European Journal of Epidemiology最新文献_第2页

An instrumental variable analysis of body mass index and risk of long-term sick leave: the HUNT Study, Norway. 体质指数与长期病假风险的工具变量分析：HUNT研究，挪威。

IF 13.6 1区医学

European Journal of Epidemiology Pub Date : 2025-09-04 DOI: 10.1007/s10654-025-01299-6

Karoline Moe,Eivind Schjelderup Skarpsno,Tom Ivar Lund Nilsen,Silje L Kaspersen,Solveig Osborg Ose,David Carslake,Paul Jarle Mork,Lene Aasdahl

{"title":"An instrumental variable analysis of body mass index and risk of long-term sick leave: the HUNT Study, Norway.","authors":"Karoline Moe,Eivind Schjelderup Skarpsno,Tom Ivar Lund Nilsen,Silje L Kaspersen,Solveig Osborg Ose,David Carslake,Paul Jarle Mork,Lene Aasdahl","doi":"10.1007/s10654-025-01299-6","DOIUrl":"https://doi.org/10.1007/s10654-025-01299-6","url":null,"abstract":"A more comprehensive understanding of the causal relationships between body mass index (BMI) and sick leave is needed. We aimed to examine the effect of BMI on the risk of cause-specific and all-cause long-term sick leave using an instrumental variable approach. The study included 21,918 adults participating in the two latest surveys of the population-based HUNT Study (HUNT3, 2006-2008 and HUNT4, 2017-2019) linked with registry data on cause-specific sick leave, including musculoskeletal and mental disorders. We used Cox regression to estimate risk of long-term sick leave per standard deviation (SD) increase in z-score of BMI, applying both conventional analysis of own BMI and instrumental variable analysis based on offspring BMI. In the conventional analyses, hazard ratios per SD increase in z-score of BMI ranged from 1.04 (95% confidence interval (CI) 0.99-1.08) for mental health disorders in women to 1.17 (95% CI 1.13-1.22) for musculoskeletal disorders in men. The instrumental variable approach supported that higher BMI increased the risk of long-term sick leave, except for sick leave due to mental health disorders in men. The analyses suggested that offspring BMI as an instrument is not independent of shared confounding. The results from both the conventional and instrumental variable analyses show that higher BMI increases the risk of long-term sick leave, except for sick leave due to mental health disorders in men. The instrumental variable method is likely to remove bias due to reverse causation, but residual bias due to shared confounding factors cannot be ruled out.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"15 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Caveats of assessing incidence trends using publicly available registry data. 使用可公开获得的登记数据评估发病率趋势的注意事项。

IF 13.6 1区医学

European Journal of Epidemiology Pub Date : 2025-09-04 DOI: 10.1007/s10654-025-01288-9

Volker Arndt,Soo-Zin Kim-Wanner,Bernd Holleczek,Alice Nennecke,Frederik Peters,Annika Waldmann

引用次数: 0

Plasma metabolites, metabolic risk score and colorectal cancer risk: a prospective cohort study. 血浆代谢物、代谢风险评分和结直肠癌风险：一项前瞻性队列研究。

IF 13.6 1区医学

European Journal of Epidemiology Pub Date : 2025-09-04 DOI: 10.1007/s10654-025-01284-z

Ying Deng,Miaomiao Yang,Panxin Peng,Ying Lin,Jiaqi Lin,Jingyao Huang,Kejia Wu,Xingxing Hu,Zibo Ni,Dongsheng Hu,Ming Zhang,Baochang He,Yinggang Chen,Lin Tian,Chunsheng Cheng,Qingtian Luo,Pei Qin,Xiuyun Chen,Jian Yang,Fulan Hu

{"title":"Plasma metabolites, metabolic risk score and colorectal cancer risk: a prospective cohort study.","authors":"Ying Deng,Miaomiao Yang,Panxin Peng,Ying Lin,Jiaqi Lin,Jingyao Huang,Kejia Wu,Xingxing Hu,Zibo Ni,Dongsheng Hu,Ming Zhang,Baochang He,Yinggang Chen,Lin Tian,Chunsheng Cheng,Qingtian Luo,Pei Qin,Xiuyun Chen,Jian Yang,Fulan Hu","doi":"10.1007/s10654-025-01284-z","DOIUrl":"https://doi.org/10.1007/s10654-025-01284-z","url":null,"abstract":"The associations of colorectal cancer (CRC) risk with metabolites, lifestyle factors and their joint effects have not been fully elucidated. Therefore, we conducted a prospective cohort study to estimate the associations of CRC risk with metabolites, metabolic risk score (MRS) and its joint associations with lifestyle factors. This study included 82,514 participants with plasma metabolites data in the UK Biobank. LASSO-COX and Random Forest was used to select metabolites. Cox regression was utilized to construct MRS and estimate the associations of CRC risk with metabolites, MRS and its joint associations with lifestyle factors. Single-cell RNA sequencing data were analyzed to identify metabolism-related genes and metabolic pathways during CRC progression. During a median follow-up of 13.28 years, 1151 incident CRC cases were identified. MRS, constructed using 6 metabolites, was significantly associated with increased CRC risk (HR = 1.39, 95% CI 1.22-1.56 for high vs. low MRS), with the strongest association for proximal colon cancer (HR = 1.51, 95% CI 1.24-1.84), followed by distal colon cancer and rectal cancer (HR = 1.35, 95% CI 1.05-1.72; HR = 1.37, 95% CI 1.11-1.69). Joint associations were identified between MRS and lifestyle factors with CRC risk. Individuals with healthy sleep, never smoking, healthy diet, and healthy lifestyle but high MRS also exhibited elevated CRC risk. Linoleic acid, histidine and tyrosine metabolism pathways played important roles during normal intestinal mucosa to CRC progression. Pre-diagnostic metabolites and MRS were significantly associated with increased CRC risk, especially proximal colon cancer. Individuals should maintain normal metabolite levels and healthy lifestyles for CRC prevention.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"27 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Associations of serum iron and its status change with mortality risk: prospective findings from the MJ cohort. 血清铁及其状态变化与死亡风险的关系：来自MJ队列的前瞻性发现。

IF 5.9 1区医学

European Journal of Epidemiology Pub Date : 2025-09-01 DOI: 10.1007/s10654-025-01295-w

Yunyun Liu, Chi Pang Wen, Junlong Pan, Jiameng Cui, Wanzhu Lu, Tong Sun, Xian Ning, June Han Lee, Wenyuan Li, Huakang Tu, Xifeng Wu

{"title":"Associations of serum iron and its status change with mortality risk: prospective findings from the MJ cohort.","authors":"Yunyun Liu, Chi Pang Wen, Junlong Pan, Jiameng Cui, Wanzhu Lu, Tong Sun, Xian Ning, June Han Lee, Wenyuan Li, Huakang Tu, Xifeng Wu","doi":"10.1007/s10654-025-01295-w","DOIUrl":"https://doi.org/10.1007/s10654-025-01295-w","url":null,"abstract":"Previous studies on serum iron levels and mortality risk have yielded inconsistent findings based on single-point measurements. How serum iron levels and their longitudinal changes influence all-cause and cause-specific mortality remains unknown. This study investigated associations between baseline serum iron levels, their longitudinal changes, and all-cause and cause-specific mortality in a prospective cohort. Participants were recruited from the Taiwan MJ cohort (1997-2007) and followed until December 31, 2022. Baseline serum iron was categorized as low, normal, or high. Based on changes at a second visit, participants were further classified as persistent normal, progression to abnormal, reversion to normal, or persistent abnormal. Cox proportional hazard models were used for analysis. Over a median follow-up of 19.0 years, 33,005 deaths occurred. Fully adjusted models demonstrated J-shaped associations between serum iron and all-cause and cause-specific mortality (all P < 0.001), with higher all-cause mortality risks in low (HR 1.27, 95% CI [1.23, 1.31]) and high iron groups (HR 1.37, 95% CI [1.30, 1.44]). Compared to persistent normal levels, those with progression to abnormal, reversion to normal, or persistent abnormal serum iron exhibited elevated mortality risks (HRs: 1.22 [1.15, 1.30], 1.16 [1.09, 1.24], 1.49 [1.36, 1.63], respectively). Moreover, maintaining normal serum iron status alongside a healthy lifestyle exhibited the lowest mortality risks. Long term abnormal serum iron status was linked to increased mortality, which could be mitigated through lifestyle modifications, suggesting significance of serum iron monitoring and potential intervention.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Women in Healthy Transition (KISO) Survey: a cohort of 153,800 women aged 45-59 years living in Denmark. 健康转型妇女调查：对生活在丹麦的153,800名年龄在45-59岁之间的妇女进行队列调查。

IF 5.9 1区医学

European Journal of Epidemiology Pub Date : 2025-08-27 DOI: 10.1007/s10654-025-01291-0

Sigrid Normann Biener, Terese Sara Høj Jørgensen, Maria Hybholt

{"title":"Women in Healthy Transition (KISO) Survey: a cohort of 153,800 women aged 45-59 years living in Denmark.","authors":"Sigrid Normann Biener, Terese Sara Høj Jørgensen, Maria Hybholt","doi":"10.1007/s10654-025-01291-0","DOIUrl":"https://doi.org/10.1007/s10654-025-01291-0","url":null,"abstract":"The nationwide Women in Healthy Transition (KISO) Survey Cohort is a population-based longitudinal prospective cohort study established to explore the significant data gap on women's symptoms through different stages of menopause in a Northern European context. The KISO Survey Cohort was set up to represent women aged 45-59 years living in Denmark. In total 575,863 women were invited to participate in the study at baseline. Data were collected through digital questionnaires from June to December 2024 and included self-reported information on stages of menopause, menopausal symptoms, quality of life, physical activity, and work productivity loss using validated scales as well as information on various health, social and lifestyle factors. The follow-up of the KISO Survey Cohort will be conducted through digital questionnaires every three years over a 15-year period, inviting baseline respondents and eligible women aged 45-59 at follow-up. A total of 153,800 women completed the baseline questionnaire, yielding a 27% response rate. Among the participants, 8% were in premenopause, 24% in perimenopause, and 45% in postmenopause. Moreover, 13% had induced menopause and 10% were undergoing menopausal hormone therapy. The KISO Survey Cohort is the first large-scale longitudinal study on menopausal symptoms among women in Denmark. Data are coupled with the personal identification numbers (CPR) enabling opportunities to link data to national administrative registers. This ongoing study, thus, offers unique and extensive data, enabling future research to advance our understanding of menopause, how it affects women, and its long-term effects on women.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The impact of modifiable risk factor reduction on future dementia burden: a microsimulation modeling study. 可改变的风险因素减少对未来痴呆负担的影响：一项微观模拟建模研究。

IF 5.9 1区医学

European Journal of Epidemiology Pub Date : 2025-08-23 DOI: 10.1007/s10654-025-01283-0

Chiara C Brück, Koen de Nijs, M Arfan Ikram, Frank J Wolters, Inge M C M de Kok

{"title":"The impact of modifiable risk factor reduction on future dementia burden: a microsimulation modeling study.","authors":"Chiara C Brück, Koen de Nijs, M Arfan Ikram, Frank J Wolters, Inge M C M de Kok","doi":"10.1007/s10654-025-01283-0","DOIUrl":"https://doi.org/10.1007/s10654-025-01283-0","url":null,"abstract":"Approximately 30%-50% of dementia cases are attributable to modifiable risk factors, but the impact of risk reduction strategies on dementia incidence at a population level is uncertain. Reliable estimates of intervention effects require accounting for changes in life expectancy when intervening on risk factors, and model realistic reduction scenarios that consider co-occurrence of risk factors. Using the microsimulation model MISCAN-Dementia, we assessed the effect of interventions on mid-life hypertension and late-life smoking on dementia and mortality risk. We modeled risk factor reductions, from small reductions to complete elimination, and evaluated effects on dementia incidence and prevalence, number of cases, and life years with and without dementia. All risk factor reductions resulted in lower dementia incidence and prevalence, fewer dementia cases, and more dementia-free life years. Eliminating smoking resulted in 1.4% fewer dementia cases for women and 2.5% for men over their lifetime. Eliminating hypertension reduced dementia cases by 1.1% for women and 3.3% for men. The number of dementia cases and life years with dementia decreased until around age 90, after which a slight increase was observed due to prolonged life expectancy with the reductions. Reducing smoking and hypertension will result in additional life years without dementia and a modest reduction in overall dementia cases, with some additional dementia cases in the oldest old. These findings emphasize the potential of dementia risk reduction strategies and the importance of considering concurrent changes in mortality when evaluating risk factor reductions.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cohort profile: the West-China hospital alliance longitudinal epidemiology wellness (WHALE) study. 队列简介：华西医院联盟纵向流行病学健康研究。

IF 5.9 1区医学

European Journal of Epidemiology Pub Date : 2025-08-23 DOI: 10.1007/s10654-025-01290-1

Yifei Lin, Yong Yang, Zhuyue Li, Liang Du, Rui Shi, Qingke Shi, Xueru Xu, Geng Yin, Fan Zhang, Wenxia Huang, Yan Huang, Ga Liao, Qilin Liu, Weimin Li, Huan Song, Jin Huang

{"title":"Cohort profile: the West-China hospital alliance longitudinal epidemiology wellness (WHALE) study.","authors":"Yifei Lin, Yong Yang, Zhuyue Li, Liang Du, Rui Shi, Qingke Shi, Xueru Xu, Geng Yin, Fan Zhang, Wenxia Huang, Yan Huang, Ga Liao, Qilin Liu, Weimin Li, Huan Song, Jin Huang","doi":"10.1007/s10654-025-01290-1","DOIUrl":"https://doi.org/10.1007/s10654-025-01290-1","url":null,"abstract":"The West-China Hospital Alliance Longitudinal Epidemiology Wellness (WHALE) Study establishes a robust, multidimensional database to provide comprehensive insights into health-to-disease transitions, advancing proactive healthcare and enhancing understanding of the interplay among genetic, behavioral, and environmental factors in disease. The WHALE Study includes a database and a cohort. The WHALE Database, established in 2010, integrates health check-up data from 11 hospitals, covering sociodemographic, lifestyle, medical history, and clinical data. The WHALE Health Trajectory Cohort, launched in November 2024, recruits adults with at least three health check-ups, featuring biennial active follow-ups and passive linkage with regional healthcare databases. As of January 2025, the WHALE Database includes over 3.4 million health records from 1,526,686 participants, with a mean age of 40.3 years and a balanced gender distribution. Notably, 23.88% of participants had at least three health check-ups, and 3.31% had more than ten, highlighting a significant proportion with repeated measurements. The study provides key insights into health trajectories by examining the associations of biomarker data and their trajectory patterns with aging, pre-disease conditions, and disease diagnoses. The strengths of the WHALE Study include its large sample size, longitudinal design, diverse representation, comprehensive data, and robust quality control. Limitations include potential selection bias, data variability across centers, and reliance on self-reported data for some variables.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Chronic high consumption of energy drinks and cardiovascular risk in adolescents-results of the EDKAR-study. 青少年长期高消费能量饮料与心血管风险——edkar研究的结果

IF 5.9 1区医学

European Journal of Epidemiology Pub Date : 2025-08-23 DOI: 10.1007/s10654-025-01292-z

Juliane Menzel, Fabian Spinka, Maria J Pie, Andrea Deichl, Sven Knüppel, Anke Ehlers, Britta Nagl, Frank Edelmann, Cornelia Weikert

{"title":"Chronic high consumption of energy drinks and cardiovascular risk in adolescents-results of the EDKAR-study.","authors":"Juliane Menzel, Fabian Spinka, Maria J Pie, Andrea Deichl, Sven Knüppel, Anke Ehlers, Britta Nagl, Frank Edelmann, Cornelia Weikert","doi":"10.1007/s10654-025-01292-z","DOIUrl":"https://doi.org/10.1007/s10654-025-01292-z","url":null,"abstract":"In recent years, acute cardiovascular effects of high energy drink (ED) consumption have been described, but no data are available on chronic high consumption of EDs and cardiovascular risk in adolescents. As a first study, the present study investigated differences in a variety of cardiological parameters in adolescents (aged 15-18 years) with a chronic high consumption of EDs (ED consumption: ≥ four days/week for ≥ last 12 months, > 3 mg caffeine from EDs/kg bodyweight/day) compared to a control group. In study phase 1 of the cross-sectional EDKAR-study, data from 5100 pupils in Berlin (Germany) on their ED consumption and lifestyle factors were assessed using an online questionnaire. Based on these, adolescents with a chronic high ED consumption (n = 97) and a control group (n = 160) were cardiologically examined at Charité - Universitätsmedizin Berlin. Blood pressure, heart rate, electrocardiographic and echocardiographic parameters were assessed. Cardiological risk factors like educational background, smoking, alcohol consumption and sleep duration were investigated. The study noticed no significant and/or clinically relevant differences in any of the cardiological parameters e.g., heart rate (Chronic high ED consumption: Geometric mean (95%-CI): 74.8 BPM (68.5-81.8) vs. control group: 71.9 BPM (65.2-79.2), p = 0.23). However, half of the high consumers reported having experienced adverse effects after consuming EDs. Furthermore, adolescents with chronic high ED consumption reported a considerably higher intake of alcohol, higher smoking rates and shorter sleep duration in comparison to the control group. Accordingly, chronic high ED consumption is associated with lifestyle factors with a potential negative impact on the cardiovascular system.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk of primary sclerosing cholangitis among patients with gastritis: a nationwide cohort study. 胃炎患者发生原发性硬化性胆管炎的风险：一项全国性队列研究

IF 5.9 1区医学

European Journal of Epidemiology Pub Date : 2025-08-23 DOI: 10.1007/s10654-025-01293-y

Lina Lindström Älgå, Isabella Ekheden, Marcus Thuresson, Jonas F Ludvigsson

{"title":"Risk of primary sclerosing cholangitis among patients with gastritis: a nationwide cohort study.","authors":"Lina Lindström Älgå, Isabella Ekheden, Marcus Thuresson, Jonas F Ludvigsson","doi":"10.1007/s10654-025-01293-y","DOIUrl":"https://doi.org/10.1007/s10654-025-01293-y","url":null,"abstract":"The pathogenesis of primary sclerosing cholangitis (PSC), a severe autoimmune liver disease, remains largely unknown. Infection with Helicobacter pylori (H. pylori) and subsequent gastritis could act as a triggering event of PSC, as H. pylori seems to be more prevalent in chronic liver disease. However, the risk of PSC among patients with gastritis and its precursor, H. pylori infection, is undetermined. In this nationwide cohort study, we included Swedish individuals undergoing a gastroscopy with biopsy during 1990-2017 showing gastritis (n = 306 588) or H. pylori (n = 11 890). Three control groups were used (1) matched controls from the Swedish general population (n = 1 544 667), (2) individuals with a gastric biopsy indicating normal mucosa (n = 318 754) and (3) sibling controls (n = 231 879). We calculated the hazard ratios (HRs) for PSC development, adjusting for age, sex, calendar year, county, comorbidities, alcohol-related disorders, education, and country of birth. Patients with a histological diagnosis of gastritis or H. pylori were more likely to be diagnosed with PSC during follow up. Compared to the general Swedish population, the fully adjusted HR for PSC among patients with gastritis was 3.35 (95% CI 2.67-4.20). However, compared to secondary controls with a normal gastric mucosa, the PSC risk was not increased among patients with gastritis. Patients with a gastroscopy biopsy showing gastritis have a moderately increased risk for PSC later in life but not compared to other individuals undergoing gastrointestinal work up (\"normal mucosa)\". The association with PSC may be non-specific and apply to several gastrointestinal disorders.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Associations of potentially inappropriate medications in older adults with mortality and hospitalizations: methodological challenges in pharmacoepidemiology. 老年人潜在不适当用药与死亡率和住院的关联：药物流行病学的方法学挑战。

IF 5.9 1区医学

European Journal of Epidemiology Pub Date : 2025-08-23 DOI: 10.1007/s10654-025-01294-x

Miriam Degen, Ben Schöttker

{"title":"Associations of potentially inappropriate medications in older adults with mortality and hospitalizations: methodological challenges in pharmacoepidemiology.","authors":"Miriam Degen, Ben Schöttker","doi":"10.1007/s10654-025-01294-x","DOIUrl":"https://doi.org/10.1007/s10654-025-01294-x","url":null,"abstract":"Previous studies on the association of potentially inappropriate medication (PIM) use with hospitalization risk and all-cause mortality among older adults were prone to confounding and biases. Using data from 217,111 participants of the population-based United Kingdom Biobank, aged 60-69 years, including 95,187 participants with primary care data linkage, the main analysis was a prospective new user design with 1:1 propensity-score stratified by indication matching of new PIM users and new appropriate medication (AM) users (assessed with the EURO-FORTA list). Results were compared to previous approaches with a prevalent user design and a new user design without propensity score matching. 43,307 (19.9%) participants used at least one PIM at baseline. Among 11,812 propensity score matched individuals with new PIM or new AM prescription within 2 years after baseline, new PIM use was associated with non-significantly 20% increased 1-month hospitalization (hazard ratio (HR) [95% confidence interval (95% CI)]: 1.20 [0.76-1.90]) and 23% increased 1-year mortality (1.23 [0.80-1.89]). Null-results were obtained with the prevalent user design (HRs [95% CIs]: 1-month hospitalization: 1.04 [0.83-1.31]; 1-year mortality: 1.01 [0.82-1.23]) and slightly stronger associations in new user design without propensity score matching stratified by indication (1-month hospitalization (1.24 [0.95-1.61]); 1-year mortality (HR [95% CI] 1.57 [1.24-2.00]). This first study with an appropriate methodology showed that previous pharmacoepidemiologic studies on the risk of PIM for hospitalization and mortality have either under- or overestimated the risk. Effect sizes of about 20% appear biologically plausible and larger studies are needed to detect such weak associations with statistical significance.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0