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Biomedical subjects

M Schroll

Publications and source records attributed to M Schroll.

At least 37 records · Page 2Linked to original sources
PubMed2001

Trends in incidence, case-fatality and recurrence of myocardial infarction in the Danish MONICA population 1982-1991.

BACKGROUND: Growing awareness of risk factors for myocardial infarction (MI), continuous mass campaigns on lifestyle factors, increasing use of heart rehabilitation and improved treatment should imply decreases in the incidence, case-fatality and recurrence rates of MI. The purpose of the study was to assess trends in the incidence, case-fatality and recurrence rate of MI and to analyse whether any changes seen were due to a period or a cohort effect. METHODS: The Danish MONICA population comprises all men and women aged 25-74 years in the period 1982-1991 living in a suburban area of Copenhagen, Denmark. Fatal and non-fatal attacks classified as definite MI and non-fatal attacks classified as possible MI were included. The incidence rate was analysed by Poisson regression, the case-fatality rate by logistic regression, and the rate of recurrence by Cox regression. Age-period-cohort analyses were carried out according to a method described by Clayton and Schifflers. RESULTS: During the 10-year period a significant decrease in the incidence rate of MI was seen for men and women and for the rate of recurrent MI. The decrease in incidence and recurrence could not unambiguously be ascribed to a period or cohort effect. The rate of case-fatality after a first MI was not changed significantly during the period, whereas men and women had different trends in case-fatality after recurrent MI. CONCLUSIONS: In accordance with results from other Western countries we found a decline in the incidence and recurrence rate of MI. Contrary, the lack of a decrease in the case-fatality rate after a first MI was unexpected and difficult to explain.

Adult↗
PubMed2001

A longitudinal study of gender differences in depressive symptoms from age 50 to 80.

The Obvious Depression Scale was administered to 739 community residents at ages 50, 60, and 80 years, with 151 present at all waves. Although selective attrition influenced the level of depressive symptoms in cross-sectional vs. longitudinal samples, both sets of analyses revealed higher scores in women than in men at ages 50 and 60, but not at age 80. Men showed increases in depressive symptoms from age 60 to 80, but women did not (interaction p < .002). This interaction was not present in somatic symptoms, which increased across time in both genders. Potential explanations include differential changes in social roles with aging.

Age Distribution↗
PubMed2001

A six months' prospective follow-up of 65+-y-old patients from general practice classified according to nutritional risk by the Mini Nutritional Assessment.

OBJECTIVE: To assess the prevalence of old people at risk of undernutrition according to the Mini Nutritional Assessment (MNA), characterise the at risk group with regard to nutritional state, energy intake, and physical and mental functioning, and to assess the consequences of the MNA score over a 6 month period. DESIGN: A cross-sectional prospective study. SETTING: The clinic of a general practitioner. SUBJECTS: Ninety-four patients 65+-y-old with no acute illness contacted at the clinic. Sixty-one subjects (65%) agreed to participate at baseline and 34 (56%) showed up at the follow-up 6 months later. RESULTS: At baseline, 23 (38%) participants were assessed as being at risk of undernutrition (17-23.5 MNA points). The remaining were classified as well-nourished (>23.5 MNA points). The 23 participants at risk had a higher prevalence of body mass index (BMI) <20 kg/m(2) (44 vs 11%, P<0.001) and insufficient energy intake (36 vs 9%, P<0.05), compared with the well-nourished group. Also, they had a higher need of meals-on-wheels (39 vs 8%, P<0.01) and home-care for shopping (48 vs 18%, P<0.05) at baseline. At the 6 months' follow-up, there was a tendency to a higher non-participation rate among the participants assessed at risk of undernutrition at baseline (44 vs 18%, 0.05<P<0.1), compared with the well-nourished group. There was a tendency to a higher prevalence of hospitalisation (38 vs 19%, 0.05<P<0.1) in the at risk group. CONCLUSION: MNA seems to be a useful tool to identify old people who need help from the public sector. However, many in the group at risk of undernutrition already have low BMI values. This might have influenced the findings.

Aged↗
PubMed2001

Increasing prevalence of diabetes mellitus and impaired glucose tolerance among 60-year-old Danes.

AIMS: The age-specific prevalence of diabetes mellitus and impaired glucose tolerance (IGT) was estimated in 60-year-old individuals in 1996/97 and compared to the prevalence in 1974/75. The study also examined whether or not the change in prevalence of diabetes and IGT could be explained by changes in body mass index (BMI) and physical activity. METHODS: Diabetes and IGT were diagnosed by a standardized oral glucose tolerance test (OGTT) in two Danish population-based, age-specific, birth cohorts. RESULTS: The prevalence of diabetes in 1996/97 was 12.3% among 60-year-old men and 6.8% among women, representing an increase in diabetes of 58% in men and 21% in women compared to 1974/75. The prevalence of IGT was 15.9% among men and 13.1% among women, representing increases of 109 and 16%, respectively. A concurrent increase in BMI in the 22-year period between the two studies explained the increase found in the prevalence of diabetes and IGT. CONCLUSIONS: A marked increase in the prevalence of diabetes and IGT among 60-year-old individuals over a 22-year period was observed - especially in men. The increase was fully explained by a concurrent increase in BMI.

Blood Glucose↗
PubMed2001

Healthy centenarians do not exist, but autonomous centenarians do: a population-based study of morbidity among Danish centenarians.

OBJECTIVE: To assess the prevalence of common illnesses in an unselected population of centenarians. DESIGN: A population-based survey. SETTING: Denmark. PARTICIPANTS: All Danes who celebrated their 100th anniversary between April 1, 1995 and May 31, 1996: 276 persons. MEASUREMENTS: All participants (including proxies) were visited at their domicile for an interview (sociodemographic characteristics, activities of daily living, living conditions, need of assistance from other people, former health and current diseases, current medication) and a clinical examination (dementia screening test, heart and lung auscultation, neurological assessment, height and weight, electrocardiogram, arm and ankle blood pressure, assessment of hearing and vision capacity, a short physical performance test, bio-impedance, lung function test, blood test). Further health information was retrieved from medical files and national health registers. RESULTS: Seventy-five percent (207) of eligible subjects participated in the study. Cardiovascular disease was present in 149 (72%) subjects. Osteoarthritis (major joints) was present in 54%, hypertension (> or =140/ > or =90) in 52%, dementia in 51%, and ischemic heart disease in 28%. The mean number of illness was 4.3 (standard deviation (SD) 1.86). Only one subject was identified as being free from any chronic condition or illness. Sixty percent had been treated for illness with high mortality. In 25 autonomous (nondemented, functioning well physically, living at home) and 182 nonautonomous centenarians, comorbidities were equivalent. CONCLUSION: Because they have a high prevalence of several common diseases and chronic conditions, Danish centenarians are not healthy. However, a minor proportion was identified as being cognitively intact and functioning well.

Activities of Daily Living↗
PubMed2001

Functional ability and oral health among older people: a longitudinal study from age 75 to 80.

OBJECTIVE: To examine whether functional ability at age 75 and age 80 is associated with oral health and use of dental services cross-sectionally and whether changes in functional ability from age 75 to age 80 are associated with oral health and regular use of dental services at age 80. DESIGN: The study included a random sample of 75-year-olds at baseline and a follow-up study 5 years later. The data are treated as two cross-sectional studies at age 75 and 80, respectively, and as a longitudinal study from age 75 to 80. SETTING: The western part of Copenhagen County. PARTICIPANTS: The two cross-sectional studies of 75- and 80-year-old people included 411 and 321 persons, respectively. The longitudinal study from age 75 to 80 included the 326 persons who participated in both surveys. MEASUREMENTS: Oral health status was measured roughly by number of teeth and chewing ability. Use of dental services was measured by frequency of visits to a dentist or denturist. Functional ability was measured by two scales on mobility in relation to tiredness and need of help. Changes in mobility from age 75 to 80 is described as (1) improved or sustained good, (2) decreased, and (3) sustained poor. Gender, chronic diseases, self-rated health, socio-demographic factors, living alone, and social relations were included as possible confounders. RESULTS: The odds ratio of having no or few teeth was 1.7 (1.1-2.6) in 75-year-old individuals who felt tired in mobility, 1.7 (1.0-2.9) in 80-year-old persons who needed help with mobility, and 2.7 (0.94-7.5) in persons with sustained need of help with mobility from age 75 to 80. The odds ratio of chewing difficulties was 1.7 (1.1-2.8) in 80-year-old people in need of help, and 1.8 (1.1-3.0) in persons age 75 to 80 needing sustained help. Dentate 80-year-old persons who felt tired in mobility had an odds ratio of 2.0 (0.94-4.2) of not using dental services. CONCLUSIONS: The results indicate that oral impairment (e.g., having no or few teeth), oral functional limitations (e.g., chewing problems), and general functional limitations (e.g., mobility problems) are interrelated and that prevention of disabilities should be aimed at both functional limitations and oral health problems if the intention is to promote a good life in old age. In addition, the results point to the importance of taking problems in mobility seriously in delivering preventive services to old people because people who are tired or dependent on help seem to be at a higher risk of not using dental services regularly.

Activities of Daily Living↗
PubMed2001

Dietary patterns and mortality in Danish men and women: a prospective observational study.

The analysis of dietary patterns emerged recently as a possible approach to examining diet-disease relation. We analysed the risk of all-cause and cardiovascular mortality associated with dietary patterns in men and women, while taking a number of potential confounding variables into account. Data were from a prospective cohort study with follow-up of total and cause-specific mortality. A random sample of 3698 men and 3618 women aged 30-70 years and living in Copenhagen County, Denmark, were followed from 1982 to 1998 (median 15 years). Three dietary patterns were identified from a twenty-eight item food frequency questionnaire, collected at baseline: (1) a predefined healthy food index, which reflected daily intakes of fruits, vegetables and wholemeal bread, (2) a prudent and (3) a Western dietary pattern derived by principal component analysis. The prudent pattern was positively associated with frequent intake of wholemeal bread, fruits and vegetables, whereas the Western was characterized by frequent intakes of meat products, potatoes, white bread, butter and lard. Among participants with complete information on all variables, 398 men and 231 women died during follow-up. The healthy food index was associated with reduced all-cause mortality in both men and women, but the relations were attenuated after adjustment for smoking, physical activity, educational level, BMI, and alcohol intake. The prudent pattern was inversely associated with all-cause and cardiovascular mortality after controlling for confounding variables. The Western pattern was not significantly associated with mortality. This study partly supports the assumption that overall dietary patterns can predict mortality, and that the dietary pattern associated with the lowest risk is the one which is in accordance with the current recommendations for a prudent diet.

Adult↗
PubMed2001

Validation of the Resident Assessment Instrument triggers in the detection of under-nutrition.

OBJECTIVE: To test the validity of Resident Assessment Instrument triggers for people in Danish nursing homes and subjects receiving home care by exploring their ability to identify older people with insufficient energy and protein intake. DESIGN: Regression analysis of insufficient energy or protein intake on each of the Resident Assessment Instrument triggers alone or in combination. SUBJECTS: 38 people receiving home care and 41 living in nursing homes. METHODS: A 4 day estimated dietary record, assessment of energy and protein intake, calculation of body mass index. RESULTS: Food remaining on the plate, weight loss and any trigger present significantly influenced the energy or protein intake of the nursinghome subjects. No triggers reflected the energy or protein intake of the subjects at home. CONCLUSION: Observation of food intake seems to be the best way to detect which older Danish people living in nursing homes or receiving home care have insufficient energy or protein intake.

Aged↗
PubMed2001

Food intake patterns, self rated health and mortality in Danish men and women. A prospective observational study.

OBJECTIVE: To examine whether self rated health confounds or modifies the relation between a prudent food intake pattern and mortality and to study whether the prudent food intake pattern predicts subsequent changes in self rated health. DESIGN: A prospective cohort study with follow up of total mortality and changes in self rated health. Food intake patterns were identified by principal component analysis from a 28 item food frequency questionnaire, collected at baseline. SETTING: MONICA surveys, Copenhagen County, Denmark. PARTICIPANTS: A random sample of 3698 men and 3618 women aged 30-70 years were followed up from 1982 to 1998 (median 15 years). MAIN RESULTS: Among participants with complete information on all variables 18% had rated their health as poor (average or bad) at the baseline examination. Poor self rated health was related to a low score on the prudent food intake pattern, which was characterised by a frequent intake of wholemeal bread, fruit and vegetables. Three hundred and seventy six men and 210 women died during follow up. Poor self rated health and a low prudent food score were associated with increased mortality in both men and women. Self rated health did not modify the relation between diet and mortality. Of the 1098 men and 1048 women with good self rated health at baseline, 243 men and 297 women reported poor health during follow up. Low prudent food score, smoking, and high BMI increased the risk of developing poor health in both men and women, but in multivariate analysis the associations attenuated and were only significant for BMI. CONCLUSION: Both prudent food intake pattern and self reported health are independent predictors of mortality. Self rated health does not seem to modify the relation between diet and mortality.

Adult↗
PubMed2001

Tiredness as determinant of subsequent use of health and social services among nondisabled elderly people.

OBJECTIVE: To examine whether self-reported tiredness in daily activities at age 75 is an independent determinant of incident hospitalization and use of home services 5 years later. METHODS: In all, 275 people participated in a prospective study in Glostrup, Denmark, when they were 75 and 80 years old. Four subgroups were created according to whether participants had been hospitalized or used home care in the year before the baseline study and whether or not they were disabled at the time. The key predictor variables were measured by two scales about tiredness in daily activities. RESULTS: Nondisabled individuals who felt tired in their daily activities had about twice the risk of being hospitalized and of being users of home help 5 years later. CONCLUSIONS: Because tiredness in daily activities is related to subsequent hospitalization and use of home help, it should be taken seriously in preventive services among elderly people.

Activities of Daily Living↗
PubMed2001

Socioeconomic status and trends in alcohol drinking in the Danish MONICA population, 1982-92.

AIMS: To examine trends in alcohol drinking in different educational groups. METHODS: Data from three cross-sectional WHO MONICA surveys conducted in 1982-84, 1987, and 1991-92 were analysed to estimate trends in abstention, moderate, heavy, and sporadic heavy alcohol use in relation to level of education, age and smoking. In total, 6,695 Danish men and women aged 30, 40, 50, and 60 years were included. RESULTS: Alcohol drinking decreased in both men and women during the study period, but changes were only significant among the highest educated. In the highest educated men the prevalence of moderate alcohol use increased from 77 to 82%, while heavy alcohol use declined from 19 to 12%. In the highest educated women the prevalence of abstention increased from 15 to 22%, while moderate alcohol use declined from 78 to 68%. CONCLUSION: During the 1980s, alcohol drinking decreased among the highest educated men and women and an educational gradient in alcohol drinking widened in men and attenuated in women.

Adult↗
PubMed2001

Quality control including validation in dietary surveys of elderly subjects. The validation of a dietary history method (the SENECA-method) used in the 1914-population study in Glostrup of Danish men and women aged 80 years.

BACKGROUND: Quality control including validation in dietary surveys is needed to reduce and detect errors which would lead to an attenuated scientific foundation for the diet-disease relationship. Especially studies in the elderly are needed because of limited knowledge of reference values, cut-off values etc. OBJECTIVE: To validate a modified dietary history method (the SENECA-method) in elderly subjects. DESIGN: A survey of Danish men and women aged 80 years, who participated in the 1914-population study in Glostrup. SUBJECTS AND METHOD: A pilot study (n = 34) validated the dietary history against 24-h urine collections; a main study (n = 240) compared dietary history with a 3-day estimated food record. RESULTS: Protein intake from dietary history was 10% higher than calculated protein intake from 24-h urine collections. Differences in intakes of energy and macronutrients between dietary history and 3-day food record were generally small and non-significant, and there was good agreement between the methods in classifying nutrient intakes into same tertiles. A Bland & Altman plot indicated increasing differences in energy intake between methods with increased energy intake. Evidence for under-reporting of energy intake and/or over-reporting of the physical activity level was further made plausible when physical activity ratio was compared to recognized cut-off limits. CONCLUSIONS: The modified dietary history method can be used to estimate dietary intake in 80 year old subjects, but some degree of misreporting, especially under-reporting, appears to be present. Keeping this in mind it is, however, possible to analyse dietary intake against other survey data.

Aged↗
PubMed2000

TNF-alpha, leptin, and lymphocyte function in human aging.

Aging is associated with increased inflammatory activity and concomitant decreased T cell mediated immune responses. Leptin may provide a link between inflammation and T cell function in aging. The aim of the study was to investigate if plasma levels of tumor necrosis factor (TNF)-alpha were associated with leptin, circulating interleukin-2 receptors (sIL-2R), and phytohaemagglutinin (PHA) induced IL-2 production in whole blood in elderly humans. Circulating levels of TNF-alpha and sIL-2R were higher in elderly humans (N=42) compared to a young control group (N=37) whereas there was no difference with regard to IL-2 production. Furthermore, there were no age-related differences in serum levels of leptin. However, women had higher levels than men. In the elderly people, serum levels of leptin were correlated with TNF-alpha in univariate regression analysis and in a multiple linear regression analysis adjusting for the effect of gender and body mass index. Furthermore, TNF-alpha, but not leptin, was positively correlated to sIL-2R and negatively correlated to IL-2 production. In conclusion, increased plasma levels of TNF-alpha in aging is associated with poor IL-2 production ex vivo and lymphocyte activation in vivo. These associations do not seem to involve leptin.

Adolescent↗
PubMed2000

All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work.

BACKGROUND: Physical activity is associated with low mortality in men, but little is known about the association in women, different age groups, and everyday activity. OBJECTIVE: To evaluate the relationship between levels of physical activity during work, leisure time, cycling to work, and sports participation and all-cause mortality. DESIGN: Prospective study to assess different types of physical activity associated with risk of mortality during follow-up after the subsequent examination. Mean follow-up from examination was 14.5 years. SETTING: Copenhagen University Hospital, Copenhagen, Denmark. PARTICIPANTS: Participants were 13,375 women and 17,265 men, 20 to 93 years of age, who were randomly selected. Physical activity was assessed by self-report, and health status, including blood pressure, total cholesterol level, triglyceride levels, body mass index, smoking, and educational level, was evaluated. MAIN OUTCOME MEASURE: All-cause mortality. RESULTS: A total of 2,881 women and 5,668 men died. Compared with the sedentary, age- and sex-adjusted mortality rates in leisure time physical activity groups 2 to 4 were 0.68 (95% confidence interval, 0.64-0.71), 0.61 (95% confidence interval, 0.57-0.66), and 0.53 (95% confidence interval, 0.41-0.68), respectively, with no difference between sexes and age groups. Within the moderately and highly active persons, sports participants experienced only half the mortality of nonparticipants. Bicycling to work decreased risk of mortality in approximately 40% after multivariate adjustment, including leisure time physical activity. CONCLUSIONS: Leisure time physical activity was inversely associated with all-cause mortality in both men and women in all age groups. Benefit was found from moderate leisure time physical activity, with further benefit from sports activity and bicycling as transportation.

Adult↗
PubMed2000

Trends in selected biological risk factors for cardiovascular diseases in the Danish MONICA population, 1982-1992.

Data from 6695 men and women of ages 30, 40, 50, and 60 years, examined in the Danish WHO MONICA surveys in 1982-84, in 1986-87, and in 1991-92, were analyzed to estimate secular trends in body height and weight, blood pressure, and serum total, HDL-, and LDL-cholesterol, and triglyceride. Body height increased 0.1% per year, and body mass index increased 0.4% per year in women. Diastolic blood pressure increased 0.4% per year in women and 0.6% per year in 60-year-old men. HDL cholesterol declined 0.4% per year. Body mass indices in men, diastolic blood pressures in men <60 years of age, systolic blood pressures, total- and LDL cholesterol and triglyceride did not change. The levels of biological risk factors in the Danish WHO MONICA study population did not show trends during the 1980s that help explain the declining incidence of myocardial infarction in the population.

Adult↗
PubMed2000

Proliferative responses of blood mononuclear cells (BMNC) in a cohort of elderly humans: role of lymphocyte phenotype and cytokine production.

Age-related impaired T cell function is associated with increased mortality risk. The purpose of the present study was therefore to identify factors associated with the age-related decreased phytohaemagglutinin (PHA)-induced proliferative response of lymphocytes in a cohort of 174 81-year-old humans and in 91 young controls. Decreased proliferation was associated with a reduced number of true naive CD4+ cells (CD62L+CD45RO-). Furthermore, a low IL-2-stimulated proliferation was correlated with a decreased PHA response in the elderly cohort, whereas reciprocal interactions of IL-10- and IL-2-producing cells were of importance in both elderly and young subjects. Accordingly, a minimum of true naive CD4+ cells was required for a normal proliferative response to PHA, perhaps by providing sufficient IL-2 which is critical for growth of naive as well as memory cells.

Adult↗