes, hypercholesterolemia, and hypertension) appreciably attenuated the relationship (HR = 1.17, 95% CI 0.84–1.65; and HR = 1.34, 95% CI 0.97–1.85, respectively). Controlling for both sleep variables and metabolic risk factors eliminated an independent association (HR = 1.09, 95% CI 0.77–1.53). A similar pattern was observed for CHD and stroke individually.ConclusionsDaytime sleepiness was not an independent risk factor for CVD in this cohort of women, but rather, was associated with sleep characteristics and metabolic abnormalities that are risk factors for CVD.     

Policy for Promotion of Women’s Mental Health: Insight from Analysis of Policy on Postnatal Depression in Mexico

This article critically examines federal, state and facility-level policies, as well as clinical practice guidelines regarding postnatal depression in Mexico. Thirteen documents including national health plans, national action plans, federal and state laws and regulations, clinical practice guidelines, and public-sector healthcare facility policies were collected and evaluated according to whether they included a statement of intent and/or actions related to the care of women at risk for or experiencing postnatal depression. While postnatal depression is included in several policies in Mexico, it is not addressed in ways that guide actions to manage postnatal depression. Specific direction on postnatal depression in policies would bridge a gap in maternal mental healthcare given that medication, treatment, and timing of interventions is unique in the postpartum context.     

Association between aluminum in drinking water and incident Alzheimer’s disease in the Canadian Study of Health and Aging cohort

Epidemiological evidence linking aluminum in drinking water and Alzheimer’s disease (AD) has been inconsistent, with previous studies often limited by small sample sizes. The present study addresses this issue using data from the Canadian Study of Health and Aging (CSHA), a prospective cohort of 10,263 subjects followed-up from 1991-1992 through 2001–2002. Participants’ residential histories were linked to municipal drinking water sources in 35 Canadian municipalities to obtain ecologic pH, aluminum, fluoride, iron and silica concentrations in drinking water. Cox proportional hazards models were used to examine associations between aluminum and incident AD [Hazard Ratios (HRs), 95% confidence intervals (CIs)], adjusting for age, gender, history of stroke, education, and high blood pressure.A total of 240 incident AD cases were identified during follow-up of 3, 638 subjects derived from the CSHA cohort with complete data on all covariates. With categorical aluminum measurements, there was an increasing, but not statistically significant, exposure-response relationship (HR = 1.34, 95% CI 0.88−2.04, in the highest aluminum exposure category; p = 0.13 for linear trend). Similar results were observed using continuous aluminum measurements (HR=1.21, 95% CI 0.97−1.52, at the interquartile range of 333.8 μg/L; p = 0.09 for linear trend). In a subsample genotyped for ApoE-ε4, there was some evidence of an association between aluminum and AD (p = 0.03 for linear trend).Although a clear association between aluminum in drinking water and AD was not found, the linear trend observed in ApoE-ε4 subsample warrants further examination.     

Sleep disorders in Alzheimer’s disease:the predictive roles and potential mechanisms

Sleep disorders are common in patients with Alzheimer’s disease,and can even occur in patients with amnestic mild cognitive impairment,which appears before Alzheimer’s disease.Sleep disorders further impair cognitive function and accelerate the accumulation of amyloid-βand tau in patients with Alzheimer’s disease.At present,sleep disorders are considered as a risk factor for,and may be a predictor of,Alzheimer’s disease development.Given that sleep disorders are encountered in other types of dementia and psychiatric conditions,sleep-related biomarkers to predict Alzheimer’s disease need to have high specificity and sensitivity.Here,we summarize the major Alzheimer’s disease-specific sleep changes,including abnormal non-rapid eye movement sleep,sleep fragmentation,and sleep-disordered breathing,and describe their ability to predict the onset of Alzheimer’s disease at its earliest stages.Understanding the mechanisms underlying these sleep changes is also crucial if we are to clarify the role of sleep in Alzheimer’s disease.This paper therefore explores some potential mechanisms that may contribute to sleep disorders,including dysregulation of the orexinergic,glutamatergic,andγ-aminobutyric acid systems and the circadian rhythm,together with amyloid-βaccumulation.This review could provide a theoretical basis for the development of drugs to treat Alzheimer’s disease based on sleep disorders in future work.     

Breastfeeding and risk of febrile seizures in the first 3 years of life: The Japan Environment and Children’s Study

ObjectiveOur study was conducted to examine the association between breastfeeding and febrile seizures (FS) in the first 3 years of life.MethodsWe analyzed the dataset of the Japan Environment and Children’s Study (JECS), which is a birth cohort study undertaken to elucidate the influence of environmental factors on children’s health during the fetal period and early childhood.Information on feeding duration and feeding pattern, as well as information on febrile seizures, were obtained from questionnaires sent to mothers/caregivers. We categorized a child as having experienced FS if the child was reported as having been diagnosed with FS in the first 3 years. Modified Poisson regression with a robust error variance was used to estimate the effect of duration of breastfeeding and the risk of FS.ResultsOf the 84,321 children included in the analysis, 6264 (7.4%) were reported to have experienced FS at least once in the first 3 years of life. Multivariate analyses showed that the risk of FS during the first 3 years of life tended to decrease as the duration of breastfeeding increased. Male sex and frequent fever episodes were also associated with an increased risk of FS.ConclusionsContinued breastfeeding until 2 years of age, the most susceptible age for FS, had a small but protective effect on FS.     

Mitochondrial DNA polymorphisms and the risk of Parkinson’s disease in Taiwan

Summary A critical role of mitochondrial dysfunction has been implicated in the pathogenesis of Parkinson’s disease (PD). The association of mitochondrial DNA (mtDNA) polymorphisms 9055G/A, 10398G/A and 13708G/A with PD has been controversial. In this study we analyzed whether these three genetic polymorphisms are associated with PD in a cohort of 416 PD cases and 372 ethnically matched controls. The allele frequency distribution of any of these three analyzed polymorphisms was not significantly different between the cases and the controls. None of the six haplotypes derived influences risk of PD. Notably, after stratification by age, individuals over 70 years of age carrying the haplotype 9055G-10398A-13708G demonstrated a significant decrease in risk of developing PD (OR = 0.44, 95% CI = 0.24–0.80, p = 0.008). These results suggest that the mtDNA haplotype 9055G-10398A-13708G plays a role in PD susceptibility among Taiwanese people older than 70 years of age.     

Trauma,Post-Traumatic Stress Disorder,and Treatment Among Middle-Aged and Older Women in the Nurses’ Health Study II

ObjectiveTrauma and post-traumatic stress disorder (PTSD) are common among women and associated with negative health outcomes across the life course. Relatively few studies, however, have examined the epidemiology of trauma, PTSD, and treatment among middle-aged and older civilian women, who are at elevated risk for adverse health outcomes. We aimed to characterize trauma, PTSD, and trauma-related treatment prevalence and correlates in a large cohort of middle-aged and older women.DesignCross-sectional, nested substudy within the Nurses’ Health Study II cohort.SettingUnited States, 2018–2020.Participants33,327 current or former nurses, aged 53–74 years.Measurements16-item modified version of the Brief Trauma Questionnaire; modified PTSD Checklist for the Diagnostic and Statistical Manual, Version 5.ResultsThe majority (82.2%) of women reported one or more lifetime traumas. The most common trauma types were unexpected death of a loved one (44.9%) and interpersonal violence (43.5%). Almost 30% reported occupational (nursing-related) trauma. Among the trauma-exposed, 10.5% met criteria for lifetime PTSD and 1.5% had past-month PTSD. One-third of lifetime PTSD cases were due to interpersonal violence event types. One-third of women with lifetime PTSD—and nearly half of those with PTSD from a nursing-related trauma—reported never receiving trauma-related treatment. Women aged 65 years and older with PTSD were less likely to be in treatment than those aged less than 65 years.ConclusionHistory of trauma and PTSD is prevalent in this population, and a treatment gap persists. Addressing this treatment gap is warranted, particularly among older women and those with nursing-related trauma.     

Association between blood lead exposure and mental health in pregnant women: Results from the Japan environment and children’s study

ObjectiveAlthough environmental lead exposure has decreased, several studies have shown that low-level lead exposure can result in adverse psychological symptoms. However, few studies have examined lead neurotoxicity in pregnant women. We investigated the association between lead exposure and psychological symptoms in pregnant women, and between socio-economic status and blood lead levels.MethodsBlood lead levels were measured in 17,267 pregnant women in the Japan Environment and Children’s Study. Odds ratios (ORs) for high blood lead levels were calculated using multinomial logistic regression. Psychological symptoms were assessed using the Kessler Psychological Distress Scale (K6). ORs for depression (K6 ≥ 13 or ≥5) were calculated using logistic regression with adjustment for potential confounders.ResultsThe geometric mean of whole blood lead levels was 0.58 μg/dl (range 0.14–6.75 μg/dl). Higher blood lead levels were associated with older age (OR 1.79, 9 5% confidence interval [CI] 1.46–2.19), unmarried status (OR 1.75, 95 % CI 1.31–2.33), lower household income (OR 1.76, 95 % CI 1.38–2.24), and lower educational attainment (OR 1.34, 95 % CI 1.20–1.48). The percentage of women with K6 scores ≥13 and ≥5 was 3 % and 28.2 %, respectively. There was no significant association between lead exposure and K6 score (K6 ≥ 13: OR 1.00, 95 % CI 0.76–1.32; K6 ≥ 5: OR 0.98, 95 % CI 0.88–1.09).ConclusionOur results indicate a small but significant association between higher blood lead levels and lower socio-economic status in a population with low blood lead levels, but no association between low-level lead exposure and psychological symptoms.     

Sex and gender differences in cognitive and brain reserve: Implications for Alzheimer’s disease in women

Women represent ⅔ of the cases of Alzheimer’s disease (AD). Current research has focused on differential risks to explain higher rates of AD in women. However, factors that reduce risk for AD, like cognitive/brain reserve, are less well explored. We asked: what is known about sex and gender differences in how reserve mitigates risk for AD? We conducted a narrative review of the literature, with keywords: “sex/gender differences”, “cognitive/brain reserve”, “Alzheimer’s Disease”, and the following cognitive reserve contributors: “education”, “IQ”, “occupation”, “cognitive stimulation”, “bilingualism”, “socioeconomic status”, “physical activity”, “social support”. Sixteen papers disaggregated their data by sex. Those papers observed sex and gender differences in reserve contributors. There is also evidence that greater reserve may be more beneficial in lowering AD risk in women, although more research is needed. We discuss how traditional reserve contributors are gendered and may not capture factors that support cognition in aging women.