Disparities in the prevalence of cognitive delay: how early do they appear?

Cognitively delayed children are at risk for poor mental and physical health throughout their lives. The economically disadvantaged and some race/ethnic groups are more likely to experience cognitive delay, but the age at which delays first emerge and the underlying mechanisms responsible for disparities are not well understood. The objective of this study was to determine when sociodemographic disparities in cognitive functioning emerge, and identify predictors of low cognitive functioning in early childhood. Data were from 7308 singleton and 1463 multiple births in the Early Childhood Longitudinal Study‐Birth Cohort (ECLS‐B), a nationally representative cohort of children born in the USA in 2001. Multiple logistic regression analyses examined associations between sociodemographic characteristics and low cognitive functioning at 9 and 24 months, and tested whether gestational and birth‐related factors mediate these associations. Sociodemographic characteristics were statistically significant predictors of low cognitive functioning among singletons at 24 months, including the three lowest quintiles of socio‐economic status [lowest quintile, odds ratio (OR) = 2.7, 95% confidence interval [CI][1.7, 4.1]], non‐white race/ethnicity (African American OR = 1.8 [95% CI 1.3, 2.5], Hispanic OR = 2.3 [95% CI 1.6, 3.2]), and gender (male OR = 2.1, [95% CI 1.7, 2.5]). Gestational and birth characteristics associated with low cognitive function at 9 months included very low and moderately low birthweight (OR = 55.0 [95% CI 28.3, 107.9] and OR = 3.6 [95% CI 2.6, 5.1]), respectively, and very preterm and moderately preterm delivery (OR = 3.6 [95% CI 2.0, 6.7] and OR = 2.4 [95% CI 1.7, 3.5]), respectively, but they had weaker effects by 24 months (ORs for birthweight: 3.7 [95% CI 2.3, 5.9] and 1.8 [95% CI 1.4, 2.3]; ORs for preterm: 1.8 [95% CI 1.1, 2.9] and 0.9 [95% CI 0.7, 1.3]). Results for multiple births were similar. Sociodemographic disparities in poor cognitive functioning emerged by 24 months of age, but were not mediated by gestational or birth characteristics. Further investigation of processes whereby social disadvantage adversely affects development prior to 24 months is needed.     

Physical activity on the job and cancer in Missouri.

We conducted a series of case-control studies to investigate the risks of 16 cancer types in relation to occupational physical activity. These studies were based on Missouri Cancer Registry data for 17,147 White male cancer patients registered between 1984 and 1989. Colon cancer risk was increased for both the moderate (odds ratio (OR) = 1.1; 95% confidence interval (CI) = 1.0, 1.3) and low (OR = 1.2; 95% CI = 1.0, 1.5) activity levels. Similar elevations were observed for prostate cancer at the moderate (OR = 1.1; 95% CI = 1.0, 1.3) and low (OR = 1.5; 95% CI = 1.2, 1.8) levels of activity, and for cancer of the testis at the low activity level (OR = 2.2; 95% CI = 1.3, 3.7). An opposite trend (p less than 0.01) was noted for lung cancer, which showed decreased risk at the moderate (OR = 0.9; 95% CI = 0.8, 1.0) and low (OR = 0.8; 95% CI = 0.6, 0.9) activity levels. These associations suggest that further study of the relationship between physical activity and site-specific cancer risk is warranted.     

Assessing relationships between health-related quality of life and adherence to antiretroviral therapy

OBJECTIVE: To investigate associations between health-related quality of life (HRQoL), as assessed using the multidimensional quality of life-HIV (MQOL-HIV) questionnaire, and adherence to antiretroviral treatment in HIV-infected subjects. DESIGN: Multicentre cross-sectional study in three institutional tertiary hospitals in northwest Spain. PATIENTS AND METHODS: The MQOL-HIV was completed by 235 HIV-infected adults undergoing antiretroviral treatment. Adherence to antiretroviral therapy was assessed by using patient's self-report. Information about sociodemographic characteristics and clinical variables was also collected. RESULTS: Good adherence (> or = 95% of prescribed pills correctly taken) was reported by 131 patients (55.7%). Univariate analyses indicated that the sociodemographic and clinical variables associated with adherence were age, educational level, income, employment, home stability, transmission route, history of previous antiretroviral therapy, and number of prescribed pills/day. Subscales of MQOL-HIV associated with adherence were mental health, cognitive functioning, financial status, medical care, partner intimacy, and (in men only) sexual functioning. Stepwise logistic regression showed that good adherence was more frequent in patients aged > 40 years (odds ratio, OR: 2.50; 95% confidence interval, CI: 1.15-5.61) and in patients with high cognitive functioning (OR: 2.26; 95% CI: 1.19-4.30). Conversely, poor adherence was more frequent in patients without stable home (OR: 2.96; 95% CI: 1.39-6.32), in patients required to take 14 or more pills/day (OR: 2.17; 95% CI: 1.18-4.28), in patients with low financial status (OR: 3.42; 95% CI: 1.57-7.45), and in patients reporting low medical care (OR: 2.07; 95% CI: 1.07-3.98). CONCLUSIONS: HRQoL dimensions, notably cognitive functioning, financial status and medical care, are closely associated with antiretroviral therapy adherence.     

Physical activity levels in adults living in Bogotá (Colombia): prevalence and associated factors

OBJECTIVE: To determine the prevalence of physical activity levels in adults aged 18 to 65 years in Bogotá city and identify the factors associated with regular physical activity. METHODS: We conducted a population-based, cross-sectional survey in 3,000 adult residents of Bogotá in 2003 who were selected through a multistage probabilistic sample. Physical activity levels were determined using the short version of the International Physical Activity Questionnaire. Factors associated with regular physical activity were identified by logistic regression models. RESULTS: The adjusted prevalence of persons undertaking regular physical activity was 36.8%. After adjustment for potential confounders, regular physical activity was more likely in men (odds ratio [OR] = 1.62; 95% CI, 1.31-2.01) and in those whose self-perceived health status was good or very good (OR = 1.87; 95% CI, 1.41-2.49) and was less likely in those aged 30-49 years or 50-65 years (OR = 0.78; 95% CI, 0.63-0.96, and OR = 0.60; 95% CI, 0.43-0.82, respectively) and in those whose main activity in the previous 30 days was searching for a job (OR = 0.71; 95% CI, 0.51-0.97) or carrying out household tasks (OR = 0.72; 95% CI, 0.54-0.96). In women, unlike men, age groups showed no association with regular physical activity. CONCLUSION: This study shows gender differences in the prevalence of physical activity levels and associated factors. Future studies should establish, in the context of Latin American cities, whether it is appropriate to determine specific measures in each domain, in addition to overall physical activity levels.     

Total homocysteine and cognitive decline in a community-based sample of elderly subjects: the Rotterdam Study.

Homocysteine has been associated with an increased risk of cardiovascular disease. Cardiovascular diseases have been related to cognitive decline. The authors investigated the association of homocysteine with concurrent cognitive impairment and subsequent cognitive decline in a random sample of 702 community-dwelling respondents aged 55 years or over to the prospective Rotterdam Study in 1990-1994. Multiple logistic regression was used to calculate odds ratios and 95 percent confidence intervals for the association between total homocysteine levels and cognitive impairment (Mini-Mental State Examination (MMSE) score <26) and cognitive decline (drop in MMSE score of >1 point/year). Mean duration of follow-up was 2.7 years. After adjustment for age, sex, and education, there was no relation between total homocysteine and cognitive impairment (highest vs. lowest tertile: odds ratio (OR) = 1.30, 95% confidence interval (CI): 0.50, 3.38) or cognitive decline (middle vs. lowest tertile: OR = 1.14, 95% CI: 0.67, 1.93; highest vs. lowest tertile: OR = 0.91, 95% CI: 0.52, 1.58). Subjects who were lost to follow-up due to death or nonresponse had slightly higher age-adjusted homocysteine levels and lower MMSE scores at baseline. Sensitivity analyses showed that selective loss to follow-up was not a likely explanation for the absence of an association in the participants. Although a relation between homocysteine and reduced cognitive function is biologically plausible, this study suggests no such association in a community-based sample of the elderly.     

Case-control study of lifetime total physical activity and prostate cancer risk

A population-based case-control study of physical activity and prostate cancer risk was conducted in Alberta, Canada, between 1997 and 2000. A total of 988 incident, histologically confirmed cases of stage T2 or greater prostate cancer were frequency matched to 1,063 population controls. The Lifetime Total Physical Activity Questionnaire was used to measure occupational, household, and recreational activity levels from childhood until diagnosis. Multivariable logistic regression analyses were conducted. No association for total lifetime physical activity and prostate cancer risk was found (odds ratio (OR) for > or =203 vs. <115 metabolic equivalent-hours/week/year=0.87, 95% confidence interval (CI): 0.65, 1.17). By type of activity, the risks were decreased for occupational (OR=0.90, 95% CI: 0.66, 1.22) and recreational (OR=0.80, 95% CI: 0.61, 1.05) activity but were increased for household (OR=1.36, 95% CI: 1.05, 1.76) activity when comparing the highest and lowest quartiles. For activity performed at different age periods throughout life, activity done during the first 18 years of life (OR=0.78, 95% CI: 0.59, 1.04) decreased risk. When activity was examined by intensity of activity (i.e., low, <3; moderate, 3-6; and vigorous, >6 metabolic equivalents), vigorous activity decreased prostate cancer risk (OR=0.70, 95% CI: 0.54, 0.92). This study provides inconsistent evidence for the association between physical activity and prostate cancer risk.     

Birth size and childhood growth as determinants of physical functioning in older age: the Helsinki Birth Cohort Study

The study reports on the associations of infant and childhood anthropometric measurements, early growth, and the combined effect of birth weight and childhood body mass index with older age physical functioning among 1,999 individuals born in 1934-1944 and belonging to the Helsinki Birth Cohort Study. Physical functioning was assessed by the Short Form 36 scale. Anthropometric data from infancy and childhood were retrieved from medical records. The risk of lower Short Form 36 physical functioning at the mean age of 61.6 years was increased for those with birth weight less than 2.5 kg compared with those weighing 3.0-3.5 kg at birth (odds ratio (OR) = 2.73, 95% confidence interval (CI): 1.57, 4.72). The gain in weight from birth to age 2 years was associated with decreased risk of lower physical functioning for a 1-standard deviation increase (OR = 0.84, 95% CI: 0.75, 0.94). The risk of lower physical functioning was highest for individuals with birth weight in the lowest third and body mass index at 11 years of age in the highest third compared with those whose birth weight was in the middle third and body mass index at age 11 years was in the highest third (OR = 3.08, 95% CI: 1.83, 5.19). The increasing prevalence of obesity at all ages and the aging of populations warrant closer investigation of the role of weight trajectories in old age functional decline.     

辽宁省成年人糖尿病患病现况及其影响因素分析

目的 描述辽宁省成年人糖尿病患病情况并探索相关影响因素,为制定适合本省的防治策略提供科学依据。方法 采用多阶段分层随机整群抽样的方法,对辽宁省17 857名成年居民进行问卷调查及体格检查,应用Logistic回归模型对糖尿病患病的相关因素进行分析。结果 辽宁省成年人糖尿病患病率为13.00%,糖尿病知晓率为61.84%,治疗率为71.31%,控制率为35.16%。年龄（45~岁:OR=1.824,95%CI:1.526~2.181;≥60岁:OR=2.077,95%CI:1.730~2.492）、体质指数（body mass index,BMI）分级（超重:OR=1.213,95%CI:1.096~1.343;肥胖:OR=1.547,95%CI:1.338~1.787）、自报血脂异常（OR=2.686,95%CI:2.308~3.126）和患高血压（OR=1.807,95%CI:1.630~2.004）是糖尿病患病的危险因素,农村居民（OR=0.866,95%CI:0.788~0.952）、受教育程度较高（高中:OR=0.859,95%CI:0.756~0.975;大专及以上:OR=0.678,95%CI:0.576~0.798）、中等收入水平（OR=0.738,95%CI:0.585~0.931）及饮酒（OR=0.779,95%CI=0.682~0.890）是糖尿病患病的保护因素。结论 辽宁省成年人糖尿病患病率和知晓率较高,治疗率和控制率较低,应针对重点人群采取有效措施积极干预。     

A case-control study of physical activity and non-insulin dependent diabetes mellitus (NIDDM). the San Luis Valley Diabetes Study

PURPOSE: The purpose of this study was to examine the association between physical activity and non-insulin dependent diabetes mellitus (NIDDM). METHODS: We conducted a population-based case-control study in Hispanic and non-Hispanic white men and women, ages 20-74. A total of 167 cases with NIDDM and 1100 controls with normal glucose tolerance were included. All subjects completed an oral glucose tolerance test. RESULTS: Persons with recently diagnosed NIDDM reported significantly lower levels of physical activity than control subjects. For total metabolic units, the odds ratio for subjects in the highest tertile compared to those in the lowest tertile was 0.60 (95% confidence interval (CI) = 0.37-0.98) after adjusting for age, sex, ethnicity, and family history of diabetes. The adjusted odds ratio for persons reporting high levels of vigorous activity (at least three times per week for 20 minutes) was also less than 1, but was not statistically significant (odds ratio (OR) = 0.73, 95% CI = 0.47-1.14). Similar adjusted odds ratios were observed for high versus low levels of self-assessed work activity (OR = 0.50, 95% CI = 0.34-0.74) and leisure time physical activity (OR = 0.62, 95% CI = 0.44-0.90). Further adjustments for body mass index attenuated the strength of the association between physical activity and NIDDM. This is consistent with the hypothesis that obesity is one consequence of physical inactivity that puts individuals at increased risk for NIDDM. The association of physical activity and NIDDM was stronger in Hispanic than in non-Hispanic white subjects, although this difference was not statistically significant. CONCLUSIONS: High levels of physical activity are associated with lower odds of NIDDM and this relationship may be stronger in Hispanic subjects.     

Physical activity patterns in a diverse population of women

BACKGROUND: Demographic and psychosocial correlates of activity in domains other than recreational activity have not been well characterized and may be particularly relevant for health promotion efforts aimed at women. METHODS: Cross-sectional relationships between recreational, occupational, and household/caregiving physical activity and demographic and psychosocial factors were assessed with a mail survey in a random sample of 2,636 ethnically diverse women members of a large health maintenance organization, ages 20-65. Activity was assessed with a modified Baecke questionnaire that uses categorical responses regarding frequency of domain-specific activities to create four semicontinuous activity indices (sports/exercise, active living, occupational, household/caregiving). RESULTS: Multivariable logistic regression analysis showed that the likelihood of being in the highest quartile of the sports/exercise and active-living indices, compared with the other three quartiles, was decreased among older, nonwhite, less well educated, heavier women who had young children at home, lacked motivation to exercise, and perceived external obstacles to exercise behavior. The odds ratios (ORs) ranged from 0.38, 95% confidence interval (CI) 0.33-0.45, associated with low motivation, to 0.95, 95% CI 0.93-0.98, associated with increasing body mass index. Social support and confidence in one's ability to continue to exercise, even when faced with other pressures and demands (termed self-efficacy), were associated with increased likelihood of high levels of sports/exercise and active living (OR = 2.34, 95% CI 1. 83-2.98 and OR = 3.96, 95% CI 2.92-5.38, respectively). In contrast, the highest quartile of household/caregiving activity was positively associated with increasing age (OR = 1.28, 95% CI 1.16-1.42), Hispanic ethnicity (OR = 1.58, 95% CI 0.55-1.01), being married (OR = 1.70, 95% CI 1.33-2.18), having young children at home (OR = 6.99, 95% CI 4.33-11), and greater time constraints as a barrier to exercise (OR = 1.55, 95% CI 1.38-1.74) and was negatively associated with employment (OR = 0.38, 95% CI 0.30-0.47). Increased likelihood of the highest quartile of occupational activity was associated with high school education or less (OR = 2.26, 95% CI 1.74-2.94) and current smoking (OR = 1.66, 95% CI 1.23-2.23), while self-efficacy regarding exercise was associated with decreased likelihood (OR = 0. 77, 95% CI 0.61-0.96). CONCLUSIONS: These findings suggest that demographic and psychosocial correlates of physical activity vary by domain and that initiatives to promote physical activity in the population need to take these differences into account.     

Predictors for the onset of different types of homeboundness among community-living older adults: two-year prospective study

BACKGROUND: Little is known about predictors for the onset of different types of homeboundness among community-living older adults. PURPOSE: This 2-year prospective study examined predictors for the onset of "type 1" and "type2" homeboundness (see definitions below) among community-living older adults. METHODS: Study subjects comprised all residents aged 65 years and over living in Yoita town, Niigata, Japan, who answered the baseline (2000) and follow-up (2002) surveys. Persons were defined as being homebound if he/she went outdoors once a week or less often. Homeboundness was further classified into "type 1" or "type 2", based on the hierarchical mobility level classification (levels 1 or 2 vs. levels 3 or over). "Type 1" homebound persons included those who could not get out into the neighborhood without assistance (i.e., level 3 or over). "Type 2" included those who were homebound, though they could get out at least into the neighborhood unassisted (i.e., level 1 or 2). A stepwise, multiple logistic regression model was used to identify the most parsimonious combination of risk factors for each type of homeboundness. RESULTS: Out of 1,322 persons who were level 1,2 non-homebound at the baseline, 77.6% remained as level 1,2 non-homebound (n = 1,026), but 1.7% were "type 1" homebound (n = 22), and 4.8% were "type 2" homebound (n = 66) at follow-up. The final model for prediction of "type 1" homeboundness at follow-up included: advanced age (OR for 5 year-increment: 2.10; 95%CI: 1.36-3.24), not having a job (OR: 4.42; 95%CI: 1.21-16.2), unable to walk 1 km (OR: 4.24; 95%CI: 1.37-13.1), and a low cognitive function identified as MMSE <24 (OR: 5.22; 95%CI: 1.98-13.8). The final model for prediction of "type 2" homeboundness at follow-up included: advanced age (OR for 5 year-increment: 1.65; 95%CI: 1.32-2.06), a depressive mode indicated by a GDS short version score >5 (OR: 2.18; 95%CI: 1.23-3.88), a low cognitive function (OR: 2.72; 95% CI: 1.47-5.05), not having close friends (OR: 2.30; 95%CI: 1.08-4.87), and not having a walking or calisthetics habit (OR: 2.21; 95%CI: 1.26-3.86). CONCLUSIONS: Reduced physical and mental functioning contribute to the subsequent occurrence of "type 1" homeboundness. Additionally, psychosocial factors are independent predictors of "type 2" homeboundness. These results suggest that different public health strategies might be required for prevention of the different types of homeboundness in Japanese older adults.     

Dietary fat intake is associated with psychosocial and cognitive functioning of school-aged children in the United States

Using cross-sectional data from the Third National Health and Nutrition Survey, 1988-1994, we examined whether dietary fat intake is associated with cognitive and psychosocial functioning in school-aged children. Based upon 24-h diet recall interviews, dietary intakes of total fat, SFA, monounsaturated fatty, PUFAs, and cholesterol were estimated in 3666 participants aged 6 to 16 y. Psychosocial functioning was evaluated in interviews of each child's mother. Cognitive functioning was measured using achievement and intelligence tests. Overall, total fat and saturated fat were unrelated to measures of cognitive and psychosocial functioning. Compared with equivalent energy intake from saturated fat or carbohydrate, each 5% increase in energy intake from PUFAs was associated with lower risks of poor performance on the digit span test (replacing SFA, OR = 0.58, 95% CI = 0.37-0.91; replacing carbohydrate, OR = 0.61, 95% CI = 0.43-0.88). Cholesterol intake was associated with an increased risk of poor performance on the digit span test (OR = 1.25, 95% CI = 1.11-1.42 for each 100-mg increment intake of cholesterol). The associations were independent of socioeconomic status, maternal education and marital status, and children's nutrition status and were consistent across different methods of energy adjustment in regression models. We conclude that high intake of PUFAs may contribute to an improved performance on the digit span test. In contrast, increased intake of cholesterol may be associated with a poorer performance.     

Alcohol intake, smoking, sleeping hours, physical activity and the metabolic syndrome

OBJECTIVE: To evaluate the association between physical activity, sleeping hours, alcohol intake and smoking and metabolic syndrome. METHODS: Social, demographic, personal and family medical histories and behavioral characteristics were collected as self-reported for 2164 participants (1332 women; 832 men), aged 18-92 years old, randomly selected during 1999-2003, among residents in Porto, Portugal, evaluated in the Department of Epidemiology of Porto Medical School. Metabolic syndrome was defined according to the NCEP-ATPIII. Associations between metabolic syndrome and lifestyles factors were computed as odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS: After adjustment, higher total physical activity (OR=0.63 95% CI%: 0.43, 0.94--females; OR=0.55 95% CI: 0.33, 0.91--males) and work activity levels in females (OR=0.55; 95% CI: 0.33, 0.91) were significantly associated with lower prevalence of the metabolic syndrome. More sleeping hours were positively associated with metabolic syndrome (OR=1.25; 95% CI: 1.13, 1.38--females; OR=1.19; 95% CI: 1.04, 1.36--males). Regarding smoking, the only statistically significant association was found in women that smoked less than 10 cigarettes per day (OR=0.32 95% CI: 0.11, 0.92). No statistically significant association was found between ethanol intake and metabolic syndrome. CONCLUSIONS: An association between decreased physical activity, increased sleeping hours and metabolic syndrome was found. No association was found between cigarette smoking, alcohol intake and the metabolic syndrome.     

老年人日常活动能力与睡眠质量及其交互作用对认知功能的影响

目的 探究我国老年人日常活动能力、睡眠质量及其交互作用对认知功能的影响。方法 基于2018年中国老年健康影响因素跟踪调查（CLHLS）数据,运用logistic回归模型进行危险因素分析。结果 控制相关变量后,多因素logistic回归结果显示,日常活动能力受损（OR = 3.941,95%CI:3.464～4.484）、睡眠障碍（OR = 1.370,95%CI:1.167～1.608）是老年人发生认知功能障碍的影响因素。交互作用结果显示,日常活动受损与睡眠障碍对认知功能障碍的发生具有相加交互作用（OR = 5.492,95%CI:4.380～6.888）,RERI（95%CI） = 1.261（0.092～2.430）,AP（95%CI） = 0.230（0.057～0.402）,S（95%CI） = 1.390（1.052～1.837）。结论 同时存在日常活动能力受损和睡眠障碍会增加老年人认知障碍的发生风险,通过有效措施提高老年人的睡眠质量和日常活动能力可有助于降低认知障碍的发生风险。     

Impact of diabetes on cognitive function among older Latinos: a population-based cohort study

BACKGROUND AND OBJECTIVES: Type 2 diabetes, which is highly prevalent in older Mexican Americans, may influence cognitive functioning. We examined the association of diabetes with decline in global cognitive function and memory function over a 2-year period. METHODS: Study subjects were derived from an existing cohort of Latinos aged 60 and over in the SALSA project (n=1,789). Statistical analysis was conducted using logistic regression and a generalized estimating equation (GEE). RESULTS: Logistic regression analysis indicated that baseline diabetes was a significant predictor of major cognitive impairment in Modified Mini Mental State Exam (3MSE) (OR=1.68, 95% CI=1.21, 2.34) and word-list test (OR=1.31, 95% CI=0.99, 1.75). GEE analysis showed that there was no significant difference between diabetic and nondiabetic subjects in change of cognitive scores over 2 years (3MSE, mean=-0.58, 95% CI=-1.48, 0.32; word-list test, mean=-0.10, 95% CI=-0.32, 0.11). CONCLUSIONS: More diabetic complications were associated with major cognitive decline among diabetic subjects. Research on long-term impact of treatment for type 2 diabetes is warranted.     

Predictors of changes in physical activity in a prospective cohort study of the Danish adult population

AIM: To investigate predictors of changes in physical activity, in a prospective population-based study. METHODS: Data were from the Danish Health Interview Surveys in 1994 and 2000, and included persons between 16 and 64 years of age who answered the questions on physical activity and various covariates in 1994, and who were re-interviewed in 2000. In total 2,957 subjects participated (62% of the original sample). Data were analysed using logistic regression. RESULTS: Predictors of physical inactivity were, for men and women respectively, heavy smoking (odds ratio (OR) 2.07, 95% confidence interval (CI) 1.24-3.48, and OR 2.23, 95% CI 1.34-3.71), poor self-rated health (OR 2.11, 95% CI 1.25-3.58, and OR 1.75, 95% CI 1.10-2.80), and believing that one's own effort has no effect on health (OR 1.86, 95% CI 1.20-2.88, and OR 1.63, 95% CI 1.00-2.65). For men, further predictors for physical inactivity were obesity as compared to normal weight (OR 2.10, 95% CI 1.11-3.98), and being unmarried as compared to being married (OR 2.22, 95% CI 1.40-3.51). The only predictor for becoming physically active among initially sedentary respondents was meeting often with family (p=0.011). CONCLUSIONS: Our results show a number of strong predictors for physical inactivity. Variables of an unhealthy lifestyle tend to cluster in some individuals, and physical inactivity interventions may therefore be more successful if they also address smoking, self-belief, and obesity. Interventions tailored to raise inactive people's level of activity should focus on social support from the family.     

Some life-style factors and the risk of invasive epithelial ovarian cancer in Swedish women

The objective of this nationwide case-control study was to examine body mass index (BMI), alcohol use, coffee consumption, cigarette smoking, and leisure-time physical activity in relation to epithelial ovarian cancer (EOC) risk. Subjects were 655 newly diagnosed EOC cases and 3899 population controls, all 50-74 years of age at recruitment between 1993 and 1995. Data were collected through mailed questionnaires. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression. Women with a BMI 30 kg/m² compared with those with a BMI < 22 kg/m² appeared to have an elevated EOC risk (OR = 1.37, 95% CI: 1.01-1.85), particularly of mucinous (OR = 2.76, 95% CI: 1.15-6.61) and clear-cell histologies (OR = 2.68, 95% CI: 0.96-7.48). The OR for EOC among coffee users reporting 6 daily cups compared with non-users was 0.68 (95% CI: 0.42-1.10). Alcohol consumption was unrelated to EOC risk. Compared to non-smokers the ORs of EOC among current smokers were 0.70 (95% CI: 0.52-0.94) for those who smoked 1-10 cigarettes/day and 0.74 (95% CI: 0.53-1.02) for heavier smokers, while former smokers were at an unaltered risk (OR = 0.83, 95% CI: 0.66-1.04). Reduced EOC risks were observed among women in the highest compared with the lowest physical activity levels both at age 18-30 years (OR = 0.67, 95% CI: 0.52-0.87) and during the last years preceding study enrollment (OR = 0.68, 95% CI: 0.53-0.87). We conclude that women may avoid an excess risk of EOC through maintaining a normal BMI and reduce their risk by participation in leisure-time physical activity. The use of coffee, alcohol, or cigarette smoking does not appearto increase the risk of EOC.     

中国9省市中老年人群体重指数与健康相关生命质量的关系

目的 研究中国中老年人BMI与健康相关生命质量(HRQOL)的关系.方法 汇集9省市(汀苏、安徽、甘肃、青海、福建、北京、吉林、江西、河南)横断面健康状况调查中老年人群数据共9539例.采用秩和检验比较BMI分类不同的中老年人生命质量的差异;用多元logistic回归模型检验排除性别、年龄、婚姻状况、学历、运动水平和慢性病史等混杂因素后,中老年人BMI分类与生命质最的相关性.结果 与体重正常的中老年人相比,体重过轻组SF-36的生理领域(P<0.001)、心理领域(P<0.01)及其8个维度(生理机能、精神健康,P<0.05;生理职能、躯体疼痛、健康状况、精力、社会功能、情感职能,P<0.01)生命质量均显著较差;超重组心理领域生命质量显著较好(P<0.05);肥胖组生理机能维度显著较差(P<0.01),心理领域(P<0.05)、精神健康维度(P<0.01)显著较好.排除已知的混杂因素后,体重过轻组在生理领域(OR=1.67,95%CI:1.35～2.06)、心理领域(OR=1.39,95%CI:1.13～1.70)以及所有8个维度生命质量减损的危险度显著增高;超重组心理领域(OR=0.86,95%CI:0.78～0.95)及其生理职能、精力、社会功能、情感职能、精神健康维度生命质最受损的危险度显著降低;肥胖组生理机能维度(OR=1.51,95%CI:1.27～1.80)受损的危险度显著增高,心理领域(OR=0.71,95%CI:0.60～0.85)及其精力、情感职能、精神健康维度生命质量受损的危险度显著降低.结论 BMI分类不同的中老年人其SF-36各领域生命质量不同,体重过轻组生理领域和心理领域生命质量均较差,超重和肥胖组心理领域生命质最较好,肥胖组生理领域生命质量较差.超重和肥胖的中老年人生命质量的减损与慢性疾病有关.     

Characteristics of non-participants in comprehensive health examinations ("Otasha-kenshin") among an urban community dwelling elderly: basic research for prevention of the geriatric syndrome and a bed-ridden state

PURPOSE: The present study was conducted to identify the characteristics of non-participants in secondary comprehensive health examinations among community-dwelling elderly. METHODS: The subjects were 728 men and 984 women aged 70 years and over who had participated in comprehensive health examinations in 2002. Multiple logistic regression analysis was performed to assess the characteristics associated with non-participation in comprehensive health examinations after 2 years (in 2004). RESULTS: The rates of participation in follow-up health examinations were 66.3% for men and 67.3% for women. Logistic regression analysis showed that male non-participants had low cognitive function (odds ratio (OR) = 2.19, 95% confidence interval (CI) = 1.07-4.49), low education (OR = 1.58, 95% CI = 1.22-2.22), and suffered from health problems (OR = 1.82, 95% CI = 1.27-2.59), and that female non-participants had low cognitive function (OR = 2.01, 95% CI 1.13-3.59), tended to be smokers (OR = 2.05, 95%, CI = 1.13-3.72), and had no hobby (OR = 0.68, 95% CI = 0.50-0.92). CONCLUSION: Poor cognitive function, health problems, and unfavorable lifestyle factors are related to non-participation in comprehensive health examinations. PROPOSAL: It is necessary to devise various approaches to encourage participation of such individuals.     

Individual and combined impacts of biomechanical and work organization factors in work-related musculoskeletal symptoms

BACKGROUND: Investigations of work-related low back (LB) and upper extremity (UE) disorders have increasingly utilized multivariable models that include biomechanical/physical and work organization factors. However, the nature of any interactive effects is not well understood. METHODS: Using questionnaires, high and low exposure groups for biomechanical/physical factors, cognitive demands, cognitive processing, interpersonal demands, participatory management, skill discretion, and time pressure for 289 individuals (U.S. Marines) were identified. Musculoskeletal symptom status was also determined by questionnaire. Individual and biomechanical-psychosocial combinations were examined in adjusted multivariable logistic regression analyses. RESULTS: Time pressure was associated with both LB and UE symptoms (odds ratio(s) (OR) range = 2.13-3.09), while higher biomechanical exposures were risk factors for LB symptoms (OR = 2.07; 95% confidence intervals (CI): 1.00-4.35) and concurrent LB and UE symptoms (OR = 2.80; CI: 1.35-5.83). Greater risks for concurrent LB and UE symptoms were indicated for combinations involving higher biomechanical exposure and: time pressure (OR = 2.21; CI: 1.19-4.10); cognitive demands (OR = 2.25; CI: 1.23-4.09); cognitive processing (OR = 2.08; CI: 1.16-3.75); interpersonal demands (OR = 2.44; CI: 1.35-4.41); participatory management (OR = 2.50; CI: 1.30-4.81). Results did not suggest any interaction between biomechanical and work organization factors. CONCLUSIONS: While no synergism was indicated, the present findings emphasize the need to consider both biomechanical factors and specific work organization factors, particularly time pressure, in reducing musculoskeletal-related morbidity.