Dataset Information

Leading Determinants for Disease-Free Status in Community-Dwelling Middle-Aged Men and Women: A 9-Year Follow-Up Cohort Study.

ABSTRACT: Background: Identifying leading determinants for disease-free status may provide evidence for action priorities, which is imperative for public health with an expanding aged population worldwide. This study aimed to identify leading determinants, especially modifiable factors for disease-free status using machine learning methods. Methods: We included 52,036 participants aged 45-64 years from the 45 and Up Study who were free of 13 predefined chronic conditions at baseline (2006-2009). Disease-free status was defined as participants aging from 45-64 years at baseline to 55-75 years at the end of the follow-up (December 31, 2016) without developing any of the 13 chronic conditions. We used machine learning methods to evaluate the importance of 40 potential predictors and analyzed the association between the number of leading modifiable healthy factors and disease-free status. Results: Disease-free status was found in about half of both men and women during a mean 9-year follow-up. The five most common leading predictors were body mass index (6.4-9.5% of total variance), self-rated health (5.2-8.2%), self-rated quality of life (4.1-6.8%), red meat intake (4.5-6.5%), and chicken intake (4.5-5.9%) in both genders. Modifiable behavioral factors including body mass index, diets, smoking, alcohol consumption, and physical activity, contributed to 37.2-40.3% of total variance. Participants having six or more modifiable health factors were 1.63-8.76 times more likely to remain disease-free status and had 0.60-2.49 more disease-free years (out of 9-year follow-up) than those having two or fewer. Non-behavioral factors including low levels of education and income and high relative socioeconomic disadvantage, were leading risk factors for disease-free status. Conclusions: Body mass index, diets, smoking, alcohol consumption, and physical activity are key factors for disease-free status promotion. Individuals with low socioeconomic status are more in need of care.

SUBMITTER: Shang X

PROVIDER: S-EPMC6857185 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Leading Determinants for Disease-Free Status in Community-Dwelling Middle-Aged Men and Women: A 9-Year Follow-Up Cohort Study.

Shang Xianwen X Shang Xianwen X Wang Wei W Keel Stuart S Wu Jinrong J He Mingguang M Zhang Lei L

Frontiers in public health 20191108

<b>Background:</b> Identifying leading determinants for disease-free status may provide evidence for action priorities, which is imperative for public health with an expanding aged population worldwide. This study aimed to identify leading determinants, especially modifiable factors for disease-free status using machine learning methods. <b>Methods:</b> We included 52,036 participants aged 45-64 years from the 45 and Up Study who were free of 13 predefined chronic conditions at baseline (2006-20 ...[more]

PMID: 31781526

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Project description:BackgroundIschaemic heart disease (IHD) often develops after decades of preceding subclinical coronary atherosclerosis. Biomarkers are useful prognostic predictors of IHD, but their long-term predictive value in a general population has not been adequately studied.PurposeTo investigate the early predictive value of multi-modality biomarkers in addition to clinical risk factors in incident IHD in a random male general population sample followed from 50 to 71 years of age.Method"The Study of Men Born in 1943" is a longitudinal cohort study during follow-up. All the men underwent a baseline examination in 1993, where a panel of biomarkers were analysed and incident IHD was registered during 21-year follow-ups.ResultsOf 739 participants, 97 men (13.1%) developed an IHD event. For time to first occurrence of IHD, univariable analyses showed that elevated levels of high sensitivity troponin T (hs-TNT), high sensitivity-C reactive protein (hs-CRP) and interleukin-6 (IL-6) were significant predictors of IHD. In addition, a high number of biomarkers with elevated levels (hs-TNT?>?10 ng/L, hs-CRP?>?1 mg/L, IL-6?>?8 ng/L and N-terminal pro b-type natriuretic peptide (NT-proBNP)?>?100 pg/mL) increased predictive ability. In univariable and multivariable analysis high-density lipoprotein-cholesterol (HDL-C) had the highest predictive ability. Hs-TNT provided better predictive ability than smoking, body mass index and glucose, and was an independent significant predictor when adjusted for HDL-C, total cholesterol and hypertension. Addition of biomarkers on top of clinical risk factors provided significantly better prediction as tested by likelihood ratio test (p?=?0.033), but did not significantly enhance the model's discriminative ability However, it appeared contributing to higher sensitivity in the late phase of follow-up.ConclusionIn this random, middle-aged male population sample, the addition of biomarker hs-TNT was an independent significant predictor of IHD and significantly improved prediction, indicating the probability of a better prediction of long-term risk of IHD in a low-risk population.Trial registrationThe study is registered at Clinical Trials.gov Identifier number: NCT03138122.

Project description:Background: Determining the incidence, progression, and patterns of multimorbidity are important for the prevention, management, and treatment of concurrence of multiple conditions. This study aimed to analyze major multimorbidity patterns and the association of the onset of a primary condition or combinations of a primary and a secondary condition with the progression to subsequent conditions. Methods: We included 53,867 participants aged 45-64 years from the 45 and Up Study who were free of 10 predefined chronic conditions at baseline (2006-2009). The incidence of multimorbidity (coexistence of ≥2, ≥3, and ≥4 conditions) was identified using the claims database until December 31, 2016. The primary, secondary, tertiary, and quaternary condition for each participant was defined according to its temporal order of onset. Results: During a mean 9-years follow-up, the cumulative incidence of primary, secondary, tertiary, and quaternary conditions was 49.6, 23.7, 9.0, and 2.9%, respectively. The time to develop a subsequent condition decreased with the accumulation of conditions (P < 0.0001). Two concurrent cardiometabolic disorders (CMDs, 30.4%) and CMDs clustered with musculoskeletal disorders (15.2%), mental disorders (13.5%), asthma (12.0%), or cancer (8.7%) were the five most common multimorbidity patterns. CMDs tended to occur prior to mental or musculoskeletal disorders but after the onset of cancers or asthma. Compared with all participants who developed cancer as a primary condition, individuals who experienced mental disorders/neurodegenerative disorders and a comorbidity as cardiovascular disease, hypertension, dyslipidemia, diabetes, asthma, or osteoarthritis were 3.36-10.87 times more likely to develop cancer as a tertiary condition. Individuals with neurodegenerative disorders and a comorbidity as hypertension, dyslipidemia, osteoarthritis, or asthma were 5.14-14.15 times more likely to develop mental disorders as a tertiary condition. Conclusions: A high incidence of multimorbidity in middle-aged adults was observed and CMDs were most commonly seen in multimorbidity patterns. There may be accelerated aging after a primary condition occurs. Our findings also reveal a potential preventative window to obviate the development of secondary or tertiary conditions.

Dataset Information

Leading Determinants for Disease-Free Status in Community-Dwelling Middle-Aged Men and Women: A 9-Year Follow-Up Cohort Study.

Publications

Leading Determinants for Disease-Free Status in Community-Dwelling Middle-Aged Men and Women: A 9-Year Follow-Up Cohort Study.

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