Population-based Longitudinal Study Research Articles

Trajectories of night light exposure and risk of overweight and obesity: a 15-year longitudinal cohort study of 218,239 Chinese children.

Light at night (LAN) is found to be associated with elevated overweight and obesity in broad population. However, evidence for the long-term LAN exposure trajectories and its influence to weight gain remained limited, especially to school-aged children who experience critical physical development. We aimed to analyze variations in body weight among children with different LAN exposure profiles, and how varying levels of LAN exposure influenced children's overweight (including obesity) risk overt time. Children who had ≥ 5 school health examinations between 2005 and 2020 in Zhongshan were recruited in this population-based longitudinal study. LAN data of each child at each survey year were modeled with group-based trajectory model and named as sharp rise (reference; 5.5%), mild rise, high stable (69.7%), and decline. Differences of overweight incidence between groups were analyzed. Among 218,283 children (1,318,542 measurements; 53.1% boys; baseline mean [SE] age, 9.1 [2.5]), 12,050 (5.5%) were categorized in the sharp rise group and 152,030 (69.7%) in the stable high group. In the 189,011 participants categorized as normal or underweight at baseline, the overall incidence of overweight during follow-up was 8.80/1000 person-years (95% CI: 8.69, 8.91). Compared to the sharp rise group, the hazard ratios (HR) for developing overweight were 1.67 (95% CI: 1.28, 2.18) for boys and 1.56 (95% CI: 1.21, 2.01) for girls in stable high group, followed by the mild rise group. The HRs in decline group were non-significant. Overall, the stable high trajectory of LAN exposure accounted for 40.24% (range: 22.14, 54.14) of overweight risk in boys and 36.09% (range: 17.79, 50.31) in girls, while the mild rise group contributed approximately 23% to the overall risk. Higher LAN exposure trajectories, especially at early school age, had persistent effect to overweight and obesity risk in school-aged children. Interventions to reduce LAN exposure during school age may help reduce excessive weight gain in children.

Subclinical Primary Aldosteronism and Major Adverse Cardiovascular Events: A Longitudinal Population-Based Cohort Study.

Primary aldosteronism (PA), an overt form of renin-independent aldosterone production, leads to a disproportionately high rate of major adverse cardiovascular events (MACEs). Mounting evidence suggests that milder forms of renin-independent aldosterone production (subclinical PA) are highly prevalent; however, the link between subclinical PA and MACE remains uncertain. This prospective study included 2017 Canadian adults 40 to 69 years of age from the randomly sampled, population-based CARTaGENE cohort (Québec, Canada), in which aldosterone and renin concentrations at enrollment (2009-2010) were measured. Follow-up data were obtained via provincial health care administrative database linkage. MACE outcomes consisted of a composite of myocardial infarction, stroke, hospitalization for heart failure, and cardiovascular death. Multivariable linear and nonlinear Cox regression models measured the associations of concentrations of aldosterone, renin, and the aldosterone-to-renin ratio with MACE. Outcome-derived optimal thresholds for these markers were then determined. The mean (SD) age of participants was 56 (8) years, and 45% were women. Mean blood pressure was 129 (15)/76 (10) mm Hg, with hypertension being present in 27%. Over a median follow-up time of 10.8 years, 57 (3%) MACE outcomes occurred. Lower renin concentration (adjusted hazard ratio [aHR], 2.22 [95% CI, 1.02-4.76]) and higher aldosterone-to-renin ratio (aHR, 2.43 [95% CI, 1.15-5.12]) were associated with a higher risk for MACE, whereas no significant association was found with aldosterone concentration (aHR, 1.57 [95% CI, 0.42-5.90]). Renin concentration exhibited a nonlinear relationship with MACE risk. The outcome-derived optimal thresholds to discriminate a higher MACE risk were renin concentration ≤4.0 ng/L (aHR, 2.12 [95% CI, 1.21-3.72]) and aldosterone-to-renin ratio ≥70 pmol/L per ng/L (aHR, 2.03 [95% CI, 1.09-3.80]). All aforementioned associations were independent of blood pressure. Independent of blood pressure, the subclinical PA biochemical phenotype is associated with an increased risk of MACE. Future studies are necessary to determine whether early identification and targeted treatment of subclinical PA mitigates this risk.

Population-based longitudinal study over two decades of Candida and Candida-like species bloodstream infection reveals gender and species differences in mortality, recurrence and resistance.

Population-based longitudinal study over two decades of Candida and Candida-like species bloodstream infection reveals gender and species differences in mortality, recurrence and resistance.

Joint association of frailty index and biological aging with all-cause and cause-specific mortality: a population-based longitudinal cohort study.

Joint association of frailty index and biological aging with all-cause and cause-specific mortality: a population-based longitudinal cohort study.

Epidemiologic Study of Pediatric Uveitis and its Ophthalmic Complications Using the Korean National Health Insurance Claim Database.

Epidemiologic Study of Pediatric Uveitis and its Ophthalmic Complications Using the Korean National Health Insurance Claim Database.

Development, validation, and clinical utility of a risk prediction model to identify older women with dementia for proactive palliative care.

Accurately estimating one-year mortality risk in older women with dementia can inform clinical decision-making, facilitate timely advanced care planning, and optimise palliative care delivery. This study aimed to develop, validate, and assess the clinical utility of a prediction model for one-year all-cause mortality in this population using a nationally representative Australian cohort. This prognostic study utilised data from the 1921-26 cohort of the nationally representative, population-based Australian Longitudinal Study on Women's Health (ALSWH) and linked national and state-based administrative health records. Candidate predictors were identified through a systematic review and expert consultation, then refined using a data-driven statistical approach. A multivariable binary logistic regression model was developed and validated to predict one-year all-cause mortality. The analysis included 1576 older women with dementia (mean age, 72.6 ± 1.5 years). The model demonstrated good discrimination (AUC: 75.1 %, 95 % CI: 72.7 %-77.5 %) and excellent calibration (slope = 1.00, 95 % CI: 0.87-1.13; intercept = 0.00, 95 % CI: 0.11 - 0.11). Model validation using both 10-fold cross-validation and 1000 bootstrap iterations showed minimal optimism in its predictive performance, with AUC optimism of 0.0047 and 0.0042, respectively. Decision curve analysis indicated a net benefit across probability thresholds from 0.24 to 0.88, supporting the model's clinical utility for guiding palliative care decisions. This prediction model, incorporating readily available predictors, demonstrated compelling performance and clinical utility for identifying older women with dementia at high risk of one-year mortality. The model has the potential to facilitate timely palliative care interventions and is publicly accessible via a web-based calculator. Further external validation in diverse populations and healthcare settings is warranted to confirm its generalisability.

Associations between positive and negative social experiences and epigenetic aging

Associations between positive and negative social experiences and epigenetic aging are not well understood. To determine associations between positive and negative social experiences and epigenetic aging. Data from Midlife in the United States (MIDUS), a US population-based longitudinal cohort study, were used to examine relationships between social experiences and epigenetic aging. Participant reports of social experiences were assessed at survey waves closest to the subsequent collection of blood samples for DNA methylation testing and epigenetic clock calculation from 2004 to 2009 (MIDUS Core Sample) or 2012–2016 (MIDUS Refresher Sample). Analyses were conducted May 2024–June 2025. Self-reported positive (e.g., marriage, attendance at social meetings) and negative (e.g., parent’s drug problems, incarceration) social experiences were examined. Epigenetic was assessed from blood DNA methylation using the GrimAge and DunedinPACE epigenetic clocks. The sample (N = 1309) was 55.5% female, 22.5% Black and averaged 51.3 (SD = 12.5) years of age. In models adjusted for sociodemographic and health confounders, participants who reported positive social experiences such as being married (GrimAge: β = − 0.807, SE = 0.269, p < 0.01; Dunedin: β = − 0.022, SE = 0.007, p < 0.01) and engaging in social meetings (GrimAge β = − 1.027, SE = 0.250, p < 0.01; Dunedin: β = − 0.020, SE = 0.007, p < 0.01) exhibited significantly decelerated GrimAge scores; participants who reported negative social experiences such as a parent experiencing drug problems (GrimAge β = 2.430, SE = 0.761, p < 0.001), dropping out of school (GrimAge β = 2.869, SE = 0.405, p < 0.001; Dunedin β = 0.046, SE = 0.011, p < 0.001), and imprisonment (GrimAge β = 1.922, SE = 0.520, p < 0.001) exhibited significantly accelerated epigenetic aging scores. Adjusted models found the sum of positive social experiences was associated with decelerated epigenetic aging scores (GrimAge β = − 0.431, SE = 0.109, p < 0.001; Dunedin β = − 0.009, SE = 0.003, p < 0.01) and that the sum of negative social experiences was associated with accelerated epigenetic aging scores (GrimAge β = 0.934, SE = 0.162, p < 0.001; Dunedin β = 0.015, SE = 0.004, p < 0.01). Respondents with a “net positive” ratio of positive to negative social experiences had GrimAge scores that were 4.63 years younger on average than those with “net negative” social experiences (β = − 4.729; SE = 0.507; p < 0.001; adjusted β including covariates = − 2.847; SE = 0.469; p < 0.001). Associations of positive and negative social experiences with epigenetic aging were found to be independent of respondents’ perceived social support and their self-rated physical and mental health. Results suggest that negative social experiences accelerate while positive social experiences decelerate epigenetic aging. Negative and positive social experiences are each independently associated with epigenetic aging and net positive social experiences are associated with slower epigenetic aging.

Polygenic score for C-reactive protein is associated with accelerated cortical thinning and increased psychopathology in adolescents: a population-based longitudinal cohort study.

Adolescence is a critical neurodevelopmental window characterized by rapid cortical thinning, during which vulnerability to psychiatric disorders significantly increases. Although increased rates of cortical thinning have been associated with adverse mental health outcomes, the biological mechanisms underlying atypical neurodevelopment remain unclear. This study investigates whether genetic predisposition to systemic inflammation, assessed via polygenic scores for C-reactive protein (PGS_CRP), influences cortical thinning trajectories and psychopathology risk in adolescents. Using longitudinal data from the Adolescent Brain Cognitive Development (ABCD) Study (baseline n=11,214; follow-up n=7,823), we found that higher genetic susceptibility to inflammation was associated with accelerated cortical thinning, particularly in medial temporal and insular regions (β = -0.013 ~ -0.018, p.FDR < 0.05), and increased externalizing psychopathology symptoms (β = 0.167, p.FDR < 0.05). Early-life infections independently predicted greater depressive and externalizing symptoms (β = 0.511 ~ 0.608, p.FDR < 0.05) but did not interact significantly with genetic predisposition. Structural equation modeling revealed that cortical thinning partially mediated the relationship between genetic inflammation risk and externalizing symptoms. Moreover, neurobiological annotation showed regional overlaps between inflammation-linked cortical thinning and neurotransmitter receptor gradients involving serotonin, GABA, cannabinoid, and glutamate systems. These findings provide evidence for genetic predisposition to inflammation as a factor in adolescent cortical maturation and behavioral outcomes, highlighting potential neuroimmune mechanisms underpinning vulnerability to mental health disorders during this sensitive developmental period.

Assessment of chronic kidney disease and associated factors at Wolkite University Specialized Hospital: A cross-sectional study

BACKGROUNDKidney is the vital organ that plays a great role in maintaining an optimal internal environment. The normal kidney function can be altered by physical injury or disease. Currently, chronic kidney disease (CKD) is an increasing major health problem worldwide. In 2017, it was ranked as the 12th leading cause of death and is expected to rise to the 5th ranked cause of death by 2040. Therefore, early detection, increasing patients' awareness and treatment of CKD are required to hold the problem. However, despite its higher prevalence of hospitalized morbidity and mortality, little is known about the magnitude and associated factor of CKD in the Ethiopian context. Hence this study aimed to determine the magnitude of CKD and associated factors at Wolkite University Specialized Hospital (WKUSTH), South West Ethiopia.AIMTo determine the magnitude, and associated factors of CKD in WKUSTH, Ethiopia.METHODSInstitutional based cross-sectional study with secondary data was conducted from November 15, 2021 to February 28, 2022 at WKUSTH. Three hundred forty five (345) participants were selected by a convenient sampling technique. Creatinine and urea were measured using cobas311 fully automated chemistry analyzer and estimated glomerular filtration rate (eGFR) was calculated using CKD epidemiology collaboration formula. Socio-demographic and clinical data were collected by using a pretested questionnaire. Data were coded and entered into EpiData 3.1 version and exported to STATA version 14 for analysis. Bivariate analysis was used to screen candidate variables for multivariate analysis. In the multivariate analysis a P value < 0.05 were considered statistically significant.RESULTSThe magnitude of CKD by impaired eGFR were 54 (15.7%) (95%CI: 0.116-0.194). In multivariable analysis, older age [adjusted odds ratio (AOR) = 5.91, 95%CI: 2.41-14.47)], hypertension (AOR =10.41, 95%CI: 4.55-23.81), diabetes mellitus (AOR = 5.90, 95%CI: 2.14-16.23), high body mass index (AOR = 3.0, 95%CI: 1.30-7.27), and anemia (AOR = 2.94, 95%CI: 1.26-6.88) were independently associated with CKD.CONCLUSIONThe magnitude of CKD among adult patients admitted to WKUSTH was high. Hence, researchers need to do a population-based study and longitudinal study on the magnitude of CKD, associated factors. Estimation of GFR for all hospitalized patients might help to early detection of CKD and prevent complications.

Multinational evaluation of AnthropoAge as a measure of biological age in the USA, England, Mexico, Costa Rica, and China: a population-based longitudinal study

We validated AnthropoAge, a biological age (BA) metric, for prediction of mortality and age-related outcomes using harmonized data from the US, England, Mexico, Costa Rica, and China. We estimated AnthropoAge and AnthropoAgeAccel as proxies of BA and age acceleration using body mass index and waist-to-height ratio. We compared mortality prediction of AnthropoAge vs. chronological age (CA) using Cox models and assessed its association with age-related outcomes with generalized estimating equations. Among 57,080 participants aged 50–94 years, AnthropoAgeAccel (c-statistic 0.806) improved mortality prediction of CA (0.803) and identified distinct aging trends for each country. Accelerated aging (AnthropoAgeAccel>0) increased mortality risk by ~37% independently of age and covariates, and predicted health deterioration, new deficits in activities of daily living, and age-related diseases. AnthropoAge is a robust BA metric with potential applications in identifying functional deficits, health decline, and mortality risk. However, it requires further validation and potential recalibration for broader applicability in underrepresented populations like Latin America.

Shared and Unique Risk Factors for Binge Eating and Binge Drinking in a Community-based Sample of Girls.

Binge eating and binge drinking commonly onset in adolescence and frequently co-occur with one another, especially among females. Understanding shared and unique risk factors for these behaviors can inform etiological models and elucidation of common and specific prevention/intervention targets. We analyzed self-report data from 1,994 participants of the Pittsburgh Girls Study, a population-based longitudinal study of behavioral and emotional development. We used path analysis to examine the impact of age 14 predictor variables on age 16 binge eating and drinking, adjusting for these behaviors at age 14. We hypothesized that greater negative emotionality, sensation-seeking, and impulsivity would be shared risk factors, whereas higher body mass index and thinness expectancies would be unique to binge eating, and positive alcohol expectancies would be unique to binge drinking. Results showed little comorbidity between binge eating and drinking (1.9% at age 14; 4.4% at age 16). Of the three hypothesized shared risks, only age 14 negative emotionality was associated with both binge eating and drinking at age 16; sensation-seeking was associated with binge drinking only and impulsivity was unrelated to either outcome. None of the hypothesized unique risk factors were associated with binge eating. Contrary to hypotheses, positive alcohol expectancies were related to both binge eating and drinking. While this study requires replication and extension to a greater spectrum of putative risk factors, findings suggest that negative emotionality and positive alcohol expectancies, but not impulse control or appearance-related factors, may be viable targets for unified prevention/treatment protocols delivered in community settings.

Prevalence of Myopia and Axial Length Distribution in China: The Wuhu Children and Adolescents Eye Study

PurposeTo re-assess myopia prevalence, update the database of ocular biometric parameters, and assess the prevalence of fundus abnormalities in schoolchildren and adolescents in Wuhu, Anhui Province, China.MethodsThe Wuhu Children and Adolescents Eye Study (WCAES) is a longitudinal population-based cohort study, and the cross-sectional analysis results of the baseline assessment are reported here. It included 315,569 out of 330,173 eligible children and adolescents (95.6%), ages 2 to 19 years, from 513 schools with measurements of presenting distance visual acuity (PDVA) and uncorrected distance visual acuity (UDVA), non-cycloplegic autorefractometry, ocular biometry, and color fundus photography. Fundus abnormalities were assessed by an artificial intelligence–based system.ResultsPrevalences of likely myopia (−1.00 D < refractive error ≤ −0.50 D), myopia (refractive error ≤−1.00 D), low myopia (−3.00 D < refractive error ≤ −1.00 D), moderate myopia (−6.00 D < refractive error ≤ −3.00 D), and high myopia (refractive error ≤ −6.00 D) were 13.58% (95% confidence interval [CI], 13.46–13.70), 56.92% (95% CI, 56.74–57.10), 32.87% (95% CI, 32.70–33.04), 19.74% (95% CI, 19.60–19.88), and 4.31% (95% CI, 4.24–4.38), respectively. Among high-school students, myopia prevalence was 92.18% (95% CI, 91.68–92.68). High myopia prevalence rates in kindergarten, elementary, middle, and high schools were 0.30% (95% CI, 0.18–0.43), 1.53% (95% CI, 1.48–1.59), 9.05% (95% CI, 8.86–9.24), and 18.57% (95% CI, 17.84–19.29), respectively. Higher prevalence of overall myopia and high myopia was associated (all P < 0.001) with female sex (odds ratio [OR] = 0.81 and OR = 0.91, respectively), older age (OR = 1.45 and OR = 1.48, respectively), longer axial length (OR = 3.71 and OR = 5.89, respectively), and higher prevalence of fundus tessellation (OR = 1.10 and OR = 1.21, respectively.). The percentage of myopic individuals using vision correction and the prevalence of an age-dependent defined suboptimal PDVA in the myopic population were 48.05% (95% CI, 47.81–48.28) and 65.84% (95% CI, 65.51–66.16), respectively.ConclusionsCompared with previous studies, the present investigation suggests a further rise in the prevalence of myopia, particularly high myopia, in the younger generations in China.

Long-Term Analysis of Suicide Incidence Among Patients with Lung Cancer: A Population-Based Longitudinal Study.

Objectives: Patients with cancer often experience severe mental distress, and suicide is an important issue, particularly prevalent in individuals with lung cancer. The present study aimed to investigate the longitudinal incidence of suicide among patients with lung cancer using national registry data. Methods: A population-based retrospective review of patients diagnosed with lung cancer in 2008 was conducted. Longitudinal medical records, including clinical outcomes and medical insurance data, were investigated. The primary outcome was the incidence of suicide, compared between patients undergoing the first curative treatment option (surgery or non-surgery). Cox proportional hazard regression models were used to adjust for medical history, sociodemographic variables, and lifestyle factors. Results: Among the 4495 patients included, 1306 (29.1%) underwent surgery as the first treatment. Compared to the non-surgery group, the surgery group was younger and had a lower Charlon comorbidity score (p < 0.001), higher physical activity (p < 0.001), and higher income level (p < 0.001). The total number of suicides was 28 (0.62%). The surgery group demonstrated similar trends in the development of suicide and early 5-year follow-up to those of the non-surgery group. Conclusions: The longitudinal risk of suicide among patients with lung cancer increased. Both surgical and non-surgical treatment groups demonstrated similar suicide trends, although patients in the surgery group had multiple protective factors.

Socio-economic and geographic survival disparities among children with lymphoma in the USA.

e22005 Background: The effect of socioeconomic status (SES) and place of residence on cancer survival has been extensively studied among adults. There is, however, a lack of research examining the role of SES and geography on survival of lymphoma in pediatric oncology. Hence, this study aimed toevaluate the role of SES on survival among children diagnosed with Hodgkin and Non-Hodgkin Lymphoma in the USA, and whether these differences varied by place of residence. Methods: The study is a population-based longitudinal study using the 2006-2020 SEER Research Plus Specialized Data with Census Tract Attributes. Internal Classification of Diseases (ICD)-0-3 topography codes C71.0 to C71.9 were used to select primary cases of malignant Hodgkin and non-Hodgkin lymphoma cases diagnosed at age 0-19 years from 2006-2020. Survival months were calculated from the date of cancer diagnosis to the date of cancer death or last follow-up or date of death from other causes, whichever occurred first. Rural/urban residence was classified using Rural Urban Continuum Codes. SES was measured as a composite pre-calculated through a factor analysis using seven indicators of neighborhood socioeconomic status. The index is a 5-level variable categorized into quintiles, with quintile 1 being the lowest SES quintile and quintile 5, the highest. Other variables included stage at diagnosis, age, gender, histology, and race/ethnicity. Chi-square tests were used to assess differences in demographic characteristics of study participants by rurality. Cause-specific Cox-proportional hazard models were used to examine the hazard of death by SES adjusting for race/ethnicity, age, gender, stage at diagnosis, and histology. An interaction term was added to test if the effect of SES differed by place of residence. The proportional hazard assumptions were tested using Schoenfeld residuals. Results: Among 12,659 children included in the study, 10.25% were from rural counties. Among children from lowest SES (level 1), 33.31% were from rural counties and 17.66% from urban counties. There was no difference in survival for both Hodgkin and non-Hodgkin lymphoma by rural/urban residence. Survival rate, however, differed by SES, even after adjusting for covariates. The hazard of death was 1.54 (95% CI: 1.14-2.07), 1.81 (95% CI: 1.41-2.33), 1.72 (95% CI: 1.34-2.19) and 1.47 (95% CI: 1.16-1.87) for SES levels 1, 2, 3 and 4, respectively, compared to the highest SES level (level 5). The interaction term between SES and rurality was not significant, indicating that the effect of SES did not differ by rural/urban residence. Conclusions: SES was significantly associated with the hazard of death for Hodgkin and non-Hodgkin lymphoma. Survival did not differ by place of residence. Interventions that address individual and neighborhood level socio-economic factors may reduce survival disparities among children diagnosed with lymphoma.

Symptom burden and post-COVID-19 syndrome 24 months following SARS-CoV-2 infection: Longitudinal population-based study.

To describe the symptom burden and associated impairment two years after SARS-CoV-2 index infection. Participants of an earlier large population-based survey in Southwestern Germany (August-September 2021) were contacted again in November 2023. We calculated the prevalences of suspected PCS and specific symptom clusters at both time points and investigated factors for their resolution or emergence. A total of 6635 subjects (mean age 46.6 years, 60.9% females) participated in the follow-up. Between baseline and follow-up (median 8.7 and 23.9 months after infection) there were only small changes in the point prevalence of post-COVID-19 syndrome (PCS) (29.9% versus 31.2%) or defined symptom clusters such as fatigue (23.8% versus 22.0%), neurocognitive impairment (15.8% versus 17.3%), or chest symptoms (14.4% versus 13.7%). Probabilities of resolution were often similar to probabilities of emergence, e.g. fatigue symptoms resolved in 9.8% of participants but emerged in 8.0%. Consistent predictors for emerging symptom clusters were female sex, obesity and medical treatment of the acute infection. The six main symptom clusters together explained 45% (physical domain) and 29% (mental domain) of the variance in health-related quality of life (hrQoL). We found a remaining high symptom prevalence two years after SARS-CoV-2 infection, but symptoms present nine months after theindex infection often resolved, which was associated with increasing hrQoL. Remarkably, a considerable portion of symptoms newly emerged, of which only a few could be attributed to reported SARS-CoV-2 reinfection.

Social health and prevention of dementia: Integration of human and mice studies.

Social health and prevention of dementia: Integration of human and mice studies.

Fertility and age at childbirth in Polycystic Ovary Syndrome: Results from a longitudinal population-based cohort study

Fertility and age at childbirth in Polycystic Ovary Syndrome: Results from a longitudinal population-based cohort study

Serum ferritin levels in women with polycystic ovary syndrome.

Serum ferritin levels in women with polycystic ovary syndrome.

The Significance of Social Connections and Health in Relation to Loneliness Experienced by Older Adults Living at Home: A Qualitative Study.

Due to ageing, physical changes can affect one's ability to actively engage with others, resulting in limitations in social connections comparable to loneliness. Hence, there is a need for research on how older adults avoid experiencing loneliness and thus promote health through social connections. The aim of this study was to describe the significance of social connections and health in relation to loneliness experienced by older adults living at home. Older adults aged 65 years and older (n = 16) purposively selected from a longitudinal population-based multicentre study participated in semi-structured interviews. The interviews were conducted in January 2024, transcribed verbatim and analysed using inductive content analysis. The findings illustrated one main category, Preventing loneliness, and three associated generic categories: The silver lining of connecting with oneself, Being surrounded by meaningful connections and Striving to maintain an active and healthy life. Preventing loneliness may be one important aspect of healthy ageing. However, for some older adults, time alone offers enrichment and well-being, with routines playing a key role. Meaningful connections and feeling needed are crucial in preventing loneliness, especially as social networks may decline with age. An active and healthy life also prevents loneliness, though barriers like age-related limitations must be addressed. It is, therefore, important to address loneliness in society. Furthermore, it is essential that healthcare education incorporates the impact of loneliness on older adults to promote healthy ageing.

Additive impact of chronic obstructive pulmonary disease (COPD) and cardiovascular disease(CVD) on all-cause and disease-Specific mortality: a longitudinal nationwide population-based study

BackgroundChronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD) are two age-related diseases commonly found in the elderly population, and they are associated with severe health consequences. However, it is currently unclear how patients with either one of these diseases or both diseases simultaneously compare to patients without COPD and CVD in terms of the additive impact on overall mortality, CVD-related mortality, and respiratory system disease-related mortality.MethodThe study included 42,317 participants from the National Health and Nutrition Examination Survey (NHANES) spanning from 1999 to 2018. The main objective of the study was to assess the outcomes of all-cause mortality, CVD mortality, and respiratory system disease mortality. We utilized the National Death Index(NDI) Public Access File, up until December 31, 2019, to determine the participants’ mortality status and causes of death, with a mean follow-up period of 9.25 years. To ensure the reliability of the results, we employed Cox proportional hazards models to calculate the hazard ratios (HR) and 95% confidence intervals (CI) for mortality rates, along with conducting sensitivity analyses.ResultsAmong the 42,317 participants, 36,251 individuals (85.7%) had neither COPD nor CVD (COPD-/CVD-). Additionally, 4,252 people (10.0%) had only CVD (COPD-/CVD+), 1,237 people (2.9%) had only COPD (COPD+/CVD-), and 577 people (1.4%) had both COPD and CVD (COPD+/CVD+). Compared to the COPD-/CVD- group, the all-cause mortality rates increased by 1.58-fold (95% CI: 1.46, 1.70), 1.56-fold (95% CI: 1.38, 1.76), and 2.02-fold (95% CI: 1.72, 2.37) in the COPD-/CVD + group, COPD+/CVD- group, and COPD+/CVD + group, respectively, with the COPD+/CVD + group having the highest all-cause mortality risk. Compared to the COPD-/CVD- group, the other three groups showed increased CVD mortality rates, with a HR of 2.35 for the COPD-/CVD + group and COPD+/CVD + group, respectively. Compared to the COPD-/CVD- group, the other three groups had increased respiratory system disease mortality rates, with a HR of 5.00 (95% CI: 3.70, 6.75) for the COPD+/CVD- group and 6.62 (95% CI: 4.56, 9.61) for the COPD+/CVD + group (All trend p-values < 0.0001).ConclusionPatients with COPD or CVD, or those who have both conditions, are at an increased risk of all-cause mortality, CVD-related mortality, and respiratory system disease-related mortality. Individuals with either of these diseases require more stringent management to prevent the progression of the other disease and reduce mortality rates.