Back pain (BP) has been rated among the most important factors affecting physical health status in old age. Yet there is an under-representation of the older population in the BP literature. We ...present extensive interview data from the Longitudinal Study of Aging Danish Twins, dealing with a population-based sample of Danish twins aged 70-102, and describing the 1-month prevalence of BP and the development of BP over time. The associations between BP and education, self-rated health, other health problems, lifestyle factors, and physical and mental function were also investigated. Data were analysed in a cross-sectional analysis for all answers given at entry into the study and in a longitudinal analysis for participants in all four surveys. Associated factors were analysed for the cross-sectional sample using univariate and multivariate analysis accounting for the non-independence of twins in complete pairs. The overall 1-month prevalence of BP was 25% and differed significantly between men and women. The variations in prevalence between the age groups and over time were negligible. The majority of participants in all four surveys had either not experienced BP during the previous month or had done so on one occasion only. Education was not associated with BP. Self-rated health was associated with BP in a significant "dose-response" like pattern. BP was associated with bone and joint disorders, migraine headaches, lung disease, cardiovascular disorders and gastric ulcer, but not neurologic or endocrinologic diseases. BP sufferers had significantly lower scores on physical but not on mental functioning. We conclude that BP is a common symptom in old age; however, the prevalence does not change with increasing age. BP may be part of a more general syndrome of poor health among the old.
Aims: The aim of this study was to explore and describe self-rated health in middle-aged and elderly Danes using both a cross-sectional and a longitudinal design. Global and (age) comparative ...self-rated health are examined and compared. Methods: This study is interview based and comprises data on 11,294 Danes aged 45-102 with more than 1,900 participants aged 90 years and older. Results: As expected, global self-rated health declines with age in both cross-sectional and longitudinal analyses. In contrast, comparative self-rated health either increases or remains stable with age in cross-sectional analyses while in longitudinal analyses there is a slight decline in comparative self-rated health. Conclusions: The agetrajectory of global self-rated health is similar in individuals and populations. For comparative self-rated health, however, the individual on average experiences a slight decline, whereas on the population level comparative self-rated health either increases or remains stable. The explanation for this is likely to be higher mortality and higher non-response among the participants with the poorest self-rated health.
Patients with chronic myeloproliferative neoplasms are at increased risk of new solid or haematological cancers, but how prognosis is affected in patients with preceding myeloproliferative neoplasms ...is unclear.
We used data from population-based medical databases in Denmark from 1980 to 2011 to compare survival between cancer patients with and without a preceding diagnosis of myeloproliferative neoplasm, matched for age, sex, year of diagnosis, and type of cancer. We assessed outcomes by cancer stage and comorbidities.
Data were available for 1246 patients with a history of myeloproliferative neoplasms and we matched 5155 patients without a history of myeloproliferative neoplasm for comparison. Among patients with new localised solid cancers, 5-year survival was 49.8% (95% CI 39.1-59.6) for patients with preceding essential thrombocythaemia, 47·9% (42·1-53·4) for those with preceding polycythaemia vera, and 48.0% (34.1-60.7) for those with preceding chronic myeloid leukaemia. The values were 72.4% (68.4-76.0), 63.9% (61.5-66.2), and 74.3% (68.2-79.4), respectively, in matched patients without preceding myeloproliferative neoplasms. The risk of death among patients with a solid tumour and preceding myeloproliferative neoplasm was 1.21-2.28 times higher than in patients without myeloproliferative neoplasms. Excess mortality risk was observed irrespective of whether new cancers were diagnosed within 5 years or 5 years or more after myeloproliferative neoplasm.
Preceding myeloproliferative neoplasm is a predictor for poor outlook in patients who develop new primary cancers.
Lundbeck and Novo Nordisk Foundation Programme for Clinical Research Infrastructure, Danish Cancer Society, and Aarhus University Research Foundation.
OBJECTIVES: The aim of the present twin study was to estimate the relative importance of genetic and environmental factors in variation in self‐reported reduced hearing among the old and the oldest ...old.
DESIGN: Self‐reported hearing abilities of older twins assessed at intake interview in a population‐based longitudinal survey.
SETTING: Denmark.
PARTICIPANTS: Twins age 75 and older identified in the population‐based Danish Twin Registry in 1995. An interview was conducted with 77% of 3,099 individuals in the study population. In 1997 and 1999, a follow‐up contact to the survivors was made and an additional 2,778 twins, age 70–76, were included in the study.
MEASUREMENTS: Reduced hearing was assessed by the same question in all interview waves. Heritability (proportion of the population variance attributable to genetic variation) was estimated using structural‐equation analyses.
RESULTS: The prevalence of self‐reported reduced hearing corresponded to previous studies and showed the expected age and sex dependence. Concordance rates, odds ratios, and correlations were consistently higher for monozygotic twin pairs than for dizygotic twin pairs in all age and sex categories, indicating heritable effects. Structural‐equation analyses revealed a substantial heritability for self‐reported reduced hearing of 40% (95% CI = 19–53%). The remaining variation could be attributed to individuals' nonfamilial environments.
CONCLUSION: We found that genetic factors play an important role in self‐reported reduced hearing in both men and women age 70 and older. Because self‐reports of reduced hearing involve misclassification, this estimate of the genetic influence on hearing disabilities is probably conservative. Hence, genetic and environmental factors play a substantial role in reduced hearing among the old and oldest old. This suggests that clinical epidemiological studies of age‐related hearing loss should include not only information on environmental exposures but also on family history of hearing loss and, if possible, biological samples for future studies of candidate genes for hearing loss.
Aim
To investigate the influence of clinical and demographic features on diagnostic delay in cluster headache patients, in order to discuss diagnostic pitfalls and raise disease awareness.
Methods
A ...large, well-characterized cohort of 400 validated cluster headache patients from the Danish Cluster Headache Survey, diagnosed according to ICHD-II, were investigated. ANOVA was applied to investigate differences in diagnostic delay between groups. Selected independent variables were assessed in relation to diagnostic delay using a gamma regression model.
Results
Diagnostic delay was significantly reduced for each decade of cluster headache onset from 1950–2010 (p < 0.001). Onset after 1990 was associated with shorter diagnostic delay (OR = 0.28, p < 0.001), whereas attack duration > 180 minutes (OR = 1.62, p < 0.034), migraine-like features (OR = 1.30, p < 0.043) and nocturnal attacks (OR = 1.39, p < 0.021) were associated with prolonged diagnostic delay. Further, diagnostic delay decreased with age of onset (age < 20: 13.8 years, age 20–40: 5.4 years and age > 40: 2.1 years, p < 0.001).
Conclusion
Diagnostic delay was reduced for every decade investigated, whereas some atypical cluster headache features were associated with prolonged diagnostic delay. Better medical education and more disease awareness are needed to prevent misdiagnosis and prolonged diagnostic delay.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Dehydrated hereditary stomatocytosis (DHSt) is a nonimmune congenital hemolytic disorder characterized by red blood cell (RBC) dehydration and lysis. It has been a recognized diagnostic entity for ...almost 50 years, and autosomal dominant inheritance has long been suspected, but it was not until 2011 that the first genetic alterations were identified. The current study reviews 73 articles published during 1971-2019 and focuses on clinical perspectives of the disease. All but one of the published clinical data in DHSt were either single case reports or case series. From these, it can be seen that patients with DHSt often have fully or partially compensated hemolysis with few symptoms. Despite this, iron overload is an almost universal finding even in patients without or with only sporadic blood transfusions, and this may lead to organ dysfunction. Other severe complications, such as thrombosis and perinatal fluid effusions unrelated to fetal hemoglobin concentration, may also occur. No specific treatment for symptomatic hemolysis exists, and splenectomy should be avoided as it seems to aggravate the risk of thrombosis. Recently, treatment with senicapoc has shown activity against RBC dehydration in vitro; however, it is not known if this translates into relevant clinical effects. In conclusion, despite recent advances in the understanding of pathophysiology in DHSt, options for clinical management have not improved. Entering data into international registries has the potential to fill gaps in knowledge and eventually care of these rare patients.
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