Browsing by Subject "cohort"

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  • Pulakka, Anna; Halonen, Jaana I.; Pentti, Jaana; Kivimäki, Mika; Vahtera, Jussi; Stenholm, Sari (2019)
    Aims: We examined the effect of retirement transition on changes in smoking, identified trajectories of smoking around the retirement transition, and investigated factors predicting the membership in the trajectories. Methods: This longitudinal cohort study included 1,432 current or former smokers who entered into statutory retirement in 2000-2011 and who filled out two to four questionnaires sent at four-year intervals. Effect of retirement on smoking was analysed as a non-randomized pseudo-trial in which we compared the likelihood of quitting and relapsing smoking between two subsequent survey waves among those who retired and did not retire. We used latent class analysis to identify trajectories of smoking status and smoking intensity (low: 10 cigarettes/day), and multinomial logistic regression models to assess pre-retirement factors associated with smoking trajectories. Results: Retirement transition was associated with 1.7-fold odds of quitting smoking (95% confidence intervals 1.3-2.2) compared with no retirement transition. We identified three smoking status trajectories: 'sustained non-smoking' (61% of the participants), 'sustained smoking' (23%) and 'decreasing smoking' (16%). For 489 baseline smokers, we identified three smoking intensity trajectories: 'sustained high intensity smoking' (32% of the participants), 'sustained low intensity smoking' (32%) and 'decreasing high intensity smoking' (35%). Living outside an inner urban area predicted membership in the 'decreasing smoking' versus 'sustained smoking' trajectory. Conclusions: Smokers are more likely to quit smoking during transition to retirement than before or after it. Characteristics of the smoking environment may affect smoking behaviour around retirement.
  • Virtanen, Suvi; Kuja-Halkola, Ralf; Mataix-Cols, David; Jayaram-Lindström, Nitya; D'Onofrio, Brian M.; Larsson, Henrik; Ruck, Christian; Suvisaari, Jaana; Lichtenstein, Paul; Latvala, Antti (2020)
    Background Causes of the comorbidity of substance misuse with anxiety-related and depressive disorders (anxiety/depression) remain poorly known. We estimated associations of substance misuse and anxiety/depression in the general population and tested them while accounting for genetic and shared environmental factors. Methods We studied individuals born in Sweden 1968–1997 (n = 2 996 398) with follow-up in nationwide register data for 1997–2013. To account for familial effects, stratified analyses were conducted within siblings and twin pairs. Substance misuse was defined as ICD-10 alcohol or drug use disorder or an alcohol/drug-related criminal conviction. Three dimensions of ICD-10 anxiety and depressive disorders and a substance misuse dimension were identified through exploratory factor analysis. Results Substance misuse was associated with a 4.5-fold (95% CI 4.50–4.58) elevated risk of lifetime generalized anxiety/depression, 4.7-fold (95% CI 4.63–4.82) elevated risk of panic disorder and agora/social phobia, and 2.9-fold elevated risk of phobias/OCD (95% CI 2.82–3.02) as compared to those without substance misuse. The associations were attenuated in within-family analyses but we found elevated risks in monozygotic twin pairs discordant for substance misuse as well as significant non-shared environmental correlations. The association between anxiety/depression and substance misuse was mainly driven by generalized anxiety/depression, whereas other anxiety/depression dimensions had minor or no independent associations with substance misuse. Conclusions Substance misuse and anxiety/depression are associated at the population level, and these associations are partially explained by familial liabilities. Our findings indicate a common genetic etiology but are also compatible with a potential partially causal relationship between substance misuse and anxiety/depression.
  • Figueiredo, Rejane Augusta De Oliveira; Roos, Eva; Eriksson, Johan G.; Simola-Strom, Sabina; Weiderpass, Elisabete (2017)
    Aims: Little is known about impact of maternal alcohol and tobacco consumption on adolescents' body size. The purpose of this study was to evaluate whether maternal alcohol or tobacco consumption is associated with their children's body size in adolescence, assessed by Body Mass Index (BMI). Methods: This study was conduct in subjects recruited into the Finnish Health in Teens cohort (Fin-HIT) between 2011 and 2014. A total of 4525 subjects aged between 9 and 14 years and their mothers or female adults responsible for the children were analysed. Relative risks (RR) and 95% confidence intervals (CI) were estimated using Multinomial Logistic Regression. Results: Most children were normal weight (74.5%), 10.6% were underweight and 14.9% were overweight or obese. Among mothers, 50.6% were never smokers, 35.7% were former smokers, and 13.7% were current smokers. Alcohol consumption was classified by Alcohol Use Disorders Identification Test (AUDIT), 12.7% were abstainers (score=0), 65.0% were low-moderate drinkers (scores 1-4) and 22.3% were harmful drinkers (scores. 5). There were statistically significant associations between currently smoking mothers and children's overweight (RR=1.36; 95% CI: 1.05-1.76). There was an inverse association between maternal former smoking and children's underweight (RR=0.70; CI: 0.56-0.87) compared with never smoker mothers. Among children in puberty, abstainer mothers were more likely to have underweight children compared with low-moderate mothers (RR=1.57; 95% CI: 1.03-2.41). Conclusions: Current smoker mothers were associated with children's overweight and former-smoker mothers were inversely associated with the children's underweight. Being an abstainer mother was associated with the children's underweight in puberty stage. If other studies confirm these results, public health interventions aiming at healthy weight of adolescents should target the whole family, not only the adolescents themselves.
  • Poropat, Goran; Archibugi, Livia; Korpela, Taija; Cardenas-Jaen, Karina; de-Madaria, Enrique; Capurso, Gabriele (2018)
    Background: Statins are perceived as potential etiological factors for acute pancreatitis (AP), but recent evidence suggests the opposite. Our aim was to evaluate the association between statin use and risk of AP in observational studies. Methods: Medline, Scopus, and Web of Science were searched for cohort (C) and case-control (CC) studies evaluating statins as intervention and AP as outcome. Pooled adjusted odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated. Results: Thirteen studies (seven CC, six C) with 34,899 AP patients and 5,377,894 controls were included. Prevalence of statin use was 9.8% among AP patients and 25% among controls. Pooled adjusted OR was 1.00 (95% CI = 0.63 to 1.59) with considerable heterogeneity (I-2 = 98%). CC studies were associated with increased AP risk (OR = 1.33; 95% CI = 1.20 to 1.47), unlike C studies (OR = 0.69; 95% CI = 0.37 to 1.31). No association with increased risk was found for studies from Western countries (OR = 0.90; 95% CI = 0.52 to 1.56), unlike for studies conducted in Asia (OR = 1.39; 95% CI = 1.10 to 1.75). Conclusion: Statin use is not associated with increased risk of AP. Increased risk was limited to CC studies, which are more prone to bias, while C studies showed no global effect. Further research is needed to clarify whether statin type, dosage, treatment duration or AP etiology might account for this difference.
  • Halonen, Jaana I.; Stenholm, Sari; Pulakka, Anna; Kawachi, Ichiro; Aalto, Ville; Pentti, Jaana; Lallukka, Tea; Virtanen, Marianna; Vahtera, Jussi; Kivimaki, Mika (2017)
    Background and AimsLife transitions such as retirement may influence alcohol consumption, but only a few studies have described this using longitudinal data. We identified patterns and predictors of risky drinking around the time of retirement. DesignA cohort study assessing trajectories and predictors of risky drinking among employees entering statutory retirement between 2000 and 2011. Setting and ParticipantsA total of 5805 men and women from the Finnish Public Sector study who responded to questions on alcohol consumption 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. MeasurementsWe assessed trajectories of risky drinking (> 24 units per week among men, > 16 units among women, or an extreme drinking occasion during past year) from pre- to post-retirement, as well as predictors of each alcohol consumption trajectory. FindingsThree trajectories were identified: sustained healthy drinking (81% of participants), temporary increase in risky drinking around retirement (12%) and slowly declining risky drinking after retirement (7%). The strongest pre-retirement predictors for belonging to the group of temporary increase in risky drinking were current smoking [odds ratio (OR)=3.90, 95% confidence interval (CI)=2.70-5.64], male sex (OR=2.77, 95% CI=2.16-3.55), depression (OR=1.44, 95% CI=1.05-1.99) and work-place in the metropolitan area (OR=1.29, 95% CI=1.00-1.66). Compared with the slowly declining risky drinking group, the temporary increase in risky drinking group was characterized by lower occupational status and education, and work-place outside the metropolitan area. ConclusionsIn Finland, approximately 12% of people who reach retirement age experience a temporary increase in alcohol consumption to risky levels, while approximately 7% experience a slow decline in risky levels of alcohol consumption. Male gender, smoking, being depressed and working in a metropolitan area are associated with increased likelihood of increased alcohol consumption.
  • Saavalainen, Liisu; Tikka, Tuulia; But, Anna; Gissler, Mika; Haukka, Jari; Tiitinen, Aila; Härkki, Päivi; Heikinheimo, Oskari (2018)
    Introduction. To study the trends in incidence rate, type and surgical treatment, and patient characteristics of surgically verified endometriosis during 1987-2012. Material and methods. This is a register-based cohort study. We identified women receiving their first diagnosis of endometriosis in surgery from the Finnish Hospital Discharge Register (FHDR). Quality of the FHDR records was assessed bidirectionally. The age-standardized incidence rates of the first surgically verified endometriosis was assessed by calendar year. Results. The cohort comprises 49956 women. The quality assessment suggested the FHDR data to be of good quality. The most common diagnosis, ovarian endometriosis (46%), was associated with highest median age 38.5years (interquartile range 31.0-44.8) and the second most common diagnosis, peritoneal endometriosis (40%), with median age 34.9years (28.6-41.7). Between 1987 and 2012, a decrease was observed in the median age, from 38.8 (32.3-43.6) to 34.0 (28.9-41.0) years, and in the age-standardized incidence rate from 116 [95% confidence interval (CI) 112-121] to 45 (42-48) per 100000 women. The proportion of hysterectomy as a first surgical treatment decreased from 38 to 19%, whereas that of laparoscopy increased from 42 to 73% when comparing 1987-1995 with 1996-2012. Conclusions. This nationwide cohort of surgically verified endometriosis showed a decrease in the incidence rate and in the patient age at the time of first diagnosis, even though the proportion of laparoscopy has increased. The number of hysterectomies has decreased. These changes are likely to reflect the evolving diagnostics, increasing awareness of endometriosis, and effective use of medical treatment before surgery.