Browsing by Subject "Cohort study"

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  • Heikkala, Eveliina; Ala-Mursula, Leena; Taimela, Simo; Paananen, Markus; Vaaramo, Eeva; Auvinen, Juha; Karppinen, Jaro (2020)
    BackgroundThe relevance of health-related behaviors to exclusion from the labor market in early adulthood remains poorly studied in relation to the magnitude of the problem. We explored whether adolescents' accumulated unhealthy behaviors and psychosocial problems are associated with later labor market exclusion, and whether multisite musculoskeletal pain (MMSP) impacts these relations.MethodsWe gathered questionnaire data on unhealthy behaviors and psychosocial problems and MMSP among adolescents aged 15 to 16 belonging to the Northern Finland Birth Cohort 1986. The findings were combined with registry data on unemployment, employment and permanent work disability during a five-year follow-up between the ages of 25 and 29 (n=6692). In the statistical modeling we used education, family leave and socioeconomic status of childhood family as potential confounders, as well as latent class and logistic regression analyses.ResultsThe Externalizing behavior cluster associated with over one year of unemployment (RR 1.64, CI 1.25-2.14) and permanent work disability (OR 2.49, CI 1.07-5.78) in the follow-up among the men. The Sedentary cluster also associated with over one year (RR 1.41, CI 1.13-1.75) and under one year of unemployment (RR 1.25, CI 1.02-1.52) and no employment days (RR 1.93, CI 1.26-2.95) among the men. Obese male participants were at risk of over one year of unemployment (RR 1.50, CI 1.08-2.09) and no employment days (RR 1.93, CI 1.07-3.50). Among the women, the Multiple risk behavior cluster related significantly to over one year of unemployment (RR 1.77, CI 1.37-2.28). MMSP had no influence on the associations.ConclusionsUnhealthy behavior patterns and psychosocial problems in adolescence have long-term consequences for exclusion from the labor market in early adulthood, especially among men. Simultaneously supporting psychological well-being and healthy behaviors in adolescence may reduce labor market inclusion difficulties in the early phase of working life.
  • Heikkala, Eveliina; Ala-Mursula, Leena; Taimela, Simo; Paananen, Markus; Vaaramo, Eeva; Auvinen, Juha; Karppinen, Jaro (BioMed Central, 2020)
    Abstract Background The relevance of health-related behaviors to exclusion from the labor market in early adulthood remains poorly studied in relation to the magnitude of the problem. We explored whether adolescents’ accumulated unhealthy behaviors and psychosocial problems are associated with later labor market exclusion, and whether multisite musculoskeletal pain (MMSP) impacts these relations. Methods We gathered questionnaire data on unhealthy behaviors and psychosocial problems and MMSP among adolescents aged 15 to 16 belonging to the Northern Finland Birth Cohort 1986. The findings were combined with registry data on unemployment, employment and permanent work disability during a five-year follow-up between the ages of 25 and 29 (n = 6692). In the statistical modeling we used education, family leave and socioeconomic status of childhood family as potential confounders, as well as latent class and logistic regression analyses. Results The Externalizing behavior cluster associated with over one year of unemployment (RR 1.64, CI 1.25–2.14) and permanent work disability (OR 2.49, CI 1.07–5.78) in the follow-up among the men. The Sedentary cluster also associated with over one year (RR 1.41, CI 1.13–1.75) and under one year of unemployment (RR 1.25, CI 1.02–1.52) and no employment days (RR 1.93, CI 1.26–2.95) among the men. Obese male participants were at risk of over one year of unemployment (RR 1.50, CI 1.08–2.09) and no employment days (RR 1.93, CI 1.07–3.50). Among the women, the Multiple risk behavior cluster related significantly to over one year of unemployment (RR 1.77, CI 1.37–2.28). MMSP had no influence on the associations. Conclusions Unhealthy behavior patterns and psychosocial problems in adolescence have long-term consequences for exclusion from the labor market in early adulthood, especially among men. Simultaneously supporting psychological well-being and healthy behaviors in adolescence may reduce labor market inclusion difficulties in the early phase of working life.
  • Halonen, Jaana I.; Dehbi, Hakim-Moulay; Hansell, Anna L.; Gulliver, John; Fecht, Daniela; Blangiardo, Marta; Kelly, Frank J.; Chaturvedi, Nish; Kivimaki, Mika; Tonne, Cathryn (2017)
    Background: Road traffic noise has been linked to increased risk of stroke, for which hypertension and carotid intima-media thickness (cIMT) are risk factors. A link between traffic noise and hypertension has been established, but there are few studies on blood pressure and no studies on cIMT. Objectives: To examine cross-sectional associations for long-term exposure to night-time noise with cIMT, systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension. Methods: The study population consisted of 2592 adults from the Whitehall II and SABRE cohort studies living within Greater London who had cIMT, SBP and DBP measured. Exposure to night-time road traffic noise (A-weighted dB, referred to as dBA) was estimated at each participant's residential postcode centroid. Results: Mean night-time road noise levels were 52 dBA (SD=4). In the pooled analysis adjusted for cohort, sex, age, ethnicity, marital status, smoking, area-level deprivation and NOx there was a 9.1 mu m (95% CI: -7.1, 25.2) increase in cIMT in association with 10 dBA increase in night-time noise. Analyses by noise categories of 5560 dBA (16.2 mu m, 95% CI:-8.7, 41.2), and N60 dBA (21.2 mu m, 95% CI:-2.5, 44.9) vs. 60 dBA vs. Conclusions: After adjustments, including for air pollution, the association between night-time road traffic noise and cIMT was only observed among non-medication users but associations with blood pressure and hypertension were largely null. (C) 2016 Elsevier Ltd. All rights reserved.
  • Martiskainen, Mika; Oksala, Niku; Pohjasvaara, Tarja; Kaste, Markku; Oksala, Anni; Karhunen, Pekka J.; Erkinjuntti, Timo (2014)
  • But, Anna; De Bruin, Marie L.; Bazelier, Marloes T.; Hjellvik, Vidar; Andersen, Morten; Auvinen, Anssi; Starup-Linde, Jakob; Schmidt, Marjanka K.; Furu, Kari; de Vries, Frank; Karlstad, Oystein; Ekstrom, Nils; Haukka, Jari (2017)
    Aims/hypothesis The aim of this work was to investigate the relationship between use of certain insulins and risk for cancer, when addressing the limitations and biases involved in previous studies. Methods National Health Registries from Denmark (1996-2010), Finland (1996-2011), Norway (2005-2010) and Sweden (2007-2012) and the UK Clinical Practice Research Datalink database (1987-2013) were used to conduct a cohort study on new insulin users (N = 327,112). By using a common data model and semi-aggregate approach, we pooled individual-level records from five cohorts and applied Poisson regression models. For each of ten cancer sites studied, we estimated the rate ratios (RRs) by duration (6 years) of cumulative exposure to insulin glargine or insulin detemir relative to that of human insulin. Results A total of 21,390 cancer cases occurred during a mean follow-up of 4.6 years. No trend with cumulative treatment time for insulin glargine relative to human insulin was observed in risk for any of the ten studied cancer types. Of the 136 associations tested in the main analysis, only a few increased and decreased risks were found: among women, a higher risk was observed for colorectal (RR 1.54, 95% CI 1.06, 2.25) and endometrial cancer (RR 1.78, 95% CI 1.07, 2.94) for 6 years (RR 0.22, 95% CI 0.05, 0.92). Comparisons of insulin detemir with human insulin also showed no consistent differences. Conclusions/interpretation The present multi-country study found no evidence of consistent differences in risk for ten cancers for insulin glargine or insulin detemir use compared with human insulin, at follow-up exceeding 5 years.
  • Stenholm, Sari; Solovieva, Svetlana; Viikari-Juntura, Eira; Aalto, Ville; Kivimaki, Mika; Vahtera, Jussi (2017)
    Background: Retirement is a major life transition affecting health behaviors. The aim of this study was to examine within-individual changes in body mass index (BMI) during transition from full-time work to statutory retirement by sex and physical work characteristics. Methods: A multiwave cohort study repeated every 4 years and data linkage to records from retirement registers. Participants were 5426 Finnish public-sector employees who retired on a statutory basis in 2000-2011 and who reported their body weight one to three times prior to (w(-3), w(-2), w(-1)), and one to three times after (w(+1), w(+2), w(+3)) retirement. Results: During the 4-year retirement transition (w(+1), vs. w(-1)) men showed decline in BMI, which was most marked among men with sedentary work (-0.18 kg/m(2), 95% CI -.30 to -0.05). In contrast, BMI increased during retirement transition in women and was most marked among women with diverse (0.14 kg/m(2), 95% CI 0.08 to 0.20) or physically heavy work (0.31 kg/m(2), 95% CI 0.16 to 0.45). Physical activity during leisure time or commuting to work, alcohol consumption or smoking did not explain the observed changes during retirement transition. Conclusions: In this study statutory retirement was associated with small changes in BMI. Weight loss was most visible in men retiring from sedentary jobs and weight gain in women retiring from diverse and physically heavy jobs.
  • Stenholm, Sari; Solovieva, Svetlana; Viikari-Juntura, Eira; Aalto, Ville; Kivimäki, Mika; Vahtera, Jussi (BioMed Central, 2017)
    Abstract Background Retirement is a major life transition affecting health behaviors. The aim of this study was to examine within-individual changes in body mass index (BMI) during transition from full-time work to statutory retirement by sex and physical work characteristics. Methods A multiwave cohort study repeated every 4 years and data linkage to records from retirement registers. Participants were 5426 Finnish public-sector employees who retired on a statutory basis in 2000–2011 and who reported their body weight one to three times prior to (w−3, w−2, w−1), and one to three times after (w+1, w+2, w+3) retirement. Results During the 4-year retirement transition (w+1, vs. w−1) men showed decline in BMI, which was most marked among men with sedentary work (−0.18 kg/m2, 95% CI −.30 to −0.05). In contrast, BMI increased during retirement transition in women and was most marked among women with diverse (0.14 kg/m2, 95% CI 0.08 to 0.20) or physically heavy work (0.31 kg/m2, 95% CI 0.16 to 0.45). Physical activity during leisure time or commuting to work, alcohol consumption or smoking did not explain the observed changes during retirement transition. Conclusions In this study statutory retirement was associated with small changes in BMI. Weight loss was most visible in men retiring from sedentary jobs and weight gain in women retiring from diverse and physically heavy jobs.
  • Lietzen, Raija; Virtanen, Pekka; Kivimaki, Mika; Korkeila, Jyrki; Suominen, Sakari; Sillanmaki, Lauri; Koskenvuo, Markku; Vahtera, Jussi (2017)
    Objective: This prospective, population-based cohort study of 1102 Finnish adults with asthma, examined whether exposure to stressful life events is associated with the intensity of usage of inhaled short-acting beta(2)-agonists. Methods: Survey data was collected by two postal questionnaires. Baseline characteristics were obtained in 1998 and data on 19 specific stressful events (e.g. death of a child or spouse or divorce) within the six preceding months in 2003. Exposure to life events was indicated by a sum score weighted by mean severity of the events. Participants were linked to records of filled prescriptions for inhaled short-acting beta(2)-agonists from national registers from 2000 through 2006. The rates of purchases of short-acting beta(2)-agonists before (2000 2001), during (2002 2003) and after (2004-2006) the event exposure were estimated using repeated-measures Poisson regression analyses with the generalized estimating equation. Results: Of the 1102 participants, 162 (15%) were exposed to highly stressful events, 205 (19%) to less stressful events. During the 7-year observation period, 5955 purchases of filled prescription for inhaled short-acting beta(2)-agonists were recorded. After exposure to highly stressful events, the rate of purchases of beta(2)-agonists was 1.50 times higher (95% confidence interval (CI): 1.05, 2.13) than before the stressful event occurred. Among those with low or no exposure to life events, the corresponding rate ratios were not elevated (rate ratio 0.81, 95% CI: 0.66, 0.99 and 0.95, 95% CI: 0.83, 1.09 respectively). Conclusion: An increase in beta(2)-agonist usage after severe life events suggests that stressful experiences may worsen asthma symptoms.
  • Mikkola, T. M.; von Bonsdorff, M. B.; Osmond, C.; Salonen, M. K.; Kajantie, E.; Cooper, C.; Valimaki, M. J.; Eriksson, J. G. (2017)
    We examined the associations between childhood growth and bone properties among women at early old age. Early growth in height predicted greater bone area and higher bone mineral mass. However, information on growth did not improve prediction of bone properties beyond that predicted by body size at early old age. We examined the associations between body size at birth and childhood growth with bone area, bone mineral content (BMC), and areal bone mineral density (aBMD) in early old age. A subgroup of women (n = 178, mean 60.4 years) from the Helsinki Birth Cohort Study, born 1934-1944, participated in dual-energy X-ray absorptiometry (DXA) measurements of the lumbar spine and hip. Height and weight at 0, 2, 7, and 11 years, obtained from health care records, were reconstructed into conditional variables representing growth velocity independent of earlier growth. Weight was adjusted for corresponding height. Linear regression models were adjusted for multiple confounders. Birth length and growth in height before 7 years of age were positively associated with femoral neck area (p <0.05) and growth in height at all age periods studied with spine bone area (p <0.01). Growth in height before the age of 7 years was associated with BMC in the femoral neck (p <0.01) and birth length and growth in height before the age of 7 years were associated with BMC in the spine (p <0.05). After entering adult height into the models, nearly all associations disappeared. Weight gain during childhood was not associated with bone area or BMC, and aBMD was not associated with early growth. Optimal growth in height in girls is important for obtaining larger skeleton and consequently higher bone mass. However, when predicting bone mineral mass among elderly women, information on early growth does not improve prediction beyond that predicted by current height and weight.
  • Mehlig, Kirsten; Bogl, Leonie H.; Hunsberger, Monica; Ahrens, Wolfgang; De Henauw, Stefaan; Iguacel, Isabel; Jilani, Hannah; Molnar, Denes; Pala, Valeria; Russo, Paola; Tornaritis, Michael; Veidebaum, Toomas; Kaprio, Jaakko; Lissner, Lauren (2018)
    Objective: The present study investigated the association between sugar and fat intake in childhood in relation to alcohol use in adolescence. We hypothesized that early exposure to diets high in fat and sugar may affect ingestive behaviours later in life, including alcohol use. Design/Setting/Subjects: Children from the European IDEFICS/I.Family cohort study were examined at ages 5-9 years and followed up at ages 11-16 years. FFQ were completed by parents on behalf of children, and later by adolescents themselves. Complete data were available in 2263 participants. Children's propensities to consume foods high in fat and sugar were calculated and dichotomized at median values. Adolescents' use of alcohol was classified as at least weekly v. less frequent use. Log-binomial regression linked sugar and fat consumption in childhood to risk of alcohol use in adolescence, adjusted for relevant covariates. Results: Five per cent of adolescents reported weekly alcohol consumption. Children with high propensity to consume sugar and fat were at greater risk of later alcohol use, compared with children with low fat and low sugar propensity (relative risk = 2.46; 95% CI 1.47, 4.12), independent of age, sex and survey country. The association was not explained by parental income and education, strict parenting style or child's health-related quality of life and was only partly mediated by sustained consumption of sugar and fat into adolescence. Conclusions: Frequent consumption of foods high in fat and sugar in childhood predicted regular use of alcohol in adolescence.
  • Dudel, Christian; Myrskylä, Mikko (2020)
    Objectives: Little is known about the length of working life, even though it is a key indicator for policy-makers. In this paper, we study how the length of working life at age 50 has developed in the United States from a cohort perspective. Methods: We use a large longitudinal sample of U.S. Social Security register data that covers close to 1.7 million individuals of the cohorts born from 1920 to 1965. For all of these cohorts, we study the employment trajectories and working life expectancy (WLE) at age 50 by gender and nativity (native-born/foreign-born). For the cohorts with employment trajectories that are only incompletely observed, we borrow information from older cohorts to predict their WLE. Results: The length of working life has been increasing for the native-born males and females, and the younger cohorts worked longer than the older cohorts. However, WLE might soon peak, and then stall. The gap in WLE between the nativeborn and the foreign-born has increased over time, although latter group might be able to catch up in the coming years. Discussion: Our findings show that studying employment from a cohort perspective reveals crucial information about patterns of working life. The future development of the length of working life should be a major concern for policy-makers.
  • Rantonen, J.; Karppinen, J.; Vehtari, A.; Luoto, S.; Viikari-Juntura, E.; Hupli, M.; Malmivaara, A.; Taimela, S. (2016)
    Background: Evidence shows that low back specific patient information is effective in sub-acute low back pain (LBP), but effectiveness and cost-effectiveness (CE) of information in early phase symptoms is not clear. We assessed effectiveness and CE of patient information in mild LBP in the occupational health (OH) setting in a quasi-experimental study. Methods: A cohort of employees (N = 312, aged Results: Compared to NC, the Booklet reduced HC costs by 196(sic) and SA by 3.5 days per year. In 81 % of the bootstrapped cases the Booklet was both cost saving and effective on SA. Compared to NC, in the Combined arm, the figures were 107(sic), 0.4 days, and 54 %, respectively. PHI decreased in both interventions. Conclusions: Booklet information alone was cost-effective in comparison to natural course of mild LBP. Combined information reduced HC costs. Both interventions reduced physical impairment. Mere booklet information is beneficial for employees who report mild LBP in the OH setting, and is also cost saving for the health care system.
  • Mantyselka, Pekka; Niskanen, Leo; Kautiainen, Hannu; Saltevo, Juha; Wurtz, Peter; Soininen, Pasi; Kangas, Antti J.; Ala-Korpela, Mika; Vanhala, Mauno (2014)
  • Kaartinen, Sara; Korhonen, Tellervo; Rottensteiner, Mirva; Kujala, Urho M.; Kaprio, Jaakko; Aaltonen, Sari (2020)
    Leisure-time physical activity has a complex relationship with low back pain (LBP). Thus, we aimed to investigate whether the diversity of sport activities is associated with the type of LBP. In the FinnTwin16 study, 4246 (55% females) Finnish twins at mean age 34.1 years replied to a health behaviour survey in 2010-2012. Based on the participation in different sport activities, we created two measures of diversity: quantity (i.e. the number of sport activities: 1, 2, 3, 4 and >= 5) and quality (i.e. the type of sport activity: endurance, strength, body care, etc.). Based on the frequency, duration and type of LBP, we created three groups: no history of LBP lasting more than one day, radiating LBP and non-radiating LBP. The associations between the quantity and quality of sport activities and the type of LBP were investigated with logistic regression analyses. Participation in >= 5 sport activities associated with less radiating and non-radiating LBP in analyses pooled across sex (odds ratio 0.46, 95% CI 0.30-0.69 and 0.66, 0.44-0.99, respectively). However, the associations attenuated after adjusting for several confounders. Participation in endurance sports was associated with less radiating (0.58, 0.43-0.76) and non-radiating (0.60, 0.44-0.81) LBP, whereas strength sports and body care only with less radiating LBP (0.76, 0.58-1.00 and 0.26, 0.09-0.74, respectively) adjusted for all sport types. On a sport-specific level, running and cycling were associated with less radiating and non-radiating LBP. In adulthood, the diversity of sport activities, particularly participation in endurance sports, may be associated with less radiating and non-radiating LBP.
  • Aaltonen, Kalle; Heinonen, Arto; Joensuu, Jaana; Parmanne, Pinja; Karjalainen, Anna; Varjolahti-Lehtinen, Tuire; Uutela, Toini; Puurtinen-Vilkki, Maija; Arstila, Leena; Blom, Marja; Sokka, Tuulikki; Nordström, Dan (2017)
    Background and objectives: Tumor necrosis factor (TNF)-inhibitors are used to treat psoriatic arthritis (PsA), but only a limited number of observational studies on this subject have been published thus far. The aim of this research was to analyze the effectiveness and drug survival of TNF-inhibitors in the treatment of PsA. Methods: PsA patients identified from the National Register for Biologic Treatment in Finland (ROB-FIN) starting their first, second, or third TNF-inhibitor treatment between 2004 and 2014 were included. Effectiveness was measured using ACR and EULAR response criteria and modeled using ordinal logistic regression. Treatment persistence was analyzed using Kaplan-Meier survival analysis and Cox proportional hazards model. Results: The study comprised 765 patients and 990 TNF-inhibitor treatment courses. EULAR moderate treatment responses at 6 months were achieved by 68% and 37% of the users of the first and the second or the third biologic, respectively. The probabilities of discontinuing the treatment within 12 and 24 months were 20% and 28%, respectively. Adjusted treatment responses to all TNF-inhibitors were similar; however, co-therapy with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) was not associated with better effectiveness. Adalimumab [hazard ratio (HR) = 0.62; 95% confidence interval (CD: 0.44-0.88] was superior to infliximab in drug survival while etanercept (HR = 0.77, 95% CI: 0.55-1.1) and golimumab (HR = 0.75, 95% CI: 0.46-1.2) did not differ from it. Co-medication with csDMARDs did not statistically improve drug survival. Conclusion: All available TNF-inhibitors showed similar treatment responses with or without csDMARDs. Adalimumab was associated with better drug survival when compared to infliximab. (C) 2017 Elsevier Inc. All rights reserved.
  • Ropponen, Annina; Narusyte, Jurgita; Silventoinen, Karri; Svedberg, Pia (2020)
    BackgroundTo investigate whether the clustering of different health behaviours (i.e. physical activity, tobacco use and alcohol consumption) influences the associations between psychosocial working conditions and disability pension due to different diagnoses.MethodsA population-based sample of 24,987 Swedish twins born before 1958 were followed from national registers for disability pension until 2013. Baseline survey data in 1998-2003 were used to assess health behaviours and psychosocial Job Exposure Matrix for job control, job demands and social support. Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI).ResultsDuring follow-up, 1252 disability pensions due to musculoskeletal disorders (5%), 601 due to mental diagnoses (2%) and 1162 due to other diagnoses (5%) occurred. In the models controlling for covariates, each one-unit increase in job demands was associated with higher (HR 1.16, 95%CI 1.01-1.33) and in job control with lower (HR 0.87, 95%CI 0.80-0.94) risk of disability pension due to musculoskeletal disorders among those with unhealthy behaviours. Among those with healthy behaviours, one-unit increase of social support was associated with a higher risk of disability pension due to mental and due to other diagnoses (HRs 1.29-1.30, 95%CI 1.04-1.63).ConclusionsJob control and job demands were associated with the risk of disability pension due to musculoskeletal disorders only among those with unhealthy behaviours. Social support was a risk factor for disability pension due to mental or other diagnoses among those with healthy behaviours. Workplaces and occupational health care should acknowledge these simultaneous circumstances in order to prevent disability pension.
  • Ropponen, Annina; Narusyte, Jurgita; Silventoinen, Karri; Svedberg, Pia (BioMed Central, 2020)
    Abstract Background To investigate whether the clustering of different health behaviours (i.e. physical activity, tobacco use and alcohol consumption) influences the associations between psychosocial working conditions and disability pension due to different diagnoses. Methods A population-based sample of 24,987 Swedish twins born before 1958 were followed from national registers for disability pension until 2013. Baseline survey data in 1998–2003 were used to assess health behaviours and psychosocial Job Exposure Matrix for job control, job demands and social support. Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI). Results During follow-up, 1252 disability pensions due to musculoskeletal disorders (5%), 601 due to mental diagnoses (2%) and 1162 due to other diagnoses (5%) occurred. In the models controlling for covariates, each one-unit increase in job demands was associated with higher (HR 1.16, 95%CI 1.01–1.33) and in job control with lower (HR 0.87, 95%CI 0.80–0.94) risk of disability pension due to musculoskeletal disorders among those with unhealthy behaviours. Among those with healthy behaviours, one-unit increase of social support was associated with a higher risk of disability pension due to mental and due to other diagnoses (HRs 1.29–1.30, 95%CI 1.04–1.63). Conclusions Job control and job demands were associated with the risk of disability pension due to musculoskeletal disorders only among those with unhealthy behaviours. Social support was a risk factor for disability pension due to mental or other diagnoses among those with healthy behaviours. Workplaces and occupational health care should acknowledge these simultaneous circumstances in order to prevent disability pension.
  • Eriksson, Mia D.; Eriksson, Johan G.; Kautiainen, Hannu; Salonen, Minna K.; Mikkola, Tuija M.; Kajantie, Eero; Wasenius, Niko; von Bonsdorff, Mikaela; Korhonen, Päivi; Laine, Merja K. (2021)
    Background Depression and cardiovascular disease (CVD) are major causes of global disease burden that are interrelated through mostly unknown mechanisms. We studied the relationship of melancholic and non-melancholic depressive symptoms with arterial stiffness, an important underlying mechanism of CVD. Methods The Helsinki Birth Cohort Study recruited 683 previously extensively phenotyped subjects for this sub-study. Cross-sectional data along with responses regarding depressive symptoms were obtained for each participant. For evaluation of depressive symptoms, the Beck Depression Inventory (BDI)and subscales were used to measure melancholic and non-melancholic depressive symptoms. Arterial stiffness was assessed as pulse wave velocity (PWV) that was measured between the carotid and radial artery, and carotid and femoral artery. Results Of the participants, 532 scored = 10 on the BDI, 122 were classified as having non-melancholic depressive symptoms and 29 as having melancholic depressive symptoms. Men had higher carotid-radial PWV (crPWV) values than women (p <.001). A positive relationship between BDI scores and crPWV (p <.001) was found in men. We also found higher crPWV in men with non-melancholic depressive symptoms compared to all others. No such differences were found in women. Discussion Arterial stiffness has a relationship with depressive symptoms and subtypes of depressive symptoms, at least in men. There is a significant relationship between higher PWV and non-melancholic depressive symptoms in men. Due to the intricate nature of the disease causality or directionality is impossible to infer solely based on this study. Further studies into the subtypes of depressive symptoms may be of benefit to understanding depression. KEY MESSAGES It is known that arterial stiffness contributes to cardiovascular disease, and is associated with depression. Higher Beck Depression Inventory scores are associated with higher carotid-radial pulse wave velocity in men. Non-melancholic depressive symptoms are associated with higher carotid-radial pulse wave velocity in men.
  • Mortensen, Jesper; Dich, Nadya; Clark, Alice Jessie; Ramlau-Hansen, Cecilia Host; Head, Jenny; Kivimäki, Mika; Kumari, Meena; Rod, Naja Hulvej (2019)
    The objective was to investigate the relationship between various aspects of informal caregiving and diurnal patterns of salivary cortisol, with special attention to the moderating effect of sex and work status. The study population was composed of 3727 men and women from the British Whitehall II study. Salivary cortisol was measured six times during a weekday. Aspects of caregiving included the relationship of caregiver to recipient, weekly hours of caregiving, and length of caregiving. Diurnal cortisol profiles were assessed using the cortisol awakening response (CAR) and diurnal cortisol slopes. Results showed that men, but not women, providing informal care had a blunted CAR compared with non-caregivers (P-Interaction = 0.03). Furthermore, we found a dose-response relationship showing that more weekly hours of informal care was associated with a more blunted CAR for men (P-trend = 0.03). Also, the blunted CAR for men was especially pronounced in short-term caregivers and those in paid work. In women, the steepest cortisol slope was seen among those in paid work who provided informal care (P-Interaction = 0.01). To conclude, we found different cortisol profiles in male and female informal caregivers. Male caregivers had a blunted CAR, which has previously been associated with chronic stress and burnout. Future research should investigate whether results are generalizable beyond UK citizens with a working history in the civil service.