Population-based Sample Research Articles

Early gross motor performance is associated with concurrent prelinguistic and social development.

To study how early gross motor development links to concurrent prelinguistic and social development. We recruited a population-based longitudinal sample of 107 infants between 6 and 21 months of age. Gross motor performance was quantified using novel wearable technology for at-home recordings of infants' spontaneous activity. The infants' prelinguistic and social development was assessed in parallel with a standardized parental questionnaire (Infant Toddler Checklist). The developmental trajectories of motor, prelinguistic, and social performance were inspected longitudinally at individual level, and correlated to each other to measure the relative, age-adjusted advance in performance (z-scores). Advanced gross motor maturation (higher z-score) links to more advanced prelinguistic development (β = 0.033, p = 0.016, R2 = 0.706) and social development (β = 0.038, p = 0.025, R2 = 0.600). When looking at specific gross motor skills, an increased amount of independent movement (crawling, standing, walking) links to more advanced prelinguistic and social abilities. We introduce a novel approach that measures individual level gross motor development longitudinally at high resolution from child's spontaneous movements at home. This approach shows that age-adjusted relative advance in motor performance is linked to concurrent prelinguistic and social development, supporting the idea of developmental interaction across neurocognitive domains. Early gross motor, prelinguistic, and social developments show trackable idiosyncratic trajectories. Maturity in gross motor performance links to concurrent prelinguistic and social development. Gross motor performance can be assessed reliably and objectively from infants' spontaneous activity using unsupervised wearable recordings in their native environment, the homes. The present methodology with longitudinal quantitative assessments and age-adjusted modeling with z-scores introduce a potential paradigm shift to studying early neurodevelopment in the context of pediatric health, benchmarking of therapeutic interventions, and other developmental studies.

Adolescent health and the intersectionality of ethnicity/race, sex, and sexual orientation: A national probability sample from the Adolescent Brain Cognitive Development study.

Although children with marginalized sociodemographic characteristics are exposed to increased health risk and disparities, there is a paucity of population-based research on health status of children occupying multiple social marginalities. The present study investigated implications of children's intersectional sociodemographic characteristics on health risk indicators. In this longitudinal cohort study, we used longitudinal data from the ongoing Adolescent Brain Cognitive Development study. The study used a population-based sample of 9- to 10-year-old children attending private and public schools in 21 U.S.-based study sites between 2016 and 2018. In the present analytic sample of 9,854 children and adolescents, eight social strata groups were identified based on children's ethnicity/race, assigned sex at birth, and sexual orientation. Five health risk indicators were included in the study: depressed mood, suicidal ideation, self-injurious behaviors, alcohol sipping, and overweight status. Results showed that compared to White heterosexual boys (referent group), sexual minority (SM) children including White and ethnic/racial minority, boys and girls were at greater risk of having depressed mood, self-injurious behavior, and suicidal ideation. White SM children, including boys and girls, were also at greater risk of sipping alcohol, whereas heterosexual ethnically/racially minoritized children, including boys and girls, were at less risk of sipping alcohol. Although no change was found in overweight status over time across social groups, children with marginalized social categories were more likely to report being overweight. Intersectional marginality accounted for an increased health risk and disparities among children from marginalized sociodemographic background. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Long-term Cognitive Trajectories in Older Adults After Surgery: A Population-based Cohort Study.

Postoperative cognitive decline (POCD) is a common, but often unrecognized condition after surgery. We evaluate postsurgical cognitive changes in a longitudinal population-based study. The study cohort comprises an age-stratified population-based random sample of individuals aged 65+ years from a small-town region of the United States. We identified as cases those participants who, during annual assessments, self-reported having undergone surgery under general anesthesia during the preceding year. We identified as controls those who reported no surgery for at least 6 consecutive years. The outcome variable changed over time (4y) in annual cognitive test composite scores encompassing the domains of attention/processing speed, executive function, memory, language, and visuospatial functions, which were modeled using Generalized Estimating Equations. A total of 436 participants had the required cognitive data; 179 participants (cases) had undergone surgery, while 257 participants (controls) had not undergone surgery. After adjusting for age, years of education, gender, race, heart failure, irregular heartbeat, and stroke, participants who underwent surgery had a greater decline in executive function, memory, and attention over a 2-year period. Participants who underwent surgery had a significant subsequent decline in cognitive function over the long term.

Nationwide population-based infection- and vaccine-induced SARS-CoV-2 antibody seroprevalence in Germany in autumn/winter 2021/2022.

BackgroundThe first Corona Monitoring Nationwide (RKI-SOEP) study (October 2020-February 2021) found a low pre-vaccine SARS-CoV-2 antibody seroprevalence (2.1%) in the German adult population (≥ 18 years).AimThe objective of this second RKI-SOEP (RKI-SOEP-2) study in November 2021-March 2022 was to estimate the prevalence of SARS-CoV-2-specific anti-spike and/or anti-nucleocapsid (anti-N) IgG antibodies (combined seroprevalence), past infection based on infection-induced seroprevalence (anti-N), and basic immunisation (at least two antigen contacts through vaccination or infection) in individuals aged ≥ 14 years. We also aimed to estimate under-reporting of infections.MethodsDried blood-spot specimens from a population-based sample embedded in a dynamic cohort, the Socio-Economic Panel (SOEP), were serologically analysed. Resulting serological data and self-reports via a questionnaire from the same individuals were used to estimate prevalences.ResultsCombined seroprevalence was 90.7% (95% CI: 89.7%-91.6%) without correction and 94.6% (95% CI: 93.6%-95.7%) with correction for sensitivity/specificity and antibody waning. While one in nine individuals had been infected (11.3%; 95% CI: 9.1%-13.5%), nine in 10 had a basic immunisation (90%; 95% CI: 88.9-90.9%), primarily due to vaccination. Population-weighted estimates differed by age, region, and socioeconomic deprivation. The under-reporting factor was estimated as 1.55 (95% CI: 1.3-1.8).ConclusionsWhen the SARS-CoV-2-Omicron wave was beginning, most people had been vaccinated, infected, or both. Large-scale vaccination, but not a high infection rate, was able to fill the immunity gap, especially in ≥ 65 year-olds who are known to be at higher risk of severe COVID-19. Our data point towards the need for targeted socioeconomically, demographically and regionally stratified mitigation strategies, including measures to enhance vaccine uptake.

Learning from experience: does providing end-of-life care support for relatives boost personal end-of-life health literacy?

BackgroundDespite the critical role of health literacy in utilizing palliative care and engaging in advance care planning, limited research exists on the determinants of end-of-life health literacy. This study investigates the association between individuals’ experiences with end-of-life care support to relatives and their end-of-life health literacy among a population-based sample of adults aged 58 and older.MethodWe used data from 1,548 respondents in Switzerland to Wave 8 (2019/2020) of the Survey on Health, Ageing, and Retirement in Europe. Their ability to understand medical jargon, find information, communicate, and make decisions about end-of-life care options was measured with the validated Subjective End-of-Life Health Literacy Scale. Experiences with end-of-life care support include having made medical decisions as healthcare proxy, accompanied, or cared for relatives at the end of life. Associations were estimated using ordinary least squares regressions, controlling for socio-demographic, health, and regional characteristics.ResultsRespondents who experienced being a healthcare proxy (p < 0.001), who accompanied (p < 0.001), or who cared for a relative at the end of life (p < 0.001) tended to have higher levels of end-of-life health literacy. These results remained significant when the three variables were simultaneously included in the multivariable model (p < 0.001, p < 0.001 and p < 0.05).ConclusionsOur findings suggest that providing end-of-life care support to relatives is associated with higher end-of-life health literacy. Thus, as caregivers gain experience caring for others, targeted interventions could leverage their skills and encourage them to think of engaging in end-of-life planning for themselves.

Prevalence of functional defecation disorders in European children: A systematic review and meta-analysis.

Functional defecation disorders (FDDs) are common among children worldwide. The prevalence of these disorders has not been clearly described in Europe. This study performed a systematic review and meta-analysis on the prevalence of FDD in European children and assessed geographical, age, and sex distribution and associated factors. PubMed, Embase, Psycinfo, Cochrane Library, and Cinahl were searched from 1999 to July 2023. Included studies were (1) prospective or cross-sectional studies of European population-based samples; (2) reporting the prevalence of infant dyschezia (ID) according to Rome II, III, or IV criteria or functional constipation (FC) or functional non-retentive fecal incontinence (FNRFI) according to Rome III or IV criteria; (3) aged 0-18 years; and (4) published in English, Dutch or Spanish. PRISMA guidelines for extracting data and assessing data quality were followed. Twenty-eight studies were included. Pooled prevalence was 6.9% (95% confidence interval [CI]: 3.1%-11.9%) for ID in infants 0-12 months (9 studies, n = 5611), 8.17% (95% CI: 6.33%-10.22%) for FC in children <4 years (25 studies, n = 35,189), 11.39% (95% CI: 9.34%-14.11%) for FC in children 4-18 years, and 0.24% (95% CI: 0.07%-0.49%) for FNRFI in children 4-18 years (7 studies, n = 16,873). No sex predominance was found for FC. FC prevalence did not differ significantly when diagnosed according to Rome III versus IV. FC prevalence differed between countries, with greatest rates in Italy, Germany, and Spain. No meta-analysis could be performed on other factors associated with FDD. FDD is common in European children. Future longitudinal studies are needed to provide better insight into associated factors in pathogenesis.

Cardiovascular Safety of Anti-CGRP Monoclonal Antibodies in Older Adults or Adults With Disability With Migraine

Monoclonal antibodies (mAbs) targeting calcitonin gene-related peptide (CGRP) or its receptor (anti-CGRP mAbs) offer effective migraine-specific preventive treatment. However, concerns exist about their potential cardiovascular risks due to CGRP blockade. To compare the incidence of cardiovascular disease (CVD) between Medicare beneficiaries with migraine who initiated anti-CGRP-mAbs vs onabotulinumtoxinA in the US. This retrospective, sequential cohort study was conducted among a nationally representative population-based sample of Medicare claims from May 2018 through December 2020. Data analysis was performed from August to December 2023. This study included fee-for-service Medicare beneficiaries aged 18 years or older with migraine who initiated either anti-CGRP mAbs or onabotulinumtoxinA. Beneficiaries who had a history of myocardial infarction (MI), stroke, cluster headache, malignant cancer, or hospice service within a 1-year baseline period prior to treatment initiation were excluded. To minimize channeling bias from new drug introductions and time-related bias due to the COVID-19 pandemic, 5 cohorts were established, representing sequential 6-month calendar intervals based on the initial prescription or date of index anti-CGRP mAbs or onabotulinumtoxinA use. Anti-CGRP mAbs vs onabotulinumtoxinA. The primary outcome was time to first MI or stroke. Secondary outcomes included hypertensive crisis, peripheral revascularization, and Raynaud phenomenon. The inverse probability of treatment-weighted Cox proportional hazards models were used to compare outcomes between the 2 treatment groups. Among 266 848 eligible patients with migraine, 5153 patients initiated anti-CGRP mAbs (mean [SD] age, 57.8 [14.0] years; 4308 female patients [83.6%]) and 4000 patients initiated onabotulinumtoxinA (mean [SD] age, 61.9 [13.7] years; 3353 female patients [83.8%]). Use of anti-CGRP mAbs was not associated with an increased risk of composite CVD events (adjusted hazard ratio [aHR], 0.88; 95% CI, 0.44-1.77), hypertensive crisis (aHR, 0.46; 95% CI, 0.14-1.55), peripheral revascularization (aHR, 1.50; 95% CI, 0.48-4.73), or Raynaud phenomenon (aHR, 0.75; 95% CI, 0.45-1.24) compared with onabotulinumtoxinA. Subgroup analyses by age group and presence of established non-MI or stroke CVD showed similar findings. In this cohort study, despite initial concerns regarding the cardiovascular effects of CGRP blockade, anti-CGRP mAbs were not associated with an increased risk of CVD compared with onabotulinumtoxinA among adult Medicare beneficiaries with migraine, who were predominantly older adults or individuals with disability. Future studies with longer follow-up periods and in other populations are needed to confirm these findings.

High Intensity Physician-Based Service Use for Mental Health Concerns in a General-Population Sample of Children and Youth: Utilisation des services de haute intensité dispensés par des médecins pour les problèmes de santé mentale dans un échantillon d'enfants et de jeunes de la population générale.

To examine factors associated with high intensity physician-based mental health care services in a population-based sample of children and youth in Ontario, Canada. Data from the 2014 Ontario Child Health Study (OCHS) were linked at the person-level to longitudinal health administrative databases containing physician contacts in outpatient settings, emergency departments and hospitals. Our analytical sample (15.8% of 9,301, n = 1,423) included children and youth with at least one physician-based contact for a mental health concern in the 24-month period post-OCHS. Over the same follow-up period, we classified high intensity service use as those in the top 10th and fifth percentiles of physician-based mental health service cost contributors. Costs were assessed using physician billing data, as well as estimated emergency department visit and hospitalization costs. Among those with at least one contact, being older (PR: 1.15, 95% CI: 1.04, 1.25), having more severe symptoms of mental ill-health (PR: 1.04, 95% CI: 1.01, 1.06) and having a history of mental health service use (PR: 3.99, 95% CI: 1.37, 11.61), were positively associated with high-intensity service use, while living in a rural setting (PR: 0.35, 95% CI: 0.15, 0.30) was negatively associated. Findings were largely consistent between the top 10th and fifth percentiles. Notably, among youth ages 14-17 years, self-reported prior suicide attempt was positively associated with high-intensity (top fifth percentile) service use (PR: 6.09, 95% CI: 1.41, 26.26). Our findings suggest older age, non-rural residency, mental health symptom severity and suicidal behaviour are important factors associated with high-intensity physician-based mental health service use. Our findings will inform efforts to better identify children and youth who may benefit from early and personalized interventions.

Gender identity and activity limitations: A national study on transgender and non-binary Canadians.

Activity limitations among transgender and non-binary individuals remain largely unexplored using population-based samples. This study examines the risk of activity limitations across different gender identities in Canada. Using data from the 2021 Canadian long-form Census, logistic regressions estimated the adjusted odds of reporting activity limitations (seeing, hearing, mobility/dexterity, mental, cognitive, and other) across gender identities. Non-binary individuals assigned female at birth (AFAB) had the highest predicted probability of reporting any activity limitations (76.13 %), followed by non-binary individuals assigned male at birth (AMAB) at 61.56 %, transgender men (44.71 %), and transgender women (34.41 %). Cisgender men (19.31 %) and cisgender women (21.98 %) had the lowest probabilities. Mental limitations showed the largest disparity, with 39.4 % of non-binary AFAB individuals affected, compared to 4.9 % of cisgender men. These findings highlight significant disparities in activity limitations across gender identities. Non-binary and transgender individuals are most at risk for activity limitations. These findings underscore the need for targeted policies to address challenges faced by gender-diverse populations. Future research should investigate the mechanisms behind these disparities. Healthcare policies must prioritize culturally competent, transgender-inclusive care to reduce disparities in activity limitations.

High CSF neurogranin level is related to lifetime reports of passive suicidal ideation in a population-based sample of older adults

ObjectiveTo investigate the association of cerebrospinal fluid (CSF) levels of markers of synaptic dysfunction and neuronal damage, neurogranin (Ng) and neurofilament light chain (NfL), with suicidal ideation in older adults. MethodThe sample was obtained from the Gothenburg H70 Birth Cohort Studies and included 316 dementia free individuals (151 women, 165 men, mean age 70.6) who underwent extensive psychiatric examinations and lumbar puncture (LP). Suicidal ideation was assessed using the Paykel questions. ResultsPast year suicidal ideation (any severity level) was reported by 9 (2.8%) participants while 58 (18.4%) reported experiencing such ideation during their lifetime. High CSF Ng level was associated with lifetime reports of life weariness (OR 2.03, 95% CI 1.01-4.11, P = 0.048), death wishes (OR 2.26, 95% CI 1.02-4.98, P = 0.044) and thoughts of taking one’s own life (OR 3.17, 95% CI 1.31-7.65, P = 0.010) in adjusted logistic regression models including self-reported lifetime depression as a covariate. The association between high CSF Ng level and lifetime suicidal ideation (all severity levels) remained in models adjusted for CSF levels of amyloid beta 42 (Aβ42), T-Tau and P-Tau. No relationship was seen between high CSF NfL and suicidal ideation. ConclusionThe association between high CSF Ng level and history of suicidal ideation suggests that synaptic dysfunction may be involved in the diathesis of passive suicidal ideation. CSF markers of neurodegeneration did not modify these findings.

LINKS BETWEEN SELF-REPORTED HEARING WITH LEARNING AND MEMORY IN THE HEALTH AND RETIREMENT STUDY

Abstract Growing evidence links hearing loss to increased risk for dementia, but the influence of sociodemographic characteristics (e.g., race/ethnicity, insurance status) on this relationship is understudied. Therefore, we examined the relationships between self-rated hearing with learning and memory in a large, population-based sample. Participants included 3,417 individuals (mean age = 74.5 years, SD = 7.9; 9.4% Black, 8.1% Latino, 82.5% White) from the Health and Retirement Study who also completed the Harmonized Cognitive Assessment Protocol (HCAP) in 2016. Individuals rated their hearing as “excellent”, “very good”, “good”, “fair”, or “poor”. Outcomes of interest included scores from each of the learning (1-3) and the delayed memory trials from the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) Word List Memory Task. Probability weighted linear regression models were fit to examine the associations between self-reported hearing with learning and memory. We fit a series of models adjusting for hearing aid use (M1), M1 + education (M2), and M2 + race/ethnicity, age, sex, and insurance (M3). Fair and poor self-reported hearing were associated with a steeper drop from trial 3 recall to delayed recall compared to those who reported excellent hearing in fully-adjusted models (M3: Δ=-0.27, se=0.12, p &amp;lt; 0.05; Δ=-0.47, se=0.16, p &amp;lt; 0.01, respectively). Self-reported poor hearing was associated with worse delayed recall after taking into account hearing aid use and several sociodemographic factors. Hearing loss may be a ubiquitous risk factor for worse delayed recall, suggesting an increased risk for Alzheimer’s disease.

Suicide Risk Among Veterans Who Receive Evidence-Based Therapy for Posttraumatic Stress Disorder

Suicide rates are increased for veterans with posttraumatic stress disorder (PTSD). To inform Veterans Health Administration (VHA) operations, it is important to assess whether suicide risk for veterans differs by receipt of evidence-based treatments. To assess suicide risks among veterans in VHA care with new PTSD diagnoses who initiated or received an adequate course of evidence-based psychotherapy (cognitive processing therapy or prolonged exposure [CPT/PE]). This cohort study of veterans in VHA care evaluated suicide risk through 2020 for veterans with initial PTSD diagnoses during 2016-2019. Data collection and analyses were performed from March 22 to November 22, 2023. The population consisted of veterans who received an initial PTSD diagnosis (preceded by at least 12 months without a PTSD diagnosis) in 2016-2019. Following the index PTSD diagnosis, receipt of a CPT/PE encounter and receipt of an adequate course of therapy (≥8 CPT/PE encounters). Suicide mortality, per death certificate data from the Veterans Affairs/Department of Defense Mortality Data Repository. Of the population-based sample of 847 217 US veterans, most were male (735 974 [86.9%]); the mean (SD) age was 50.1 (16.3) years. From initial PTSD diagnosis through 2020, there were 1552 suicides. Multivariable proportional hazards regression indicated that initiation of CPT/PE treatment was associated with a 23% lower suicide risk compared with those who did not initiate CPT/PE (hazard ratio [HR], 0.77; 95% CI, 0.59-0.99). Receipt of an adequate course was not associated with suicide (HR, 0.80; 95% CI, 0.55-1.18). Similar results were observed when limiting the cohort to those who received any psychotherapy (n = 552 742; CPT/PE initiation: HR, 0.73; 95% CI, 0.56-0.95; adequate course: HR, 0.77; 95% CI, 0.52-1.12). The findings of this study suggest that, among veterans in VHA care with new PTSD diagnoses, CPT/PE initiation was associated with lower suicide risk. However, for those who initiated CPT/PE, receipt of 8 or more sessions was not associated with added benefit.

Exposure to physical, sexual and emotional violence and health-related factors among the adult population in the Faroe Islands.

The Faroe Islands is a small homogenous archipelago located in the North Atlantic Ocean with no prior study of violence among adults. In an adult population-based sample, we studied physical, sexual and emotional violence and health and socio-economic determinants. A population-based cross-sectional survey conducted between November 2020 and February 2021 was based on a newly initiated questionnaire that included 1068 randomly selected individuals aged 18-75. A total of 34.8% reported exposure to physical violence, 21.8% to sexual violence and 22.3% to emotional violence. A total of 12.6% of the women and 7.6% of the men reported exposure to all three types of violence. The consequences of childhood violence had a more significant effect on the subjects compared to adult-life violence. Additionally, individuals exposed to violence had significantly lower odds of achieving any educational attainment. Compared to men and after adjustments, women had 50% lower odds of exposure to physical (odds ratio=0.5, p<0.001) and more than three times the odds of exposure to sexual violence (odds ratio=3.1, p<0.001). The odds of emotional violence were sex independent, both unadjusted and adjusted. Moreover, exposure to violence showed a life-long negative impact.

Women’s stress during the COVID-19 pandemic in Germany and the Netherlands: a longitudinal perspective on the role of part-time employment and parenthood for different educational groups

ABSTRACT This study longitudinally investigates women’s levels of perceived stress during the COVID-19 pandemic in Germany and the Netherlands, in relation to work- and family stressors. It further examines the moderating role of education as a protective factor against stress. Our country cases represent similar pre-pandemic gender regimes that extensively relied on women’s part-time work but exhibited variation in pandemic governance. Drawing on longitudinal data from population-based samples, we estimate random effects panel models across three time points (pre-pandemic, during or shortly after first lockdown, later stage of the pandemic). For the Netherlands, we find that women initially experienced an increase in stress but later recovered. In Germany, stress initially decreased, but only for women without children. Multivariate models show that working fewer hours protected women against stress in Germany, particularly those with higher education. In the Netherlands, no such moderation effects were found. Instead, in the Netherlands, differences between educational groups were larger than differences between women with varying working hours. These results are discussed in light of country differences in pandemic governance.

Socioeconomic position interacts with the genetic effect of a CRP gene common variant to influence C-reactive protein values.

C-Reactive Protein (CRP) values are partly determined by variation at the CRP gene locus, but also influenced by socioeconomic position (SEP) and related lifestyle factors. As gene-by-SEP interactions have been suggested for traits associated with CRP and SEP (e.g., BMI, coronary artery disease), the aim of this study was to investigate the strength of a possible interaction between a CRP gene common variant (rs4287174) and SEP in their joint influence on CRP levels in a population-based study sample. Single nucleotide polymorphism rs4287174 was genotyped in 4065 participants (aged 45-75 years) of the Heinz Nixdorf Recall study, a population-based prospective cohort. SEP indicators (education and income), risk factors (i.e., body mass index (BMI), total cholesterol, diabetes mellitus, coronary artery calcification, current smoking, hypertension, diet, no exercise) and blood serum CRP (mg/dl) were assessed at study baseline. Interaction analysis was based on linear regression and on stratified analyses (genetic effect stratified by SEP and vice versa) adjusted for age and sex using loge(CRP + 1) as dependent variable. Low SEP and rs4287174 T allele were both associated with higher CRP values. The strongest genetic effect was observed in the lowest educational group (≤ 10 years of education) with an exp(β) indicating 1.058-fold (95%-CI: 1.018; 1.100) average CRP values per additional T allele, while in the highest educational group (≥ 18 years) the association was considerably less strong (exp(β): 1.005 (95%-CI: 0.975; 1.037)). After including rs4287174-by-education interaction terms in the regression analysis, interaction was indicated suggesting stronger genetic effects on CRP in low SEP groups (exp(βinteraction): 1.056 (95%-CI: 1.005; 1.108); p = 0.029). The observed interaction did not seem to be substantially mediated by the risk factors included in the analysis. No indication for rs4287174-by-income interaction was observed. Results imply that genetic effects of the CRP locus are modified by education as an indicator of life course SEP.

Post-COVID Condition Risk Factors and Symptom Clusters and Associations with Return to Pre-COVID Health-Results from a 2021 Multi-State Survey.

Little is known about how symptoms or symptom clusters of Post-COVID Conditions (PCC) impact an individual's return to pre-COVID health. We used four state-level COVID-19 case reporting systems and patient-reported survey data to identify patients with PCC and associations with an individual's return to pre-COVID health after laboratory-confirmed SARS-CoV-2 infection. Participants had a positive SARS-CoV-2 test between March-December 2020. Weighted regression models were used to 1) estimate prevalence of PCC; 2) identify risk factors associated with developing PCC; and 3) examine associations between PCC symptom clusters and return to pre-COVID health. Factor analysis was used to statistically identify post-COVID symptom clusters. Prevalence of PCC in this population-based sample was 29·9% for persons with SARS-CoV-2 infection, during the pre-delta variant period (March-December 2020); 77·2% of persons experiencing PCC had not returned to pre-COVID health within 8-60 weeks after infection. Female sex, acute COVID-19 illness severity, and number of pre-existing comorbidities were significant risk factors associated with PCC. Myalgic encephalomyelitis/chronic fatigue syndrome-like symptoms, upper-respiratory symptoms, and gastrointestinal symptoms were significantly associated with not returning to pre-COVID health. Understanding PCC symptom clustering may provide insight into pathophysiology, severity of PCC, and management for patients who have not returned to their usual state of health after SARS-CoV-2 infection. Tracking PCC can help measure the impact of COVID-19 vaccination and acute COVID-19-specific treatments on reducing PCC in the US.

Analysis of exonic deletions in a large population study provides novel insights into NRXN1 pathology

The NRXN1 locus is a hotspot for non-recurrent copy number variants and exon-disrupting NRXN1 deletions have been associated with increased risk of neurodevelopmental disorders in case-control studies. However, corresponding population-based estimates of prevalence and disease-associated risk are currently lacking. Also, most studies have not differentiated between deletions affecting exons of different NRXN1 splice variants nor considered intronic deletions. We used the iPSYCH2015 case-cohort sample to obtain unbiased estimates of the prevalence of NRXN1 deletions and their associated risk of autism, schizophrenia, depression, and ADHD. Most exon-disrupting deletions affected exons specific to the alpha isoform, and almost half of the non-exonic deletions represented a previously reported segregating founder deletion. Carriage of exon-disrupting NRXN1 deletions was associated with a threefold and twofold increased risk of autism and ADHD, respectively, whereas no significantly increased risk of depression or schizophrenia was observed. Our results highlight the importance of using population-based samples in genetic association studies.

Stress reactivity moderates the association between stressful life events and depressive symptoms in adolescents: Results from a population-based study.

A large body of evidence links stressful life events with depression. However, little is understood about the role of perceived impact in this association. We performed regression analysis to investigate whether self-reported stress reactivity (derived by regressing the impact-weighted life event score on the unweighted score) moderated the association between stressful life events and depressive symptoms in adolescents from the Avon Longitudinal Study of Parents and Children cohort (n = 4791), controlling for age at outcome, sex, ethnicity, and maternal education. Depressive symptoms were assessed using the self-report Short Mood and Feelings Questionnaire (score range 0-26) at 16 years of age. Adolescents also reported on their exposure to 23 possible stressful life events since age 12 and their impact, which were used to define stress reactivity groups using a residual regression approach. We identified a moderating effect of stress reactivity. Adolescents with high stress reactivity showed a stronger association between the number of stressful life events and depressive symptoms than adolescents with low (b = 0.32, 95 % CI = 0.13, 0.50, p < 0.001) or typical (b = 0.44, 95 % CI = 0.28, 0.60, p < 0.001) stress reactivity. Limitations include the use of retrospective life event measures and limited generalisability of findings to other population-based, high-risk, or clinical samples. When resources are limited, interventions should prioritise individuals with high stress reactivity who have experienced multiple stressful life events, as these individuals may be at greater risk for depression.

Multimodal neuroimaging biomarkers and subtle cognitive decline in a population-based cohort without dementia.

The relationship between subtle cognitive decline and Alzheimer's disease (AD) pathology as measured by biomarkers in settings outside of specialty memory clinics is not well characterized. To investigate how subtle longitudinal cognitive decline relates to neuroimaging biomarkers in individuals drawn from a population-based study in an economically depressed, small-town area in southwestern Pennsylvania, USA. A subset of participants without dementia (N = 115, age 76.53 years ± 6.25) from the Monongahela Youghiogheny Healthy Aging Team (MYHAT) study completed neuroimaging including magnetic resonance imaging (MRI) measures of AD-signature region cortical thickness and white matter hyperintensities (WMH), Pittsburgh compound B (PiB)-positron emission tomography (PET) for amyloid-β (Aβ) deposition, and [18F]AV-1451-PET for tau deposition. Neuropsychological evaluations were completed at multiple timepoints up to 11 years prior to neuroimaging. Aβ positivity was determined using a regional approach. We used linear mixed models to examine neuroimaging biomarker associations with retrospective cognitive slopes in five domains and a global cognitive composite. Among Aβ(+) participants (38%), there were associations between (i) tau Braak III/IV and language decline (p < 0.05), (ii) cortical thickness and both memory decline (p < 0.001) and global cognitive decline (p < 0.01), and (iii) WMH and decline in executive function (p < 0.05) and global cognition (p < 0.05). Among Aβ(-) participants, there was an association between tau Braak III/IV and decline on tests of attention/psychomotor speed (p < 0.05). These findings confirm an Aβ-dependent early AD biomarker pathway, and suggest a possible Aβ-independent, non-AD process underlying subtle cognitive decline in a population-based sample of older adults without dementia.

Early Childhood Exposures to Fluorides and Cognitive Neurodevelopment: A Population-Based Longitudinal Study.

It is important to maintain confidence in the risk and benefit balance of major caries-preventive programs using fluoride. The ongoing debate about potential effects of early-life exposures to fluoride on cognitive neurodevelopment requires high-quality scientific evidence. This study aimed to investigate the potential effects of fluoride exposure on cognitive neurodevelopment assessed with the Wechsler Adult Intelligence Scale 4th edition (WAIS-IV) in an Australian population-based sample. The sample was selected from the National Child Oral Health Study (NCOHS) 2012-2014. NCOHS collected data on socioeconomic factors, oral health behaviors, and residential history to estimate percentage lifetime exposure to fluoridated water during the first 5 y of life (%LEFW). NCOHS children were also examined by trained and calibrated examiners to assess dental fluorosis (a reliable and valid individual biomarker of total fluoride intake during early childhood). The sample was followed up in 2022-2023 to collect data on cognitive neurodevelopment (intelligence quotient [IQ]) using the WAIS-IV, which was administered by trained and calibrated qualified psychologists. Multivariable regression models were generated to investigate associations between the 2 exposure measurements (%LEFW and dental fluorosis) with full-scale IQ (FSIQ) scores, controlling for important confounding effects. Hypotheses of noninferiority were also tested, contrasting different levels of exposure to fluoride. Some 357 participants aged 16 to 26 y completed the WAIS-IV, with a mean FSIQ score of 109.2 (95% confidence interval [CI]: 107.8-110.5). The estimates of the multivariable regression models demonstrated slightly higher FSIQ scores among the exposed than the nonexposed. The adjusted β of 100%LEFW versus 0%LEFW was 1.07 (95% CI: -2.86, 5.01) and of having dental fluorosis versus no fluorosis was 0.28 (95% CI: -3.00, 3.57). The hypothesis of noninferiority tests found that FSIQ scores of those exposed and nonexposed to fluoride were equivalent. The study provided consistent evidence that early childhood exposure to fluoride does not have effects on cognitive neurodevelopment.