Differences In Strength Of Associations Research Articles

Development and Evaluation of Linguistic Stimuli for Pain Research

Linguistic stimuli are commonly used in research to investigate the processing of pain. To provide researchers with a dataset of pain-related and non-pain-related linguistic stimuli, this research investigated 1) the associative strength between pain-related words and the pain construct; 2) the pain-relatedness ratings of pain words; and 3) the variability in the relatedness of pain words within pain word classifications (eg, sensory pain words). In Study 1, 194 pain-related and matched non-pain-related words were retrieved by reviewing the pain-related attentional bias literature. In Study 2, adults with (n = 85) and without (n = 48) self-reported chronic pain completed a speeded word categorization paradigm and rated the pain-relatedness of a subset of pain words. Analyses revealed that 1) despite differences in associative strength of 11.3% of the words between chronic and non-chronic pain groups, no overall group difference was found, 2) the chronic pain group rated the pain words as more pain-related compared to the non-chronic pain group, and 3) there was variability in the relatedness of pain words within pain word classifications. The findings highlight the importance of validating linguistic pain stimuli. The resulting dataset is openly accessible and new published sets can be added to the Linguistic Materials for Pain (LMaP) Repository. PerspectiveThis article presents the development and preliminary evaluation of a large pool of pain-related and non-pain-related words in adults with and without self-reported chronic pain. Findings are discussed and guidelines are offered to select the most suitable stimuli for future research.

Racial Differences in Strength of Associations Between Colorectal Cancer Screening, Area Deprivation, Demographics, and Clinical Characteristics.

Background: In Louisiana, colorectal cancer (CRC) incidence and mortality exceed national rates. Census tract, sex, and racial disparities across the state are well documented. This study examined whether there were subpopulation differences in associations between CRC screening, area deprivation index (ADI), and patient characteristics. Methods: This retrospective observational study included patients aged 50 to 75 years who received care within Ochsner Health in Louisiana between July 1, 2012, and December 31, 2020. Logistic regression models were used to generate adjusted odds ratios (95% CI). Results: A total of 75,344 patients met eligibility criteria for inclusion in the data analysis (60% female, 36% Black, 56% with spouse/partner, 42% Medicare/Medicaid,17% living in high deprivation areas, 41% with 2+ chronic conditions, 56% never smoked, 51% obese). Living in areas with less deprivation (state decile 1-3 vs 8-10: 1.19 [1.14-1.24]), number of comorbidities (3+ conditions: 1.15 [1.12-1.17]), and prior outpatient visits (1.63 [1.58-1.67]) increased odds of CRC screening. Male sex (0.82 [0.79-0.84]), age group 55 to 59 years (0.97 [0.95-0.99]), and Medicaid insurance (0.89 [0.86-0.92]) decreased odds of screening. ADI was collinear with sex, race, marital status, body mass index, and smoking status. In subgroup analyses, between-group differences in strength of associations of CRC screening with ADI and patient characteristics varied most prominently by race. Conclusion: There may be an unmeasured social context explaining persistent racial differences among factors associated with CRC screening. A combination of census tract and individual-level social determinants may guide population health management for at-risk subpopulations.

A Comparison of the Australian Dietary Guidelines to the NOVA Classification System in Classifying Foods to Predict Energy Intakes and Body Mass Index.

NOVA classification distinguishes foods by level of processing, with evidence suggesting that a high intake of ultra-processed foods (UPFs, NOVA category 4) leads to obesity. The Australian Dietary Guidelines, in contrast, discourage excess consumption of “discretionary foods” (DFs), defined according to their composition. Here, we (i) compare the classification of Australian foods under the two systems, (ii) evaluate their performance in predicting energy intakes and body mass index (BMI) in free-living Australians, and (iii) relate these outcomes to the protein leverage hypothesis of obesity. Secondary analysis of the Australian National Nutrition and Physical Activity Survey was conducted. Non-protein energy intake increased by 2.1 MJ (p < 0.001) between lowest and highest tertiles of DF intake, which was significantly higher than UPF (0.6 MJ, p < 0.001). This demonstrates that, for Australia, the DF classification better distinguishes foods associated with high energy intakes than does the NOVA system. BMI was positively associated with both DFs (−1. 0, p = 0.0001) and UPFs (−1.1, p = 0.0001) consumption, with no difference in strength of association. For both classifications, macronutrient and energy intakes conformed closely to the predictions of protein leverage. We account for the similarities and differences in performance of the two systems in an analysis of Australian foods.

Cognitive and Academic Skills in Two Developmental Cohorts of Different Ability Level: A Mutualistic Network Perspective.

Mutualistic theories assume that the mastering of a skill, either cognitive or academic, supports and amplifies the development of other such abilities. The current study uses network science to model cross-sectional associations between cognitive and academic performance in two age-matched developmental cohorts. One cohort was a community sample drawn from the general school population, while the other included struggling learners. The community sample outperformed the struggling learners across all measures. Network models suggested that although the tasks were similarly interrelated across cohorts, there were some notable differences in association strength: Academic skills were more closely coupled in the community sample, while maths was more strongly related to cognitive skills in the struggling learners. We demonstrate the utility of network models as an analytic framework that is consistent with contemporary theories of learning difficulties and the nature of the relationship between cognitive and learning skills more broadly.

The association of depressive and anxiety symptoms with the metabolic syndrome and its components among Russian, Somali, and Kurdish origin adults in Finland: A population-based study

ObjectivePositive association of depressive and anxiety symptoms with the metabolic syndrome (MetS) have been reported, however there is little information on these among migrant origin populations. The aim of this study was to examine these associations among diverse migrant origin populations in Finland. MethodsData of 318 Russian, 212 Somali, and 321 Kurdish origin participants in the cross-sectional Finnish Migrant Health and Wellbeing Study (Maamu) aged 30–64 years was used. The general population reference group constituted of 786 Health 2011 Survey participants. Depressive and anxiety symptoms were measured with HSCL-25 subscales. Harmonized definition of MetS was used. ResultsDepressive symptoms were associated with elevated blood pressure in Kurdish origin (30.1%, 95% CI 22.7–38.8 vs. 19.9%, 95%CI 15.4–25.4 for those with and without symptoms respectively); and elevated waist circumference (72.1%, 95%CI 56.9–83.5 vs. 55.0%, 95%CI 50.6–59.4) and triglycerides (30.8%, 95%CI 16.0–51.0 vs. 11.9%, 95%CI 9.3–15.0) in general population. Anxiety symptoms were associated with MetS (47.0%, 95%CI 37.6–56.7 vs. 31.9%, 95%CI 26.7–37.6) and elevated blood pressure (37.2%, 95%CI 28.3–46.9 vs. 18.8%, 95%CI 14.7–23.6), and with elevated triglycerides in Somali origin (33.0%, 95%CI 14.5–59.0 vs. 5.7%, 95%CI 3.3–9.6) and general population (30.2%, 95%CI 16.4–48.8, 12.8%, 95%CI 9.9–16.2). No associations between low HDL-cholesterol and depressive or anxiety symptoms were observed. ConclusionCardiometabolic health should be taken into account in mental health services. Future studies should explore the underlying pathways to the observed differences in strengths of associations of depressive and anxiety symptoms with MetS and its components across diverse migrant origin populations.

The Differential Effects Fallacy in the Study of Self-compassion: Misunderstanding the Nature of Bipolar Continuums

This brief commentary highlights the faulty reasoning underlying claims that selfcompassion should not be conceptualized or measured as a unitary construct because compassionate self-responding (CS) and uncompassionate self-responding (UCS) are differential predictors of psychological outcomes. The Self-Compassion Scale (SCS) is a well-validated measure that has been used in thousands of studies on selfcompassion.Self-compassion forms a bipolar continuum ranging from UCS (selfjudgment, isolation, and over-identification) to CS (self-kindness, common humanity, and mindfulness), so that higher SCS scores represent increased CS and reduced UCS. Several scholars have argued that because CS and UCS display different strengths of association with various psychological outcomes, that CS and UCS should be examined separately and a total SCS score is invalid. This conclusion is assumed to be self-evident. However, there is no known logical, scientific or psychometric principle that supports the view that opposite ends of a bipolar continuum must have the same strength of association with outcomes in order to operate as a unitary construct. In fact, it is common for opposite ends of a continuum to be differential predictors of outcomes (e.g., coldness is a stronger predictor of frostbite than warmth).Unfortunately, this unexamined assumption has spread widely in the field of selfcompassion research, setting the field back and muddying the waters for researchers.This commentary sheds light on this false premise in the hope of clearing up confusion.

Intention to adhere to test, trace, and isolate during the COVID-19 pandemic (the COVID-19 Rapid Survey of Adherence to Interventions and Responses study).

Objectives(1) To investigate factors associated with intention to self‐isolate, request a test, and share details of close contacts when required. (2) To determine whether associations were stronger during periods when less stringent national COVID‐19 restrictions were in place.DesignSeries of cross‐sectional nationally representative surveys. We selected survey waves where different national restrictions were in place in England (first lockdown, summer release, second lockdown, third lockdown).MethodsWe investigated whether psychological factors and increased out‐of‐home activity in the last week were associated with intention to self‐isolate and request a test if you were to develop COVID‐19 symptoms, and intention to share details of contacts if you were to test positive. We also investigated whether the strength of associations differed by timepoint in the pandemic.ResultsIntention to self‐isolate, request a test and share details of contacts were associated with greater perceived risk of COVID‐19 to people in the United Kingdom, knowing that COVID‐19 transmission can be asymptomatic, and agreeing that personal behaviour has an impact on COVID‐19 transmission. There were few differences in strength of associations by timepoint suggesting these effects are broadly stable over time.ConclusionsPsychological factors were associated with intention to adhere to key components of the contact tracing system; there was no evidence for an association with increased out‐of‐home activity. Messages that increase knowledge that COVID‐19 can be transmitted even if someone does not have symptoms and that an individual’s actions can contribute to the spread of the virus may promote engagement with the test, trace, and isolate system.

The best mirror of the students' longitudinal performance: Portfolio or structured oral exam assessment at clerkship?

This study aimed to compare the strength of association (i.e., explained variability) of the cumulative grade point average (GPA) with the grades obtained in the clerkship portfolio and the final structured oral exam by dental students. A prospective longitudinal study was designed to analyze quantitative data from three cohorts of dental school students. Univariate and multivariate linear regression models were built to evaluate the association between the students' cumulative GPA with the grades obtained in their clerkship portfolio and the final structured oral exam. In total, 171 students in the last year of the undergraduate program were considered (76% women, age average 24.8±1.6 years). The dental students' grades of both portfolio and structured oral exam were significantly associated with the GPA score but with different strengths of association. The clerkship portfolio was more strongly associated with cumulative GPA than the structured oral exam (R2 =19.6% versus R2 =7.6%). On the opposite, the association between the structured oral exam and GPA can be interpreted as a lower precision in its practical significance and thus reflecting different concurrent validity. Considering the results of this study, it could probably incline the balance toward the portfolio because it may be closer to a programmatic assessment model, with timely feedback, development of metacognition, and the achievement of formative process measurement rather than evidence of a single instance of examination.

Cognitive and Academic Skills in Two Developmental Cohorts of Different Ability Level: A Mutualistic Network Perspective

Mutualistic theories assume that the mastering of a skill, either cognitive or academic, supports and amplifies the development of other such abilities. The current study uses network science to model cross-sectional associations between cognitive and academic performance in two age-matched developmental cohorts. One cohort was a community sample drawn from the general school population, while the other included struggling learners. The community sample outperformed the struggling learners across all measures. Network models suggested that although the tasks were similarly interrelated across cohorts, there were some notable differences in association strength: Academic skills were more closely coupled in the community sample, while maths was more strongly related to cognitive skills in the struggling learners. We demonstrate the utility of network models as an analytic framework that is consistent with contemporary theories of learning difficulties and the nature of the relationship between cognitive and learning skills more broadly.

Genome-wide association study of body fat distribution traits in Hispanics/Latinos from the HCHS/SOL.

Central obesity is a leading health concern with a great burden carried by ethnic minority populations, especially Hispanics/Latinos. Genetic factors contribute to the obesity burden overall and to inter-population differences. We aimed to identify the loci associated with central adiposity measured as waist-to-hip ratio (WHR), waist circumference (WC) and hip circumference (HIP) adjusted for body mass index (adjBMI) by using the Hispanic Community Health Study/Study of Latinos (HCHS/SOL); determine if differences in associations differ by background group within HCHS/SOL and determine whether previously reported associations generalize to HCHS/SOL. Our analyses included 7472 women and 5200 men of mainland (Mexican, Central and South American) and Caribbean (Puerto Rican, Cuban and Dominican) background residing in the USA. We performed genome-wide association analyses stratified and combined across sexes using linear mixed-model regression. We identified 16 variants for waist-to-hip ratio adjusted for body mass index (WHRadjBMI), 22 for waist circumference adjusted for body mass index (WCadjBMI) and 28 for hip circumference adjusted for body mass index (HIPadjBMI), which reached suggestive significance (P < 1 × 10−6). Many loci exhibited differences in strength of associations by ethnic background and sex. We brought a total of 66 variants forward for validation in cohorts (N = 34 161) with participants of Hispanic/Latino, African and European descent. We confirmed four novel loci (P < 0.05 and consistent direction of effect, and P < 5 × 10−8 after meta-analysis), including two for WHRadjBMI (rs13301996, rs79478137); one for WCadjBMI (rs3168072) and one for HIPadjBMI (rs28692724). Also, we generalized previously reported associations to HCHS/SOL, (8 for WHRadjBMI, 10 for WCadjBMI and 12 for HIPadjBMI). Our study highlights the importance of large-scale genomic studies in ancestrally diverse Hispanic/Latino populations for identifying and characterizing central obesity susceptibility that may be ancestry-specific.

Genome-Wide Association Study of Non-syndromic Orofacial Clefts in a Multiethnic Sample of Families and Controls Identifies Novel Regions.

Orofacial clefts (OFCs) are among the most prevalent craniofacial birth defects worldwide and create a significant public health burden. The majority of OFCs are non-syndromic and vary in prevalence by ethnicity. Africans have the lowest prevalence of OFCs (~ 1/2,500), Asians have the highest prevalence (~1/500), Europeans and Latin Americans lie somewhere in the middle (~1/800 and 1/900, respectively). Thus, ethnicity appears to be a major determinant of the risk of developing OFC. The Pittsburgh Orofacial Clefts Multiethnic study was designed to explore this ethnic variance, comprising a large number of families and individuals (~12,000 individuals) from multiple populations worldwide: US and Europe, Asians, mixed Native American/Caucasians, and Africans. In this current study, we analyzed 2,915 OFC cases, 6,044 unaffected individuals related to the OFC cases, and 2,685 controls with no personal or family history of OFC. Participants were grouped by their ancestry into African, Asian, European, and Central and South American subsets, and genome-wide association run on the combined sample as well as the four ancestry-based groups. We observed 22 associations to cleft lip with or without cleft palate at 18 distinct loci with p-values < 1e-06, including 10 with genome-wide significance (<5e-08), in the combined sample and within ancestry groups. Three loci - 2p12 (rs62164740, p = 6.27e-07), 10q22.2 (rs150952246, p = 3.14e-07), and 10q24.32 (rs118107597, p = 8.21e-07) are novel. Nine were in or near known OFC loci - PAX7, IRF6, FAM49A, DCAF4L2, 8q24.21, NTN1, WNT3-WNT9B, TANC2, and RHPN2. The majority of the associations were observed only in the combined sample, European, and Central and South American groups. We investigated whether the observed differences in association strength were (a) purely due to sample sizes, (b) due to systematic allele frequency difference at the population level, or (c) due to the fact certain OFC-causing variants confer different amounts of risk depending on ancestral origin, by comparing effect sizes to observed allele frequencies of the effect allele in our ancestry-based groups. While some of the associations differ due to systematic differences in allele frequencies between groups, others show variation in effect size despite similar frequencies across ancestry groups.

Long term pre-treatment opioid use trajectories in relation to opioid agonist therapy outcomes among people who use drugs in a Canadian setting

BackgroundOpioid agonist therapy (OAT) models are generally provided without consideration of how pre-treatment characteristics may be associated with outcome. Therefore, we aimed to first characterize longitudinal trajectories of opioid use before initiating OAT. Then we explored the impact of OAT on opioid use across these pre-treatment trajectories. MethodsData were derived from three prospective cohort studies involving people who use drugs in Vancouver, Canada. Latent class growth analysis was applied to identify opioid use trajectories based on individual-level observations three years before starting OAT. Multivariable generalized linear mixed model was used to examine whether engaging in OAT was associated with lower risk of illicit opioid use among participants with different pre-treatment opioid use trajectories. Results464 participants were included in the study between September 2005 and November 2018. Two pre-treatment opioid use trajectories were identified: high frequency users (246, 53.0%) and gradually increasing frequency users (218, 47.0%). We observed different strengths of association between OAT engagement and illicit opioid use among high frequency users (adjusted odds ratio [AOR] = 0.36, 95% Confidence Interval [CI]: 0.20 – 0.63) and gradually increasing frequency users (AOR = 0.91, 95% CI: 0.53 – 1.56). Unstable housing, any stimulant use, experiencing violence, drug dealing, sex work involvement, and incarceration were independently and positively associated with ongoing illicit opioid use. ConclusionsDistinct pre-treatment opioid use trajectories are likely to influence treatment outcomes. Research is required to determine if tailored strategies specific to people with different pre-treatment opioid use patterns have potential to improve outcomes of OAT.

Characterization of occupational, demographic and health determinants in Canadian reservists veterans and the relationship with poor self-rated health

BackgroundSelf-rated health is an useful indicator of the general health in specific populations and used to propose interventions after service in the military context. However, there is scarce literature about self- rated health (SRH) in the Canadian Veterans of the Reserve Force and its relationship with demographic, health and occupational characteristics of this specific group. The aims of this research were to determine the SRH in Canadian Reserve Force Veterans and to explore the relationship between demographic, military service and health factors by reserve class.MethodsData from the individuals was collected from the Life After Service (LASS) 2013 survey, including Veterans with Reserve Class C (n = 922) and Class A/B (n = 476). Bivariate and multivariate analysis using logistic regression models, were used to assess the association between the demographic characteristics, physical health, mental health, and military service characteristics and the self-rate health by both reserve classes.ResultsThe overall prevalence of poor SRH in Reserve Class C Veterans was 13.1% (CI:11.08–15.4) and for Reserve Class A/B was 6.9% (CI:5.0–9.1). Different degrees of associations were observed during the bivariate analysis and two different models were produced for each reserve class. Veterans of Reserve Class C showed that being single was (OR = 2.76, CI: 1.47–5.16), being 50–59 years old (OR = 4.6, CI: 1.28–17.11), reporting arthritis (OR = 2.49, CI: 1.33–4.67), back problems (OR = 3.02, CI:1.76–5.16), being obese (OR = 1.96, CI: 1.13–3.38), depression (OR = 2.34, CI: 1.28–4.20), anxiety (OR = 4.11, CI: 2.00–8.42), PTSD (OR = 2.1 CI: 0.98–4.47), and being medically released (OR = 4.48, CI: 2.43–8.24) were all associated with higher odds of poor SRH. The Reserve Class A/B model showed that completing high school (OR = 4.30, CI: 1.37–13.81), reporting arthritis (OR = 6.60, CI: 2.15–20.23), diabetes (OR = 11.19, CI: 2.72–46.0), being obese (OR = 3.37, CI: 1.37–8.27), daily smoking (OR = 2.98, CI: 1.05–8.38), having anxiety (OR = 9.8, CI: 3.70–25.75) were associated with higher odds of poor SRH.ConclusionsThese results suggested that the relationship of poor SRH with demographic, health and military occupation domains varied depending on the class on the Reserve Force Service. Different strengths of association showed different risk compositions for both populations. This can be used to better understand the health and well-being of Veterans of the Reserve Force.

Objective neighbourhood attributes as correlates of neighbourhood dissatisfaction and the mediating role of neighbourhood perceptions in older adults from culturally and physically diverse urban environments

Neighbourhood dissatisfaction appears to be detrimental to older adults' health. Understanding associations between objective neighbourhood attributes and neighbourhood satisfaction is important to provide optimal neighbourhood environments for older adults. Comparable data from epidemiological studies conducted in two cities (Hong Kong and Ghent, Belgium) were employed. Generalised additive mixed models were used to examined associations between objectively measured neighbourhood environment attributes and neighbourhood dissatisfaction, mediated by perceived neighbourhood attributes and moderated by city and lower extremity function. All associations between objective neighbourhood attributes and neighbourhood dissatisfaction (total effects) were significant and in the expected direction, six were curvilinear. No moderation by city was observed. With one exception, conceptually-comparable perceived counterparts fully or partially mediated associations between objectively-assessed neighbourhood environment attributes and neighbourhood dissatisfaction. Six of the 10 perceived environment mediated effects of objective environment attributes on neighbourhood dissatisfaction varied by city. Most pertained to differences in strength of associations, rather than significance or direction of associations. Physical functionality did not moderate any of the examined associations. This study suggests that provision of good access to neighbourhood destinations and public transport is important for older adults' neighbourhood satisfaction and, thus, their health.

Incidence of Postoperative Opioid Overdose and New Diagnosis of Opioid Use Disorder Among US Veterans.

Perioperative exposure to opioids is associated with adverse outcomes. We aim to determine the associations between surgery and subsequent opioid overdose, an acute event, and a new diagnosis of opioid use disorder (OUD), a chronic relapsing disease, in parallel. This retrospective cohort study of US veterans used surgery as exposure and the two outcomes were (1) occurrence of overdose and (2) new diagnosis of OUD in the first postoperative year. Surgical group was matched to the reference controls based on the propensity score of having surgery, and matched logistic regression was used to calculate the odds ratio (OR). A total of 261 208 surgical patients were matched to 479 531 controls. Overdose occurred in 1893 (0.7%) of the surgical patients and in 518 (0.1%) of the matched controls in the first postoperative year (OR, 6.71; 95% confidence interval [CI], 5.80-7.75; P < .001). Among patients with no history of OUD, surgery was also associated with a new diagnosis of OUD in the first postoperative year (OR, 1.13; 95% CI, 1.02-1.24; P = .015). The postoperative period is strongly associated with opioid overdose, but only weakly associated with new diagnosis of OUD. This is likely due to the difficulty of diagnosing OUD in the postoperative period. This is the first study that has examined opioid overdose and new-onset OUD in the postoperative period in parallel. Our analysis suggests different risk factors for each, as well as different strengths of association with surgery. More sensitive diagnostic criteria for postoperative OUD are needed to promptly diagnose and treat this condition. (Am J Addict 2020;00:00-00).

Self-rated health scores predict mortality among people with type 2 diabetes differently across three different country groupings: findings from the ADVANCE and ADVANCE-ON trials.

AimsTo explore whether there is a different strength of association between self‐rated health and all‐cause mortality in people with type 2 diabetes across three country groupings: nine countries grouped together as 'established market economies'; Asia; and Eastern Europe.MethodsThe ADVANCE trial and its post‐trial follow‐up were used in this study, which included 11 140 people with type 2 diabetes from 20 countries, with a median follow‐up of 9.9 years. Self‐rated health was reported on a 0–100 visual analogue scale. Cox proportional hazard models were fitted to estimate the relationship between the visual analogue scale score and all‐cause mortality, controlling for a range of demographic and clinical risk factors. Interaction terms were used to assess whether the association between the visual analogue scale score and mortality varied across country groupings.ResultsThe visual analogue scale score had different strengths of association with mortality in the three country groupings. A 10‐point increase in visual analogue scale score was associated with a 15% (95% CI 12–18) lower mortality hazard in the established market economies, a 25% (95% CI 21–28) lower hazard in Asia, and an 8% (95% CI 3–13) lower hazard in Eastern Europe.ConclusionsSelf‐rated health appears to predict 10‐year all‐cause mortality for people with type 2 diabetes worldwide, but this relationship varies across groups of countries.

Temporolimbic cortical volume is associated with semantic odor memory performance in aging

Olfactory function, and specifically semantic olfactory memory (i.e., odor identification), has frequently been shown to predict cognitive functioning across multiple domains in old age. This observation suggests that olfactory function can serve as a marker for the integrity of temporolimbic cortical networks, but a clear delineation of this association is still missing. To address this issue, the present study employed voxel-based morphometry in a region of interest-based design to determine the extent to which gray matter volumes of core olfactory and memory areas are associated with olfactory memory performance in an aging population free from neurodegenerative disease. We further aimed to determine potential overlap in structural anatomical correlates, and differences in association strength, for semantic and episodic olfactory memory. Structural magnetic resonance imaging (MRI), episodic and semantic odor memory and episodic and semantic verbal memory data were collected in 422 participants from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), all aged ​≥ ​60 years. Controlling for age and education, semantic, but not episodic, olfactory memory was positively related to gray matter volume in a cluster extending from the anterior hippocampus and amygdala into the posterior piriform cortex. The observed associations remained even when verbal memory performance was controlled for, supporting a link between the olfactory memory domain and cortical volume over and above more generalized memory abilities. As such, our data provide evidence for distinct functional-structural associations for semantic odor memory, supporting the idea of temporolimbic integrity as a neurobiological substrate linking olfactory function to cognitive health in old age.

Are socioeconomic inequalities in the incidence of small-for-gestational-age birth narrowing? Findings from a population-based cohort in the South of England

ObjectivesTo investigate socioeconomic inequalities, using maternal educational attainment, maternal and partner employment status, and lone motherhood indicators, in the risk of small-for-gestational-age (SGA) births, their time trend, potential mediation by...

Assessing risk factors of non-fatal outcomes amid a competing risk of mortality: the example of hip fracture.

Factors like age, sex, and race are associated not only with risk of hip fracture but also with mortality. Substantial misunderstanding remains regarding the appropriate statistical approach to account for the competing risk of mortality. In the Cardiovascular Health Study, an ongoing cohort study of 5888 older adults, we followed participants for incident hip fracture from their 1992-1993 visit through June 2014. We contrasted the conventional cause-specific Cox analysis, which censors individuals at the time of death, with the Fine-Gray (FG) approach, which extends participant follow-up even after death, to estimate the association of well-established demographic and clinical factors with incident hip fracture. For age, current smoking and sex, Cox and FG methods yielded directionally concordant but quantitatively different strengths of association. For example, the Cox hazard ratio (HR) for a 5-year increment in age was 1.74 (95% CI, 1.61-1.87), while the corresponding FG HR was 1.16 (1.09-1.24). In contrast, the FG approach estimated a stronger association of hip fracture with sex. The two approaches yielded nearly identical results for race. For diabetes and kidney function, the estimates were discordant in direction, and the FG HRs suggested effects that were in the opposite direction of well-understood and widely accepted associations. Cause-specific Cox models provide appropriate estimates of hazard for non-fatal outcomes like hip fracture even in the presence of competing risk of mortality. The Cox approach estimates hazard in the population of individuals who have not yet had an incident hip fracture and remain alive, which is typically the group of clinical interest. The Fine-Gray method estimates hazard in a hypothetical population that can yield misleading inferences about risk factors in populations of clinical interest.

Associations of Accelerometer and Questionnaire Measured Physical Activity and Sedentary Behavior with All-cause Mortality in Older Multiethnic Women

PURPOSE: Few studies have evaluated whether associations with health risks differ between accelerometer and questionnaire measures of physical activity (PA) and sedentary behavior (SB), which was the objective of this study. METHODS: We followed 5,992 women (mean age 79 yr; 49.8% white, 33.3% black, 16.9% Hispanic) for all-cause mortality in the Objective PA and Cardiovascular Health Study. Vector magnitude counts/15 sec epoch from a hip worn ActiGraph GT3X+ triaxial accelerometer (required ≥4 of 7 days with ≥10 hr/d wear) were used to define time spent in SB (<19 counts/15 sec), light (19-518), moderate to vigorous (MVPA; ≥519), and total PA (≥19). The CHAMPS and CARDIA questionnaires were used to obtain detailed self-reports on PA and SB, respectively. Cox regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for a 30-min/day increment in PA or SB, controlling for age, race-ethnicity, education, smoking, number of comorbidities, self-rated health and SF36 physical function score (and awake wear time for accelerometer model). RESULTS: Mean time (min/d) from the accelerometer (wear time adjusted) and questionnaire were 337.9 and 600.4 for total PA, 287.3 and 337.8 for light PA, 50.7 and 222.6 for MVPA, and 555.7 and 482.7 for SB. Wear time-adjusted Spearman correlations between these measures were 0.29, 0.16, 0.34, and 0.28 for total, light, MVPA, and SB, respectively. There were 706 (11.9%) deaths documented during a mean 4.5 year follow-up. HRs (95% CIs) for accelerometer and questionnaire were 0.88 (0.87, 0.91) and 0.98 (0.97, 0.99) for total PA; 0.88 (0.85, 0.91) and 0.98 (0.97, 0.99) for light PA, 0.65 (0.59, 0.72) and 0.98 (0.97, 0.99) for MVPA, and 1.14 (1.10, 1.17) and 1.02 (1.01, 1.03) for SB. Associations did not meaningfully differ when stratified on categories of race-ethnicity (white, black, Hispanic) or age (<80 vs ≥80 year). CONCLUSIONS: Associations with all-cause mortality risk are stronger for accelerometer compared with questionnaire measures of PA and SB. The differences in strength of associations and the modest correlations between accelerometer and questionnaire measures suggest less precision with questionnaires and that accelerometer measures are capturing health-promoting aspects of movement in older women that are not captured in widely used questionnaires.