Journal of Epidemiology and Global Health最新文献

{"title":"Temporal Trends and Mortality Patterns in Peripheral Arterial Disease: A Comprehensive Analysis of Hospitalized Patients in Kazakhstan between 2014 and 2021.","authors":"Gulnur Zhakhina, Yesbolat Sakko, Sauran Yerdessov, Temirgali Aimyshev, Zhalaliddin Makhammajanov, Anara Abbay, Denis Vinnikov, Ildar Fakhradiyev, Zhanar Yermakhanova, Yalcin Solak, Alessandro Salustri, Abduzhappar Gaipov","doi":"10.1007/s44197-024-00313-6","DOIUrl":"10.1007/s44197-024-00313-6","url":null,"abstract":"<p><strong>Background: </strong>Peripheral artery disease (PAD) is a global health concern associated with arterial narrowing or blockage, leading to significant morbidity and mortality. The aim of this study is to assess the disease burden and trends in mortality utilizing nationwide administrative health data.</p><p><strong>Methods: </strong>This retrospective study utilized data from the Unified National Electronic Healthcare System (UNEHS) from 2014 to 2021. Patients meeting PAD criteria were included, with demographic and clinical data analyzed. Cox regression and Competing Risk Analysis assessed mortality risks.</p><p><strong>Results: </strong>Between 2014 and 2021, 19,507 individuals were hospitalized due to PAD, with 8,332 (43%) being women and 11,175 (57%) men. The incidence of PAD increased markedly over the observation period, rising from 79 individuals per million population (PMP) in 2014 to 309 PMP in 2021. Concurrent heart failure (HF), acute myocardial infarction (AMI), diabetes, and essential hypertension were prevalent in 50%, 27%, 27%, and 26% of the PAD patients, respectively. Competing Risk Analysis showed a subdistribution hazard ratio (SHR) of 6.53 [95% CI: 4.65-9.19] for individuals over 80 years. Heart failure was associated with lower all-cause HR [0.80, 95% CI: 0.76-0.86, p < 0.001] but higher SHR [1.30, 95% CI: 1.18-1.44, p < 0.001]. Comorbidities such as heart failure, stroke, and acute myocardial infarction significantly increased mortality risks, while essential hypertension was associated with lower risk of death.</p><p><strong>Conclusion: </strong>The significant rise in the incidence rate of PAD underscores the growing burden of the disease, highlighting the urgent need for targeted preventive and management strategies in Kazakhstan.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":"1609-1618"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Potentially Inappropriate Prescribing in Older Adults in Gulf Cooperation Council Countries: A Systematic Review and Meta-Analysis.","authors":"Abdullah A Alshehri, Wael Y Khawagi, Sara M Alqahtani, Reem M Aljohani, Reuof M Aldajani, Manal S Althobaiti, Teef T Alzlami, Akshaya Srikanth Bhagavathula","doi":"10.1007/s44197-024-00332-3","DOIUrl":"10.1007/s44197-024-00332-3","url":null,"abstract":"<p><strong>Introduction: </strong>Potentially Inappropriate Prescribing (PIP) poses a significant risk to patient safety and associated with poor healthcare outcomes in Gulf Cooperation Council (GCC) countries. This study aimed to assess PIP prevalence and patterns in older adults across all care settings in GCC.</p><p><strong>Methods: </strong>A comprehensive search was conducted on six medical databases to identify studies assessing the PIP prevalence in older adults using validated criteria in GCC. Pooled prevalence estimates and odds ratios were calculated using STATA Software (version 16). Statistical heterogeneity was evaluated with the I² statistic, and publication bias was assessed using funnel plot symmetry and Egger's regression test. The risk of bias was assessed using the JBI Prevalence Critical Appraisal Tool.</p><p><strong>Results: </strong>Fourteen eligible studies conducted over ten years included 18,647 patients. The median prevalence of PIP was 54.4% (IQR: 37.6-62.1%), higher in hospital settings (59.5%; IQR: 53.7-65.3%) compared to primary care (44.2%; IQR: 18.5-54.4%). Cardiovascular medications were the most common PIP (15,353 occurrences). Polypharmacy was significantly associated with PIP exposure (OR: 5.26; 95% CI: 2.33-11.84). The odds of PIP exposure were significantly increased among older individuals with chronic kidney disease (OR: 1.87; 95% CI: 1.19-2.54) and diabetes (OR: 1.74; 95% CI: 1.18-2.30).</p><p><strong>Conclusion: </strong>This study highlights high PIP prevalence among older adults in GCC countries, particularly in hospital settings. Polypharmacy and certain chronic conditions were significantly associated with PIP exposure. These findings emphasize the need for targeted interventions to improve prescribing practices and medication safety.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":"1737-1747"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long COVID-19 and Coexistence of Fatigue and Depression: A Cross-sectional Study from Saudi Arabia.","authors":"Abdulrahman Alharbi, Faisal Almogbel, Unaib Rabbani, Ziad A Memish","doi":"10.1007/s44197-024-00312-7","DOIUrl":"10.1007/s44197-024-00312-7","url":null,"abstract":"<p><strong>Background and objectives: </strong>Coronavirus disease 2019 (COVID-19) is associated with various manifestations even after infection resolution. This study aimed to assess the prevalence of post-COVID-19 fatigue and its predictors.</p><p><strong>Methods: </strong>We conducted a nationwide cross-sectional study among Polymerase Chain Reaction test confirmed COVID-19 cases in Saudi Arabia from July 2021 to February 2022. We collected data through telephonic interviews covering socio-demographics, comorbidities, body mass index, smoking, illness severity, and COVID-19 vaccination status. We assessed fatigue using Fatigue Severity Scale while depression was assessed using Patient Health Questionnaire-2. Logistic regression was employed to analyze the relationship between post-COVID-19 fatigue and depression.</p><p><strong>Results: </strong>The analysis included 361 participants with a mean age of 37 ± 10.5 years, among whom 43% were female. Approximately 10% had comorbidities, and 21% were current smokers. Nearly two-thirds (68%) of the participants reported mild illness. The prevalence of perceived fatigue was 22.7%, while fatigue measured by the Fatigue Severity Scale was 14.4%. The multivariable logistic regression model revealed that COVID-19 severity and depression were significant predictors of post-COVID-19 fatigue; adjusted odds ratio 1.87 (95% CI: 1.10 to 3.18) and 14.3 (95% CI: 4.55 to 45.0), respectively.</p><p><strong>Conclusion: </strong>Our findings suggest a higher prevalence of perceived fatigue compared to that measured by the Fatigue Severity Scale, underscoring the importance of using a valid assessment tool for fatigue among COVID-19 patients to ensure proper management. The significant association between post-COVID-19 fatigue and depression highlights the need for psychological assessment of COVID-19 patients to enhance their post-infection quality of life.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":"1602-1608"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, Radiological Features and Treatment Outcomes of Tuberculosis in Patients Aged 75 Years and Older.","authors":"Afrah Alsehali, Haneen Alrajih, Hamdan Al-Jahdali, Eiman Al-Safi, Laila Layqah, Salim Baharoon","doi":"10.1007/s44197-024-00311-8","DOIUrl":"10.1007/s44197-024-00311-8","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis (TB) is a significant contributor to morbidity and mortality. With a progressively aging population, TB is increasingly encountered in older adults. Understanding the clinical presentation and optimal treatment strategies for TB in this population is essential.</p><p><strong>Method: </strong>Clinical, radiological features, treatment, and outcome of patients aged 75 and above who were diagnosed with tuberculosis at King Abdulaziz Medical City in Riyadh in the period between January 2015 to December 2021wereevaluated retrospectively.</p><p><strong>Results: </strong>Among 92 elderly tuberculosis patients, most were male (76.1%) with a mean age of 82.5 years. Pulmonary TB was diagnosed in 52.2% of patients, Extra Pulmonary TB in 32.6%, and Disseminated TB in 15.2%. Comorbidities included Diabetes Mellitus (59.8%) and Congestive Heart Failure (41.3%). The most common presentation symptoms included cough (51.1%), fever (43.5%), dyspnea (39.1%), and weight loss (31.5%). Delay of TB diagnosis for up to 3 months was observed in 31.5% of patients. Weight loss and male gender were significant predictors of delayed diagnosis. Laboratory findings varied among TB types, with disseminated TB showing higher eosinophilia and thrombocytopenia. Completion of an initial RIPE treatment protocol was achieved in 67.6% of patients. Mortality during treatment occurred in 23.9% of patients. Pulmonary TB was associated with higher mortality compared to extrapulmonary TB (p = 0.007).</p><p><strong>Conclusion: </strong>Tuberculosis is associated with high mortality in patients above the age of 75. There is still a substantial delay in TB diagnosis in the elderly. RIPE regimen is frequently changed due to side effects. Alternative regimen choices were quite variable. More studies on tuberculosis in this patient's population are needed to define the most effective therapeutic approach.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":"1591-1601"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incompleteness and Misclassification of Maternal Deaths in Zimbabwe: Data from Two Reproductive Age Mortality Surveys, 2007-2008 and 2018-2019.","authors":"Reuben Musarandega, Lennarth Nystrom, Grant Murewanhema, Chipo Gwanzura, Solwayo Ngwenya, Robert Pattinson, Rhoderick Machekano, Stephen Peter Munjanja","doi":"10.1007/s44197-024-00318-1","DOIUrl":"10.1007/s44197-024-00318-1","url":null,"abstract":"<p><strong>Introduction: </strong>We implemented two cross-sectional reproductive age mortality surveys in 2007-2008 and 2018-2019 to assess changes in the MMR and causes of death in Zimbabwe. We collected data from health institutions, civil registration and vital statistics, the community, and surveillance. This paper analyses missingness and misclassification of deaths in the two surveys.</p><p><strong>Methods: </strong>We compared proportions of missed and misclassified deaths in the surveys using Chi-square or Fisher's exact tests. Using log-linear regression models, we calculated and compared risk ratios of missed deaths in the data sources. We assessed the effect on MMRs of misclassifying deaths and analysed the sensitivity and specificity of identifying deaths in the surveys using the six-box method and risk ratios calculated through Binomial exact tests.</p><p><strong>Results: </strong>All data sources missed and misclassified the deaths. The community survey was seven times [RR 7.1 (5.1-9.7)] and CRVS three times [RR 3.4 (2.4-4.7)] more likely to identify maternal deaths than health records in 2007-08. In 2018-19, CRVS [RR 0.8 (0.7-0.9)] and surveillance [RR 0.7 (0.6-0.9)] were less likely to identify maternal deaths than health records. Misclassification of causes of death significantly reduced MMRs in health records [RR 1.4 (1.2-1.5)]; CRVS [RR 1.3 (1.1-1.5)] and the community survey/surveillance [RR 1.4 (1.2-1.6)].</p><p><strong>Conclusion: </strong>Incompleteness and misclassification of maternal deaths are still high in Zimbabwe. Maternal mortality studies must triangulate data sources to improve the completeness of data while efforts to reduce misclassification of deaths continue.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":"1642-1649"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifiable Cross-cultural Research on Medical Mistrust is Necessary for Effective and Equitable Vaccination in Low- and Middle-income Countries.","authors":"Sean P Prall","doi":"10.1007/s44197-024-00319-0","DOIUrl":"10.1007/s44197-024-00319-0","url":null,"abstract":"<p><p>Perceptions of healthcare personnel and institutions substantially impact healthcare behaviors. In the US, minority experiences with racist events like the Tuskegee study, alongside everyday experiences of marginalization and discrimination, drive medical mistrust in populations that are already burdened with health inequalities. However, the concept of medical mistrust is rarely applied outside of industrialized contexts. Histories of colonialism, underfunded healthcare institutions, and the enormous cultural and ethnolinguistic diversity present in low- and middle-income countries (LMICs) make medical mistrust a likely contributor to health behavior in these contexts. In the era of COVID-19 and emergent malaria vaccines, there is an urgent need to mitigate factors leading to medical mistrust, which impedes interest in novel vaccines. Doing so requires substantial investment in research that examines the causes of medical mistrust across diverse communities, develops methodological tools that can effectively measure medical mistrust across diverse cultural and ethno-linguistic contexts, and applies this data to policy and public health messaging. This commentary highlights the role of medical mistrust in vaccination and argues for its utility in addressing vaccine decision-making in LMICs.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":"1771-1777"},"PeriodicalIF":3.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing Detection of Legionnaires' Disease in a Large Italian Hospital in the Period 2016-2023.","authors":"Marilena La Sorda, Flavio De Maio, Maria Scaturro, Barbara Fiori, Giulia Santarelli, Jessica Iera, Fabiola Mancini, Brunella Posteraro, Maria Luisa Ricci, Maurizio Sanguinetti","doi":"10.1007/s44197-024-00276-8","DOIUrl":"10.1007/s44197-024-00276-8","url":null,"abstract":"<p><p>The pandemic marked the beginning of an era of dynamic and rapid changes in the diagnosis of respiratory infections. Herein we describe Legionnaires' disease trend in the years 2016-2023 in a large Italian hospital showing how improvements in diagnostic algorithms impact on its detection.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":"1358-1362"},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Regional Distribution of Beta-Hemoglobin Variants in Saudi Arabia: Insights from the National Premarital Screening Program\".","authors":"Mansour Aljabry, Suha Sulimani, Ghazi Alotaibi, Hassan Aljabri, Shaker Alomary, Omar Aljabri, Maha Sallam, Abdulrahman Alsultan","doi":"10.1007/s44197-024-00281-x","DOIUrl":"10.1007/s44197-024-00281-x","url":null,"abstract":"<p><strong>Background: </strong>Hemoglobinopathies are among the most prevalent inherited disorders globally, with carrier prevalence varying significantly across regions. In Saudi Arabia, high rates of consanguineous marriages amplify the risk of these disorders.</p><p><strong>Aim: </strong>This study aims to assess the burden of hemoglobinopathies by evaluating the prevalence and regional distribution of beta-hemoglobin variants, including rare variants, among couples participating in the national premarital screening program.</p><p><strong>Methods: </strong>Data were collected from the premarital genetic screening program and entered into the SEHA platform, covering the 13 administrative regions of Saudi Arabia. Blood samples underwent various screening tests for infectious and genetic diseases. Hemoglobin electrophoresis samples were analyzed using capillary electrophoresis, High-Performance Liquid Chromatography (HPLC), or a combination of both methods.</p><p><strong>Results: </strong>From 2011 to 2018, 1,871,184 individuals were included in the study, with 49.8% male and 50.2% female. The average age was 30.2 years. Hemoglobin S (HbS) was identified in 88,431 individuals (4.7% of the tested population and 78.5% of abnormal screening results), primarily as a sickle cell trait. β-thalassemia was the second most common disorder, identified in 22,420 individuals (1.2% of the population and 19.9% of hemoglobin disorders). HbC and HbD were each detected in 0.04% of cases, while HbO-Arab was identified in 0.007% and HbG in 0.006%. Hemoglobin E and hemoglobin Lepore were found to be extremely rare.</p><p><strong>Conclusion: </strong>The study demonstrates regional variation in the prevalence of hemoglobin genetic variants in Saudi Arabia. To effectively mitigate this risk, it is imperative to strengthen public education and awareness, particularly focusing on genetic screening and counseling.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":"1242-1248"},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141788226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Child Feces Management Mediates Reductions in Childhood Diarrhea from an On-Site Sanitation Intervention: Causal Mediation Analysis of a Cluster-Randomized Trial in Rural Bangladesh.","authors":"Jesse D Contreras, Mahfuza Islam, Andrew Mertens, Amy J Pickering, Benjamin F Arnold, Jade Benjamin-Chung, Alan E Hubbard, Mahbubur Rahman, Leanne Unicomb, Stephen P Luby, John M Colford, Ayse Ercumen","doi":"10.1007/s44197-024-00210-y","DOIUrl":"10.1007/s44197-024-00210-y","url":null,"abstract":"<p><strong>Background: </strong>The WASH benefits Bangladesh trial multi-component sanitation intervention reduced diarrheal disease among children < 5 years. Intervention components included latrine upgrades, child feces management tools, and behavioral promotion. It remains unclear which components most impacted diarrhea.</p><p><strong>Methods: </strong>We conducted mediation analysis within a subset of households (n = 720) from the sanitation and control arms. Potential mediators were categorized into indicators of latrine quality, latrine use practices, and feces management practices. We estimated average causal mediation effects (ACME) as prevalence differences (PD), defined as the intervention's effect on diarrhea through its effect on the mediator.</p><p><strong>Results: </strong>The intervention improved all indicators compared to controls. We found significant mediation through multiple latrine use and feces management practice indicators. The strongest mediators during monsoon seasons were reduced open defecation among children aged < 3 and 3-8 years, and increased disposal of child feces into latrines. The strongest mediators during dry seasons were access to a flush/pour-flush latrine, reduced open defecation among children aged 3-8 years, and increased disposal of child feces into latrines. Individual mediation effects were small (PD = 0.5-2 percentage points) compared to the overall intervention effect but collectively describe significant mediation pathways.</p><p><strong>Discussion: </strong>The effect of the WASH Benefits Bangladesh sanitation intervention on diarrheal disease was mediated through improved child feces management and reduced child open defecation. Although the intervention significantly improved latrine quality, relatively high latrine quality at baseline may have limited benefits from additional improvements. Targeting safe child feces management may increase the health benefits of rural sanitation interventions.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":"765-778"},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140175012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Changes in Social Isolation and Loneliness with Incident Cardiovascular Events and Mortality.","authors":"Yilin Chen, Huachen Xue, Yu Nie, Yujing Zhou, Sizhi Ai, Yaping Liu, Jihui Zhang, Yannis Yan Liang","doi":"10.1007/s44197-024-00243-3","DOIUrl":"10.1007/s44197-024-00243-3","url":null,"abstract":"<p><strong>Background: </strong>It remains unknown how the patterns of change of social isolation and loneliness are associated with the onset of cardiovascular disease (CVD) and mortality. We aimed to investigate the longitudinal association of changes in social isolation and loneliness with incident CVD, all-cause mortality, CVD mortality and subsequent cardiac function.</p><p><strong>Methods: </strong>This prospective cohort study included 18,258 participants aged 38-73 years who participated in visit 0 (2006-2010) and visit 1 (2012-2013) using UK Biobank (mean age 57.1, standard deviation [SD] 7.4; 48.7% males). Social isolation or loneliness was categorized into four patterns: never, transient, incident, and persistent. Incident CVD, all-cause and CVD mortality were ascertained through linkage data. Cardiac function was assessed by cardiovascular magnetic resonance imaging in a subsample (N = 5188; visit 2, since 2014).</p><p><strong>Results: </strong>Over a median follow-up of 8.3 (interquartile range [IQR] 8.1-8.6) years, compared with never social isolation, persistent social isolation was associated with the higher risk of incident CVD (hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.03-1.33), all-cause (1.42, 1.12-1.81) and CVD (1.53, 1.05-2.23) mortality. Likewise, persistent loneliness was strongly associated with the greater risk of incident CVD (1.13, 1.00-1.27), all-cause (1.28, 1.02-1.61) and CVD mortality (1.52, 1.06-2.18).</p><p><strong>Conclusions: </strong>Persistent social isolation and loneliness posed a substantially higher risk for incident CVD, all-cause and CVD mortality, and cardiac dysfunction than other patterns. Persistent social isolation and loneliness, along with an increasing cumulative score, are associated with lower cardiac function.</p>","PeriodicalId":15796,"journal":{"name":"Journal of Epidemiology and Global Health","volume":" ","pages":"962-973"},"PeriodicalIF":3.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11442883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141154952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}