Biomedical subjects

L J Launer

Publications and source records attributed to L J Launer.

103 records · Page 6Linked to original sources

PubMed1992

Maternal recall of infant feeding events is accurate.

STUDY OBJECTIVE: Retrospective infant feeding data are important to the study of child and adult health patterns. The accuracy of maternal recall of past infant feeding events was examined and specifically the infant's age when breast feeding was stopped and formula feeding and solid foods were introduced. DESIGN AND SETTING: The sample consisted of Bedouin Arab women (n = 318) living in the Negev in Israel who were a part of a larger cohort participating in a prospective study of infant health and who were delivered of their infants between July 1 and December 15, 1981. Data from interviews conducted 12 and 18 months postpartum were compared to the standard data collected six months postpartum. MAIN RESULTS: As length of recall increased there was a small increase in the mean difference, and its standard deviation, between the standard and recalled age when breast feeding was stopped and formula feeding and solid foods were started. Recall on formula feeding was less accurate than recall on solid foods and breast feeding. In particular, among those 61% reporting formula use at the six month interview, 51% did not recall introducing formula when interviewed at 18 months. The odds ratio (95% CI) of stunting versus normal length for age for formula fed versus breast fed infants based on recall data (OR = 2.07; 95% CI 0.82-5.22) differed only slightly from those based on the standard data (OR = 2.21; 95% CI 0.77-6.37). The accuracy of a mother's recall varied with her child's nutritional status at the time of the interview, but not with other sociodemographic, infant, or interviewer characteristics. CONCLUSIONS: Retrospective infant feeding data based on maternal recall of events up to 18 months in the past can be used with confidence in epidemiological studies. However, data on formula feeding may not be as accurate as data on breast feeding and solid food feeding, and accuracy may decrease as length of recall increases.

Bottle Feeding↗

PubMed1992

Studies on the incidence of dementia: the European perspective.

Dementing diseases, the most common of which are Alzheimer's disease and vascular dementia, are highly prevalent in Europe. To progress further in the search for the etiology of these diseases, incidence studies are needed. Comparison of the data of such studies will be important; the question of whether they produce comparable and interpretable data is therefore critical. We discuss the methodologic differences between earlier and more recent studies conducted in Europe that may account for some of the variation in the incidence rates of the dementia they report. Issues to be explored in the current European studies on the incidence of dementing diseases are also described.

Age Factors↗

PubMed1992

Overview of incidence studies of dementia conducted in Europe.

In the next 10 years findings will become available from various incidence studies on dementing diseases conducted throughout Europe. Comparisons across studies will greatly enhance our understanding of the disease process. Preliminary to these comparisons we conducted a survey of the methodology used in these studies, which is described in this report.

Aged↗

PubMed1992

Epidemiologic approach to the study of dementing diseases: a nested case-control study in European incidence studies of dementia.

In 1994 several European studies will have available risk factor information on incident cases of dementia collected in prospective community-based studies. These centers will collaborate in a nested-case control study based on the pooled cases and a sample of the non-diseased respondents. This paper describes the general design and the risk factors to be studied in a European nested case-control study of Alzheimer's disease and vascular dementia.

Aged↗

PubMed1991

Patterns of variability in the nutrient intake of nutritionally vulnerable pregnant women.

Intra/inter-individual variance ratios for energy, protein, fat and retinol-equivalent intake during the third trimester of pregnancy were calculated. Data were collected on 743 pregnant women from rural Indonesia between 1982 and 1984. Food intake of these women was directly weighed for three consecutive days per month during months 6-9 of pregnancy, yielding 7139 observations for analysis. Ratios were calculated separately for a single month of pregnancy and for the last trimester of pregnancy. The intra/inter-individual variance ratio for kilocalorie and protein intake was less than 1.0 for a single month; it was greater than 1.0 for the trimester. This suggests that women varied their intake of kilocalories and protein more over the course of their pregnancy than they did during one month of their pregnancy. Both the monthly and trimester variance ratios for fat and retinol-equivalent intake were greater than 1.0. Our findings suggest that usual mean intake during the third trimester of pregnancy can be measured with relative precision with two replicates per individual. However, more measurements are needed for regression analyses: measurement error greatly attenuated the coefficients, even though data were collected by the direct weighing method. Thus the number of measurements per individual needed in a study of nutrition and pregnancy depends on the nutrient, the period of 'usual intake' that is of interest, as well as the analytical strategy.

Dietary Fats↗

PubMed1990

Breast feeding protects infants in Indonesia against illness and weight loss due to illness.

The authors tested the hypothesis that breast feeding modifies the effect of morbidity on growth by examining, at different levels of breast feeding: 1) number of days ill; and 2) the relation between morbidity and weight change. A total of 200 observations made at 3-weekly intervals between 1983 and 1984 on 33 breast-fed infants from a rural village on the island of Madura, Indonesia were used. Levels of breast feeding were defined as quartiles (Q1-Q4) of proportion of household visit time spent breast feeding. Regression analysis and analysis of variance were used and within child effects examined. Number of days ill from respiratory tract illness decreased significantly (p = 0.01) as quartile of breast feeding increased. Weight change was not affected by respiratory tract illness in Q2-Q4 but was significantly and negatively affected by such illness in the lowest quartile, Q1 (beta = -22.5 +/- 4.8 g/day ill). The slopes of Q2-Q4 were not significantly different from each other but were significantly different (p = 0.0094) from the Q1 slope. The authors examined whether measurement, reverse causality, or confounding bias changed the interpretation of findings; they did not. The authors conclude that breast feeding protects infants against the nutritional consequences of illness by decreasing the number of days with respiratory tract illness and protecting against weight loss due to this form of illness. However, this protective effect of breast feeding is attained only when levels of breast feeding are adequate, because at the lowest level of breast feeding, illness had a negative impact on weight performance.

Breast Feeding↗

PubMed1990

The effect of maternal work on fetal growth and duration of pregnancy: a prospective study.

The effect on birth outcome of work requiring different degrees of physical exertion was examined among 15,786 pregnant women who were followed through the Guatemalan Social Security Institute's hospital. Work inside and outside the home was ascertained through a questionnaire administered to each women before delivery. Odds ratios were adjusted for household income, maternal height and age, and birthweight of previous infant. Women with three or more children and no household help were at increased risk for small-for-gestational-age (SGA) births compared with women with family (odds ratio (OR) 1.79; 95% confidence interval (CI) 1.31, 2.47) or hired help (OR 2.0; 95% CI 1.16 to 3.33). Compared with office work, manual work increased the risk for an SGA (OR 1.32; 95% CI 1.12 to 1.56) and SGA/preterm birth (OR 2.56; 95% CI 1.10 to 5.96). Work in a standing compared with sitting position significantly increased the risk for a preterm birth (OR 1.56; 95% CI 1.04 to 2.60). There was a significant positive trend in frequency of SGA and SGA/preterm birth with an increase in the physical demands at work, as measured by an activity score. These data suggest that interventions to reduce physical exertion among pregnant women could improve birth outcome.

Adult↗

PubMed1989

Concepts about infant health, growth, and weaning: a comparison between nutritional scientists and Madurese mothers.

Nutrition education is a critical component of programs designed to improve nutritional status, yet it often fails because of differences in the concepts underlying the educational message and those motivating mothers' behavior. To illustrate this discrepancy in the context of infant feeding we compare the views of nutritional scientists' and mothers in Madura, Indonesia on (a) health and disease and (b) the relationship of foods to the concepts of state-of-health, infancy and growth. The relationship of these concepts to mothers' practices and nutritional scientists' recommendations are also explored. Views of the nutritional scientist were drawn from the published literature and those for the Madurese mothers' from ethnographic and survey data gathered between February 1983 and June 1984. While mothers and nutritional scientists both seek to give a diet appropriate for a stage of infancy, their definitions of key concepts differed. Nutritional scientists recommend feeding infants high quality clean foods in amounts sufficient for maintenance, activity and growth. Underlying these recommendations are the concepts of disease as a deviation from the norm, food as a source of pathogens as well as nutrients, infancy as a period of physiological growth, and poor growth as an indicator of disease. All infants have the same type of nutrient requirements. Madurese mothers perceive health and its components as a process of balance. Balance is partly attained either by feeding rice soon after birth or by withholding rice until after one year of age. This concept results in two distinct but coexisting types of requirement and weaning patterns for infants. The important development during an infant's first year of life is 'growth' from a vulnerable state in the 'neonatal' period (40 days) to a state of independence and reason (akal) in late infancy (greater than 7 months). To foster 'growth' in rice-fed infants, mothers force-feed increasing amounts of quality foods. Once akal is achieved, mothers no longer feed quality foods or increase amounts of food, and the infant, not the mother, initiates feeding. These comparisons suggest how nutritional scientists can help improve the process of communication in nutrition programs. First they can describe and analyze the mother's as well as their own conceptual framework to arrive at approaches and messages that blend together points of views. Second, by studying the consequence on infants of mother's behavior, nutritional scientists may gain further insight into the biological processes leading to good nutrition and refine messages and interventions accordingly.

Attitude to Health↗

PubMedDate not supplied

Midlife blood pressure and dementia: the Honolulu-Asia aging study.

We studied the association of mid-life blood pressure to late age dementia, specifically Alzheimer's disease and vascular dementia. Data are from the cohort of 3703 Japanese-American men who were followed in the Honolulu Heart Program (HHP;1965-1971), and subsequently re-examined in 1991 for dementia. We assessed the risk (odds ratio (95% CI)) for dementia associated with categories of systolic (SBP) and diastolic blood pressure (DBP), stratified by never/ever treatment with anti-hypertensive medications, and adjusting for age, education, apolipoprotein epsilon allele, smoking and alcohol intake. Among those never treated (57% sample), the risk for dementia was OR 95% CI 3.8 (1.6-8.7) for DBP of 90-94 mm Hg, and 4. 3 (1.7-10.8) for DBP of 95 mmHg and over compared to those with DBP of 80 to 89 mm Hg. Compared to those with SBP of 110 to 139 mm Hg, the risk for dementia was 4.8 (2.0-11.0) in those with SBP 160 mm Hg and higher. Blood pressure was not associated with the risk for dementia in treated men. These results were consistent for Alzheimer's disease and vascular dementia. This study suggests elevated levels of blood pressure in middle age can increase the risk for late age dementia in men never treated with anti-hypertensive medication.

Age Factors↗

PubMedDate not supplied

Midlife blood pressure and neuritic plaques, neurofibrillary tangles, and brain weight at death: the HAAS. Honolulu-Asia aging Study.

Midlife hypertension is associated with later development of cognitive impairment, vascular dementia (VsD), and possibly Alzheimer's disease (AD). Neuropathic cerebrovascular lesions and brain atrophy have been associated with elevated blood pressure (BP), however, to our knowledge there have been no prospective investigations of an association of blood pressure levels measured in midlife with the microscopic lesions of AD. We investigated the relationship of BP level in midlife to development of neurofibrillary tangles (NFT), neuritic plaques (NP), and low brain weight at autopsy among Japanese-American men who were members of the Honolulu Heart Program/Honolulu-Asia aging Study (HHP/HAAS) cohort. The HHP/HAAS is a population-based, longitudinal study of cognitive function and dementia with 36 years of follow-up. Neocortical and hippocampal NFT and NP were counted per mm(2), and fixed brain weight was measured for 243 decedents. Elevated systolic BP, (> or =160 mm Hg) in midlife was associated with low brain weight and greater numbers of NP in both neocortex and hippocampus. Diastolic BP elevation, (> or =95 mm Hg) was associated with greater numbers of NFT in hippocampus. Results indicate that in addition to the accepted association of high BP with neuropathic cerebrovascular lesions, there is a direct relationship with brain atrophy, NP and NFT.

Aged↗

PubMedDate not supplied

Histamine H2 blocking drugs and the risk for Alzheimer's disease: the Rotterdam Study.

We investigated the cross-sectional relation of the use of histamine H2 blocking drugs and the risk for AD in the population based Rotterdam Study. AD was clinically diagnosed according to DSM-IIIR and NINCDS-ADRDA criteria. Data on medication used in the past week were obtained by having subjects show vials of medications and were classified according to the Anatomical Therapeutic Chemical (ATC) index. There were 7276 subjects with complete data, including 208 with AD and 378 H2 users (ATC code A0BA). Compared to the total cohort of non-H2 users, the relative risk (estimated as the odds ratio) for AD among those taking H2 blockers was 0.95 (95% confidence interval (CI) 0.52-1.75), after controlling for age, education, sex, history of stroke, and use of benzodiazepines and nonsteroidal antiinflammatory drugs. To address unmeasured confounding (by (contra) indication), we compared the risk of AD in H2 users with a subset of subjects using topical medications (ATC code D and S; n = 436). The adjusted OR in this comparison was 1.24 (95% CI 0.52-2.98). These results do not support the hypothesis that use of histamine H2 blocking drugs protect against AD.

Aged↗

PubMedDate not supplied

NSAIDs and incident Alzheimer's disease. The Rotterdam Study.

Recent studies suggest that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce the risk for Alzheimer's disease (AD). We investigated the relation of NSAID use over a 10-year period and the risk for incident AD using a nested case-control design in the population-based Rotterdam Study. The study was performed in 306 subjects; 74 Alzheimer patients diagnosed according to NINCDS-ADRDRA criteria and 232 age and sex-matched controls. NSAID use was abstracted from general practitioners' medical records and expressed as cumulative prescription days. The relative risk for AD associated with long-term use (> or = 2 months) was 0.95 (95% CI: 0.46-1.99) as compared to nonusers, after controlling for possible confounders. In a separate examination, subjects who had more than 6 months of prescription days had a reduced relative risk for AD (RR = 0.74 (95% CI: 0.20-2.72). In an age-stratified analysis the effect in long-term users was evident in those aged 85 and under; 0.53 (95% CI: 0.15-1.77). All risk estimates were lower when the last 2 years of exposure were excluded from the analyses. Our point estimates in subjects younger than 85 years and in subjects using NSAIDs for 6 months or more are consistent with the hypothesis that long-term use of NSAIDs reduces the risk for AD. However, overall there was no association between NSAID use and the risk for incident AD.

Aged↗

PubMedDate not supplied

CASCADE: a European collaborative study on vascular determinants of brain lesions. Study design and objectives.

Dementia is a highly prevalent disease that may have a cardiovascular component. White matter lesions and brain atrophy (brain abnormalities) are prevalent in dementia cases and might form part of the anatomical basis for the disease. We designed a multi-centre study, CASCADE (Cardiovascular Determinants of Dementia), to examine long-term (10-20 years) and short-term (5 years) cardiovascular risk factors for, and the cognitive consequence of, brain abnormalities. White matter lesions and atrophy are measured with magnetic resonance imaging. Cognitive function is measured with nine tests of memory and executive function. The studies included in CASCADE were ongoing and geographically spread throughout Europe to capture the cardiovascular risk gradient. In each study, a random sample of at least 100 subjects aged 65-75 years was selected who participated in the previous research examinations conducted by the respective centres. The objectives and design of the CASCADE project are described.

Aged↗