Qianqian Ji, Jingqi Chen, Yafei Li, Enxiang Tao, Yiqiang Zhan
{"title":"Incidence and prevalence of Alzheimer's disease in China: a systematic review and meta-analysis.","authors":"Qianqian Ji, Jingqi Chen, Yafei Li, Enxiang Tao, Yiqiang Zhan","doi":"10.1007/s10654-024-01144-2","DOIUrl":"10.1007/s10654-024-01144-2","url":null,"abstract":"<p><p>As China faces demographic shifts and socioeconomic changes, the burden of Alzheimer's disease (AD) and associated cognitive impairments is increasing dramatically, with significant implications for public health and the economy. This systematic review and meta-analysis aims to provide a comprehensive assessment of the prevalence and incidence of AD across China. Drawing from an extensive search of international and Chinese databases up to August 27, 2023, including PubMed, Embase, and the Cochrane Library, we synthesized data from 105 studies. Our analysis reveals a combined prevalence of AD of 3.48% within a sample of 626,276 elderly individuals and an incidence rate of 7.90 per 1000 person-years. Subgroup and meta-regression analyses highlight age and gender as pivotal factors influencing these epidemiological patterns. Notably, significant heterogeneity exists due to variations in diagnostic criteria and study quality, impacting the comparability of findings. This meta-analysis underscores the need for continued research into demographic and modifiable risk factors influencing AD, while emphasizing standardized reporting practices to address these limitations and improve the understanding of AD's challenge in China.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":"701-714"},"PeriodicalIF":7.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859405","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}
Julie Bergeron, Demetris Avraam, Lucinda Calas, William Fraser, Jennifer R Harris, Barbara Heude, Piush Mandhane, Theo J Moraes, Gina Muckle, Johanna Nader, Jean R Séguin, Elinor Simons, Padmaja Subbarao, Morris A Swertz, Suzanne Tough, Stuart E Turvey, Isabel Fortier, Naja Hulvej Rod, Anne-Marie Nybo Andersen
{"title":"Stress and anxiety during pregnancy and length of gestation: a federated study using data from five Canadian and European birth cohorts.","authors":"Julie Bergeron, Demetris Avraam, Lucinda Calas, William Fraser, Jennifer R Harris, Barbara Heude, Piush Mandhane, Theo J Moraes, Gina Muckle, Johanna Nader, Jean R Séguin, Elinor Simons, Padmaja Subbarao, Morris A Swertz, Suzanne Tough, Stuart E Turvey, Isabel Fortier, Naja Hulvej Rod, Anne-Marie Nybo Andersen","doi":"10.1007/s10654-024-01126-4","DOIUrl":"10.1007/s10654-024-01126-4","url":null,"abstract":"<p><p>While its etiology is not fully elucidated, preterm birth represents a major public health concern as it is the leading cause of child mortality and morbidity. Stress is one of the most common perinatal conditions and may increase the risk of preterm birth. In this paper we aimed to investigate the association of maternal perceived stress and anxiety with length of gestation. We used harmonized data from five birth cohorts from Canada, France, and Norway. A total of 5297 pregnancies of singletons were included in the analysis of perceived stress and gestational duration, and 55,775 pregnancies for anxiety. Federated analyses were performed through the DataSHIELD platform using Cox regression models within intervals of gestational age. The models were fit for each cohort separately, and the cohort-specific results were combined using random effects study-level meta-analysis. Moderate and high levels of perceived stress during pregnancy were associated with a shorter length of gestation in the very/moderately preterm interval [moderate: hazard ratio (HR) 1.92 (95%CI 0.83, 4.48); high: 2.04 (95%CI 0.77, 5.37)], albeit not statistically significant. No association was found for the other intervals. Anxiety was associated with gestational duration in the very/moderately preterm interval [1.66 (95%CI 1.32, 2.08)], and in the early term interval [1.15 (95%CI 1.08, 1.23)]. Our findings suggest that perceived stress and anxiety are associated with an increased risk of earlier birth, but only in the earliest gestational ages. We also found an association in the early term period for anxiety, but the result was only driven by the largest cohort, which collected information the latest in pregnancy. This raised a potential issue of reverse causality as anxiety later in pregnancy could be due to concerns about early signs of a possible preterm birth.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":"773-783"},"PeriodicalIF":7.7,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11344005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141157606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chen Liang, Annette J. Dobson, Hsin-Fang Chung, Yvonne T. van der Schouw, Sven Sandin, Elisabete Weiderpass, Gita D. Mishra
{"title":"Association of infertility and recurrent pregnancy loss with the risk of dementia","authors":"Chen Liang, Annette J. Dobson, Hsin-Fang Chung, Yvonne T. van der Schouw, Sven Sandin, Elisabete Weiderpass, Gita D. Mishra","doi":"10.1007/s10654-024-01135-3","DOIUrl":"https://doi.org/10.1007/s10654-024-01135-3","url":null,"abstract":"<p>Emerging evidence has shown the association between female reproductive histories (e.g., menarche age, parity, premature and early menopause) and the risk of dementia. However, little attention has been given to infertility and pregnancy loss. To examine the associations of infertility, recurrent miscarriages, and stillbirth with the risk of dementia, this study used data from four cohorts in the International Collaboration for a Life Course Approach to Reproductive Health and Chronic Disease Events. Women with data on at least one of the reproductive exposures of interest, dementia, and all covariates were included. Histories of infertility, miscarriage, and stillbirth were self-reported. Dementia (including Alzheimer’s disease) was identified through surveys, aged care, pharmaceutical, hospital, and death registry data. Cause-specific Cox regression models were used to estimate the hazard ratios of dementia, accounting for well-established risk factors of dementia, study variability, and within-study correlation. Overall, 291,055 women were included at a median (interquartile range) age of 55.0 (47.0–62.0) at baseline. During the median (interquartile range) follow-up period of 13.0 (12.0–14.0) years, 3334 (1.2%) women developed dementia. Compared to women without stillbirth, a history of recurrent stillbirths (≥ 2) was associated with 64% higher risk of dementia (adjusted hazard ratio = 1.64, 95% confidence interval: 1.46–1.85). Compared to women without miscarriage, women with recurrent miscarriages (≥ 3) were at 22% higher risk of dementia (adjusted hazard ratio = 1.22, 95% confidence interval: 1.19–1.25). These findings suggest that recurrent stillbirths is a risk factor for dementia and may need to be considered in risk assessment of dementia in women.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"75 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141334409","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}
Yuxia Wei, Sara Hägg, Jonathan K L Mak, Tiinamaija Tuomi, Yiqiang Zhan, Sofia Carlsson
{"title":"Metabolic profiling of smoking, associations with type 2 diabetes and interaction with genetic susceptibility.","authors":"Yuxia Wei, Sara Hägg, Jonathan K L Mak, Tiinamaija Tuomi, Yiqiang Zhan, Sofia Carlsson","doi":"10.1007/s10654-024-01117-5","DOIUrl":"10.1007/s10654-024-01117-5","url":null,"abstract":"<p><strong>Background: </strong>Smokers are at increased risk of type 2 diabetes (T2D), but the underlying mechanisms are unclear. We investigated if the smoking-T2D association is mediated by alterations in the metabolome and assessed potential interaction with genetic susceptibility to diabetes or insulin resistance.</p><p><strong>Methods: </strong>In UK Biobank (n = 93,722), cross-sectional analyses identified 208 metabolites associated with smoking, of which 131 were confirmed in Mendelian Randomization analyses, including glycoprotein acetyls, fatty acids, and lipids. Elastic net regression was applied to create a smoking-related metabolic signature. We estimated hazard ratios (HR) of incident T2D in relation to baseline smoking/metabolic signature and calculated the proportion of the smoking-T2D association mediated by the signature. Additive interaction between the signature and genetic risk scores for T2D (GRS-T2D) and insulin resistance (GRS-IR) on incidence of T2D was assessed as relative excess risk due to interaction (RERI).</p><p><strong>Findings: </strong>The HR of T2D was 1·73 (95% confidence interval (CI) 1·54 - 1·94) for current versus never smoking, and 38·3% of the excess risk was mediated by the metabolic signature. The metabolic signature and its mediation role were replicated in TwinGene. The metabolic signature was associated with T2D (HR: 1·61, CI 1·46 - 1·77 for values above vs. below median), with evidence of interaction with GRS-T2D (RERI: 0·81, CI: 0·23 - 1·38) and GRS-IR (RERI 0·47, CI: 0·02 - 0·92).</p><p><strong>Interpretation: </strong>The increased risk of T2D in smokers may be mediated through effects on the metabolome, and the influence of such metabolic alterations on diabetes risk may be amplified in individuals with genetic susceptibility to T2D or insulin resistance.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":"667-678"},"PeriodicalIF":7.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140329729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fabien de Oliveira, Lucas Léger, Vincent Costalat, Ihssen Belhadj, Maxime Pastor, Héléne de Forges, Jean-Paul Beregi, Thierry Boudemaghe, Julien Frandon
{"title":"Population-based analysis of the number of thrombectomies performed after cerebral ischemic stroke and prognostic factors of mortality in France.","authors":"Fabien de Oliveira, Lucas Léger, Vincent Costalat, Ihssen Belhadj, Maxime Pastor, Héléne de Forges, Jean-Paul Beregi, Thierry Boudemaghe, Julien Frandon","doi":"10.1007/s10654-023-01074-5","DOIUrl":"10.1007/s10654-023-01074-5","url":null,"abstract":"","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":"691-696"},"PeriodicalIF":7.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139466401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriella Chauca Strand, Ulf Strömberg, Anna Forsberg, Carl Bonander
{"title":"Correction: Impact of organised colorectal cancer screening on age-specific population incidences: evidence from a quasi-experimental study in Sweden.","authors":"Gabriella Chauca Strand, Ulf Strömberg, Anna Forsberg, Carl Bonander","doi":"10.1007/s10654-024-01115-7","DOIUrl":"10.1007/s10654-024-01115-7","url":null,"abstract":"","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":"697-699"},"PeriodicalIF":7.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kristin Gustavson, Fartein Ask Torvik, George Davey Smith, Espen Røysamb, Espen M Eilertsen
{"title":"Familial confounding or measurement error? How to interpret findings from sibling and co-twin control studies.","authors":"Kristin Gustavson, Fartein Ask Torvik, George Davey Smith, Espen Røysamb, Espen M Eilertsen","doi":"10.1007/s10654-024-01132-6","DOIUrl":"10.1007/s10654-024-01132-6","url":null,"abstract":"<p><p>Epidemiological researchers often examine associations between risk factors and health outcomes in non-experimental designs. Observed associations may be causal or confounded by unmeasured factors. Sibling and co-twin control studies account for familial confounding by comparing exposure levels among siblings (or twins). If the exposure-outcome association is causal, the siblings should also differ regarding the outcome. However, such studies may sometimes introduce more bias than they alleviate. Measurement error in the exposure may bias results and lead to erroneous conclusions that truly causal exposure-outcome associations are confounded by familial factors. The current study used Monte Carlo simulations to examine bias due to measurement error in sibling control models when the observed exposure-outcome association is truly causal. The results showed that decreasing exposure reliability and increasing sibling-correlations in the exposure led to deflated exposure-outcome associations and inflated associations between the family mean of the exposure and the outcome. The risk of falsely concluding that causal associations were confounded was high in many situations. For example, when exposure reliability was 0.7 and the observed sibling-correlation was r = 0.4, about 30-90% of the samples (n = 2,000) provided results supporting a false conclusion of confounding, depending on how p-values were interpreted as evidence for a family effect on the outcome. The current results have practical importance for epidemiological researchers conducting or reviewing sibling and co-twin control studies and may improve our understanding of observed associations between risk factors and health outcomes. We have developed an app (SibSim) providing simulations of many situations not presented in this paper.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":"587-603"},"PeriodicalIF":7.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Caroline Rometsch, Giovanni Mansueto, Frederic Maas Genannt Bermpohl, Alexandra Martin, Fiammetta Cosci
{"title":"Prevalence of functional disorders across Europe: a systematic review and meta-analysis.","authors":"Caroline Rometsch, Giovanni Mansueto, Frederic Maas Genannt Bermpohl, Alexandra Martin, Fiammetta Cosci","doi":"10.1007/s10654-024-01109-5","DOIUrl":"10.1007/s10654-024-01109-5","url":null,"abstract":"<p><p>Functional Disorders (FD) refer to persistent somatic symptoms caused by changes in the functioning of bodily processes. Previous findings suggest that FD are highly prevalent, but overall prevalence rates for FD in European countries are scarce. Therefore, the aim of the present work was to estimate the point prevalence of FD in adult general populations. PubMed and Web of Science were searched from inception to June 2022. A generalized linear mixed-effects model for statistical aggregation was used for statistical analyses. A standardized quality assessment was performed, and PRISMA guidelines were followed. A total of 136 studies were included and systematically synthesized resulting in 8 FD diagnoses. The large majority of studies was conducted in the Northern Europe, Spain, and Italy. The overall point prevalence for FD was 8.78% (95% CI from 7.61 to 10.10%) across Europe, with the highest overall point prevalence in Norway (17.68%, 95% CI from 9.56 to 30.38%) and the lowest in Denmark (3.68%, 95% CI from 2.08 to 6.43%). Overall point prevalence rates for specific FD diagnoses resulted in 20.27% (95% CI from 16.51 to 24.63%) for chronic pain, 9.08% (95% CI from 7.31 to 11.22%) for irritable bowel syndrome, and 8.45% (95% CI from 5.40 to 12.97%) for chronic widespread pain. FD are highly prevalent across Europe, which is in line with data worldwide. Rates implicate the need to set priorities to ensure adequate diagnosis and care paths to FD patients by care givers and policy makers.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":"571-586"},"PeriodicalIF":7.7,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140326493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The perpetual need of randomized clinical trials: challenges and uncertainties in emulating the REDUCE-AMI trial","authors":"Maarten J.G. Leening, Eric Boersma","doi":"10.1007/s10654-024-01127-3","DOIUrl":"https://doi.org/10.1007/s10654-024-01127-3","url":null,"abstract":"<p>Trial emulations in observational data analyses can complement findings from randomized clinical trials, inform future trial designs, or generate evidence when randomized studies are not feasible due to resource constraints and ethical or practical limitations. Importantly, trial emulation designs facilitate causal inference in observational data analyses by enhancing counterfactual thinking and comparisons of real-world observations (e.g. Mendelian Randomization) to hypothetical interventions. In order to enhance credibility, trial emulations would benefit from prospective registration, publication of statistical analysis plans, and subsequent prospective benchmarking to randomized clinical trials prior to their publication. Confounding by indication, however, is the key challenge to interpreting observed intended effects of an intervention as causal in observational data analyses. We discuss the target trial emulation of the REDUCE-AMI randomized clinical trial (ClinicalTrials.gov ID NCT03278509; beta-blocker use in patients with preserved left ventricular ejection fraction after myocardial infarction) to illustrate the challenges and uncertainties of studying intended effects of interventions without randomization to account for confounding. We furthermore directly compare the findings, statistical power, and clinical interpretation of the results of the REDUCE-AMI target trial emulation to those from the simultaneously published randomized clinical trial. The complexity and subtlety of confounding by indication when studying intended effects of interventions can generally only be addressed by randomization.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"17 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140907425","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}
{"title":"The Chinese keratoconus (CKC) cohort study.","authors":"Kaili Yang, Xiaotian Liu, Liyan Xu, Yuwei Gu, Qi Fan, Shanshan Yin, Yifan Wang, Yi Yuan, Anqi Chang, Yonghao Zang, Chenchen Yin, Chenjiu Pang, Chongjian Wang, Shengwei Ren","doi":"10.1007/s10654-024-01128-2","DOIUrl":"https://doi.org/10.1007/s10654-024-01128-2","url":null,"abstract":"<p><p>The Chinese keratoconus (CKC) cohort study is a population-based longitudinal prospective cohort study in the Chinese population involving a clinical database and biobanks. This ongoing study focuses on the prevention of KC progression and is the first to involve the effect of gene‒environment interactions on KC progression. The CKC cohort is hospital-based and dynamic and was established in Zhengzhou, China; KC patients (n = 1114) from a large geographical area were enrolled from January 2019 to June 2023, with a mean age of 22.23 years (6‒57 years). Demographic details, socioeconomic characteristics, lifestyle, disease history, surgical history, family history, and visual and social function data are being collected using questionnaires. General physical examination, eye examination, biological specimen collection, and first-degree relative data were collected and analyzed in the present study. The primary focus of the present study was placed on gene, environment and the effect of gene‒environment interactions on KC progression. The follow-up of the CKC cohort study is expected to include data collection at 3 months, 6 months, and 1 year after the initial examination and then at the annual follow-up examinations. The first follow-up of the CKC cohort study was recorded. A total of 918 patients completed the follow-up by June 1, 2023, with a response rate of 82.40%. Aside from the younger age of patients who were followed up, no significant differences were found between patients who were followed up and patients who were not.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":""},"PeriodicalIF":13.6,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861645","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}