Dataset Information

Differing trends in the incidence of vascular comorbidity in MS and the general population.

ABSTRACT:

Background

Although the adverse effects of vascular comorbidities are increasingly recognized in multiple sclerosis (MS), the epidemiology of these conditions remains poorly understood.

Methods

Using population-based administrative data, we identified 44,452 Canadians with MS and 220,849 age-, sex- and geographically matched controls. We applied validated definitions to estimate the incidence of diabetes, hypertension, hyperlipidemia, and ischemic heart disease (IHD) from 1995 to 2005.

Results

Of the MS cases, 31,757 (71.4%) were in female participants, with a mean (SD) age at the index date of 43.8 (13.7) years. Over time, the age-standardized incidence of diabetes rose more in the MS population (incidence rate ratio [IRR] per year 1.06; 95% confidence interval [CI] 1.03-1.08) than in the matched population (IRR per year 1.02; 95% CI 1.01-1.03). Temporal trends in the age-standardized incidence of hyperlipidemia, hypertension, and IHD were similar in both populations. Among those aged 20-44 years, the incidence of IHD was higher in the MS population (IRR 1.59; 95% CI 1.19-2.11). The increased incidence of IHD in the MS population was attenuated among those aged 60 years and older (IRR 1.01; 95% CI 0.97-1.06).

Conclusions

The incidence rates of diabetes, hypertension, and hyperlipidemia are rising within the MS population. Programs to systematically prevent and treat these conditions are needed.

SUBMITTER: Marrie RA

PROVIDER: S-EPMC4828682 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

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Publications

Differing trends in the incidence of vascular comorbidity in MS and the general population.

Marrie Ruth Ann RA Fisk John J Tremlett Helen H Wolfson Christina C Warren Sharon S Blanchard James J Patten Scott B SB

Neurology. Clinical practice 20160401 2

<h4>Background</h4>Although the adverse effects of vascular comorbidities are increasingly recognized in multiple sclerosis (MS), the epidemiology of these conditions remains poorly understood.<h4>Methods</h4>Using population-based administrative data, we identified 44,452 Canadians with MS and 220,849 age-, sex- and geographically matched controls. We applied validated definitions to estimate the incidence of diabetes, hypertension, hyperlipidemia, and ischemic heart disease (IHD) from 1995 to ...[more]

PMID: 27104065

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Project description:BackgroundChronic social and health inequities faced by indigenous peoples in Brazil foretell the detrimental impact of COVID-19.MethodsWe use de-identified, publicly available data from the Ministry of Health from March/2020 - December/2021 to describe vaccination coverage, cumulative incidence, and cumulative mortality rates due to COVID-19 among indigenous peoples. We also compare vaccination coverage among indigenous peoples with that reported for older adults, who were simultaneously included as a priority group in the vaccination strategy. Finally, we compared COVID-19 incidence and mortality rates in the indigenous population with that reported for the general Brazilian population.FindingsWe found important heterogeneities in vaccination coverage across the 34 indigenous districts, and a lower overall coverage among indigenous peoples compared to older adults. We observed higher COVID-19 cumulative incidence rates among indigenous populations compared to the general Brazilian population. Although mortality rates were seemingly lower, data should be interpreted with caution due to a younger age structure and more frequent underreporting of cases and deaths among indigenous populations. After the beginning of COVID-19 vaccination program, we observed a decrease in both incidence and mortality rates among indigenous peoples in all Brazilian regions.InterpretationThe COVID-19 pandemic has had a heavy toll on vulnerable populations. Although social and geographic isolation challenges the implementation of any vaccination program for indigenous populations, prior experience suggests that the COVID-19 vaccination strategy lacked effectiveness. The absence of a coordinated strategy to reinforce the importance of the vaccine and other prevention methods, to guarantee the access to trustworthy information, and to respond with the necessary resources in extreme situations, resulted in lower COVID-19 vaccination coverage, higher incidence rates, and preventable deaths due to COVID-19 among indigenous peoples in Brazil.FundingThis work was not supported by specific funding.

Project description:ObjectivesTo examine trends overtime in the incidence and in-hospital outcomes of vascular dementia (VaD) hospitalisations in patients aged 70 years or over suffering and not suffering from type 2 diabetes mellitus (T2DM) between 2004 and 2013 in Spain.DesignRetrospective study.SettingSpain.ParticipantsNational hospital discharge data were used; patients aged ≥70, discharged from a hospital with VaD as a primary diagnosis, were selected.Main outcome measuresOverall incidence, therapeutic and diagnostic procedures, comorbidities, infectious complications, duration of hospital stays and in-hospital mortality (IHM).ResultsIn total, 170 607 admissions for VaD (34.3% with T2DM) were identified. We found a significant upward linear trend in the incidence of VaD for men and women with and without diabetes between 2004 and 2013. The adjusted incidence was higher among people with T2DM over the study period. We found a higher incidence in men than women in all years under study. A positive association between T2DM and VaD hospitalisation was found among both men (IRR 2.14, 95% CI 2.11 to 2.16) and women (incidence rate ratio (IRR) 2.22; 95% CI 2.19 to 2.25). Pneumonia was significantly associated with a higher mortality (OR 2.59, 95% CI 2.52 to 2.67). We found that percutaneous endoscopic gastrostomy was associated with lower IHM (OR 0.37, 95% CI 0.31 to 0.45), while parenteral nutrition had the opposite effect (OR 1.29, 95% CI 1.18 to 1.41). There was no association between diabetes and higher IHM (OR 0.99, 95% CI 0.93 to 1.06). The time-trend analyses of the entire sample showed a significant reduction in mortality in patients with VaD (OR 0.98, 95% CI 0.97 to 0.99).ConclusionsIncidence rates for VaD hospitalisations were twice as high in patients with diabetes compared with those without. Men had significantly higher incidence rates than women, regardless of diabetes status. In both groups studied, pneumonia and parenteral nutrition were associated with mortality while percutaneous endoscopic gastrostomy was associated with survival. Having diabetes was not associated with higher IHM after hospitalisation with VaD.

Dataset Information

Differing trends in the incidence of vascular comorbidity in MS and the general population.

Background

Methods

Results

Conclusions

Publications

Differing trends in the incidence of vascular comorbidity in MS and the general population.

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