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PubMed1993

Comparative evaluation of serum CA 195 and carcinoembryonic antigen in metastatic carcinoma.

BACKGROUND: Carcinoembryonic antigen (CEA) is a well-described human tumor-associated antigen most useful clinically in colon cancer. However, the clinical usefulness of CEA is limited by the marker's overall poor specificity and low sensitivity in patients with minimal disease. CA 195 is a recently discovered human tumor-associated glycoprotein that can be measured in serum using an immunoradiometric assay. CA 195 is expressed on the membrane of human colon cancer cells and shares an epitope with the Lewis A blood group antigens. The authors initiated a study to compare the clinical utility of serum CA 195 with CEA in patients with advanced cancer. A control population was studied to assess the effects of age, gender, alcohol, and tobacco on the measured levels of serum CA 195. METHODS: Using a solid-phase two-site immunoradiometric assay, serum CA 195 and CEA levels were measured in 71 control subjects and 167 patients with a prior diagnosis of cancer. The tumor histologic types included breast cancer, 49 patients; colon cancer, 38; prostate cancer, 24; lung cancer, 22; gastrointestinal noncolon cancer, 7; and miscellaneous, 27. Among patients with a history of cancer, 124 (74%) had active metastatic disease, and 43 (26%) were without evidence of active disease. The control population was composed of subjects without a history of malignancy. Clinical data collected from them included age, gender, smoking history, and alcohol consumption. RESULTS: In this laboratory, the normal ranges established for CA 195 and CEA in the control group were: 0.0-8.3 U/ml and 0.2-4.2 ng/ml, respectively. In the control subjects, the serum CA 195 level, unlike that of CEA, was not affected by age, gender, alcohol consumption, or tobacco use. In the study population, CA 195 had either equivalent or inferior specificity and sensitivity to CEA in all tumor types. A determination of the additive specificity and sensitivity of CA 195 and CEA did not significantly improve its clinical utility compared with CEA alone. However, CA 195 was significantly elevated in three patients with a prior history of colon cancer thought to be without evidence of active disease. Because all three of these patients had a relapse within the next 1-15 months, CA 195 might identify early relapses of colon cancer in some patients. CONCLUSIONS: Based on these results, it was concluded that CA 195 is not superior to CEA as an indicator of disease activity in advanced colon cancer or other solid tumors. However, studies utilizing CA 195 in the detection of early relapses of colon cancer may be warranted. A review of the English literature revealed that CA 195 might be a useful marker in pancreatic cancer.

Aged↗
PubMed1996

Evaluation of associations between breast feeding and subsequent development of juvenile rheumatoid arthritis.

OBJECTIVE: To determine if previously breast fed children are more or less likely to have developed juvenile rheumatoid arthritis (JRA). Reports suggest that non-breast fed children are more likely to develop certain diseases for which an autoimmune pathogenesis is suspected. METHODS: Data from a longitudinal, case controlled population survey of childhood rheumatic diseases in Saskatchewan, Canada, included information pertaining to breast feeding history. These data were analyzed in the context of a retrospective, case controlled study to confirm results of an earlier report in which JRA was found to occur less frequently in previously breast fed children. For this analysis a child who had been breast fed for any length of time was categorized as having been a breast fed subject. RESULTS: A population of 88 children with pauciarticular JRA were more likely than an unmatched control population of 331 healthy children (p = 0.01) or those with polyarticular JRA (p = 0.006) to have been breast fed. However, when corrected for the number of comparisons made, statistical significance was not achieved 49 children with polyarticular JRA did not have a breast feeding history significantly different from the unmatched control population. In a retrospective, case control analysis of 54 children with pauciarticular JRA and 23 children with polyarticular JRA, no significant differences were noted when the JRA populations were compared to the parent selected, matched control populations (odds ratio for pauciarticular JRA 2.17: confidence interval 0.87-5.44; p = 0.06 and for polyarticular JRA 1.17: CI 0.33-4.20: p = 0.78). CONCLUSION: These results do not indicate a strong relationship between antecedent breast feeding and the subsequent onset of JRA and fail to confirm the results of earlier analyses in which JRA was found to occur more frequently in children who had not been breast fed.

Age Factors↗
PubMed1995

Immunoglobulin allotype frequencies in responders and nonresponders to the Rh(D) antigen.

Immunoglobulin allotype frequencies were determined in well characterised groups of responders (n = 160) and non-responders (n = 32) to Rh(D) antigen immunisation. Allotype frequencies in these groups were compared with frequencies in a normal control population (n = 500). No significant differences in allotype frequencies were observed between the responder and non-responder groups, or when these two groups where compared with a normal control population. These results suggest that the immunoglobulin heavy-chain genes do not influence the anti-Rh(D) immune response.

Female↗
PubMed1985

Cancer in rheumatoid arthritis: a prospective long-term study of mortality.

Eight hundred and five consecutive patients with definite or classic rheumatoid arthritis, representative of a general population, were followed prospectively over an average of 12 years with 94 percent follow-up, during which time 233 patients died. Mortality rates were increased in rheumatoid arthritis by approximately 50 percent compared with population controls. "Excess deaths" (78) were due, in part, to disease-related causes, infections, and gastrointestinal problems secondary to therapy. Thirty-one deaths (14.1 percent) were due to malignancy, compared with 22.8 percent in non-age-adjusted population controls. Frequency of malignancy type (colon seven, lung four, breast three, prostate three, leukemia three, ovary three, stomach two, and lymphoma zero) did not differ significantly from the general population. Age-adjusted figures showed lower malignancy rates for patients with rheumatoid arthritis except after age 80. Two treatments were suitable for analysis. Gold-treated patients trended toward lower malignancy rates (11 versus 17 percent) than did those not treated with gold, and prednisone-treated patients had less malignancy (11 versus 20 percent) than did those not treated with prednisone. These data indicate that there is not an important increase in deaths due to malignancy in rheumatoid arthritis, and that at least two treatments, gold and prednisone, are not associated with higher risk of malignancy.

Adolescent↗
PubMed2005

The plasma hemostatic proteome: thrombin generation in healthy individuals.

BACKGROUND AND OBJECTIVES: The range of plasma concentrations of hemostatic analytes in the population is wide. In this study these components of blood coagulation phenotype are integrated in an attempt to predict clinical risk. METHODS: We modeled tissue factor (TF)-induced thrombin generation in the control population (N = 473) from the Leiden Thrombophilia Study utilizing a numerical simulation model. Hypothetical thrombin generation curves were established by modeling pro- and anticoagulant factor levels for each individual. These curves were evaluated using parameters which describe the initiation, propagation and termination phases of thrombin generation, i.e. time to 10 nm thrombin (approximate clot time), total thrombin and the maximum rates and levels of thrombin generated. RESULTS AND CONCLUSIONS: The time to 10 nm thrombin varied over a 3-fold range (2.9-9.5 min), maximum levels varied over a approximately 4-fold range (200-800 nm), maximum rates varied approximately 4.8-fold (90-435 nm min(-1)) and total thrombin varied approximately 4.5-fold (39-177 microm s(-1)) within this control population. Thrombin generation curves, defined by the clotting factor concentrations, were distinguished by sex, age, alcohol consumption, body mass index (BMI) and oral contraceptive (OC) use (OC > sex > BMI > age). Our results show that the capacity for thrombin generation in response to a TF challenge may represent a method to identify an individual's propensity for developing thrombosis.

Adult↗
PubMed2005

Increased cardiovascular disease risk indices in HIV-infected women.

Little is known regarding cardiovascular disease risk indices in HIV-infected women. This study investigated cardiovascular disease risk indices in 100 consecutively recruited HIV-infected women and 75 healthy female control subjects. Subjects were recruited from hospital- and community-based health care providers. C-reactive protein (CRP), interleukin-6 (IL-6), adiponectin, lipid, and glucose levels were the main outcome measures. CT scan, dual-energy x-ray absorptiometry (DXA), and anthropometry were used to assess body composition. Although similar in age, weight, and racial composition, HIV-infected women demonstrated higher CRP (4.6 +/- 0.7 vs. 2.3 +/- 0.4 mg/L, P = 0.007), IL-6 (2.7 +/- 0.2 vs. 1.8 +/- 0.1 pg/mL, P = 0.02), triglyceride (1.84 +/- 0.21 vs. 0.85 +/- 0.05 mM, P = 0.0002), 2-hour glucose after oral glucose challenge (6.88 +/- 0.22 vs. 5.72 +/- 0.17 mM, P = 0.0003), and fasting insulin (81 +/- 8 vs. 45 +/- 2 pM, P = 0.0002) and lower high-density lipoprotein cholesterol (1.17 +/- 0.03 vs. 1.45 +/- 0.05 mM, P < 0.0001) and adiponectin (5.4 +/- 0.3 vs. 7.6 +/- 0.5 mg/L, P = 0.0001) levels compared with the control population. HIV-infected women had more abdominal visceral fat and less extremity fat by CT and DXA scan and demonstrated a higher waist-to-hip ratio (WHR) than the control population. Within the HIV group, CRP and other indices were significantly related to body composition in stepwise regression models. Among all subjects, WHR, but not HIV status, was significantly related to CRP and other cardiovascular disease risk indices. HIV-infected women demonstrate significantly increased risk factors for cardiovascular disease in association with abnormal fat distribution.

Absorptiometry, Photon↗
PubMed2004

Effectiveness of sexual selection in preventing fitness deterioration in bulb mite populations under relaxed natural selection.

Under the 'good genes' mechanism of sexual selection (SS), females benefit from mate choice indirectly: their offspring inherit genes of the preferred, high quality fathers. Recent models assume that the genetic variance for male quality is maintained by deleterious mutations. Consequently, SS can be predicted to remove deleterious mutations from populations. We tested this prediction by relaxing selection in populations of the bulb mite, thus increasing their rate of accumulation of deleterious mutation. SS, allowed to operate in half of these populations, did not prevent the fitness decline observed in the other half of the relaxed selection lines. After 11 generations of relaxed selection, female fecundity in lines in which males were allowed to compete for females declined compared with control populations by similar amount as in monogamous lines (17.5 and 14.5%, respectively), whereas other fitness components (viability, longevity, male reproductive success) did not differ significantly between both types of lines and control populations.

Analysis of Variance↗
PubMed2006

Nonsteroidal anti-inflammatory drugs and the esophageal inflammation-metaplasia-adenocarcinoma sequence.

Observational studies suggest that nonsteroidal anti-inflammatory drugs (NSAIDs) reduce the risk of esophageal adenocarcinoma, but it is not known at what stage they may act in the esophageal inflammation-metaplasia-adenocarcinoma sequence. In an all-Ireland case-control study, we investigated the relationship between the use of NSAIDs and risk of reflux esophagitis, Barrett's esophagus, and esophageal adenocarcinoma. Patients with esophageal adenocarcinoma, long-segment Barrett's esophagus and population controls were recruited from throughout Ireland. Esophagitis patients were recruited from Northern Ireland only. Data were collected on known and potential risk factors for esophageal adenocarcinoma and on the use of NSAIDs, including aspirin, at least 1 year before interview. Associations between use of NSAIDs and the stages of the esophageal inflammation-metaplasia-adenocarcinoma sequence were estimated by multiple logistic regression. In total, 230 reflux esophagitis, 224 Barrett's esophagus, and 227 esophageal adenocarcinoma and 260 population controls were recruited. Use of aspirin and NSAIDs was associated with a reduced risk of Barrett's esophagus [odds ratio [OR; 95% confidence interval (95% CI)], 0.53 (0.31-0.90) and 0.40 (0.19-0.81), respectively] and esophageal adenocarcinoma [OR (95% CI), 0.57 (0.36-0.93) and 0.58 (0.31-1.08), respectively]. Barrett's esophagus and esophageal adenocarcinoma patients were less likely than controls to have used NSAIDs. Selection or recall bias may explain these results and the results of previous observational studies indicating a protective effect of NSAIDs against esophageal adenocarcinoma. If NSAIDs have a true protective effect on the esophageal inflammation-metaplasia-adenocarcinoma sequence, they may act early in the sequence.

Acetaminophen↗
PubMed2006

Prophylactic therapy for patients with reproductive failure who were positive for anti-phospholipid antibodies.

PROBLEM: To elucidate the efficacy of the treatment using a Japanese-modified Chinese herbal medicine, Sairei-to, and low-dose aspirin with or without a corticosteroid hormone for the patients with adverse pregnancy histories positive for anti-phospholipid antibodies. METHOD OF STUDY: Fifteen cases positive for anti-phospholipid antibodies, who had experienced preterm delivery in which an extremely low birthweight infant (<1000 g) was born as a result of intrauterine growth restriction with or without severe preeclampsia, were treated with the medication according to the current protocol. Four cases with the same condition, who were treated with only low-dose aspirin, or without medication, were chosen as a control population. The pregnancy outcome was compared between the two groups. RESULTS: The rate of patients in whom the next pregnancy continued until the 36th week of gestation or later was significantly higher in treated patients (80.0%) compared with the control population (0%). CONCLUSIONS: In this series, we obtained case report data that Sairei-to may provide some benefit for patients with reproductive disorders positive for anti-phospholipid antibodies; however, randomized controlled trial evidence is needed before current treatment can be recommended.

Adult↗
PubMed1994

Evaluation of six minute walking test in patients with single chamber rate responsive pacemakers.

OBJECTIVE: To validate a simplified exercise protocol (the six minute walk) as a means of evaluating pacing modes and rate responsive pacemakers. DESIGN: Two groups of patients with different pacemaker types (activity and dual sensor) were randomly assigned to four consecutive pacing settings (fixed rate--or VVI at 60, 85, and 110/min, and optimal rate response--or VVIR). A third group of elderly patients without arrhythmias or conduction disturbances formed a control population. SETTING: Ambulatory consultation for patients with a pacemaker in a tertiary referral centre for treatment of arrhythmias. SUBJECTS: 16 patients with rate responsive pacemakers for complete heart block and limited functional capacity and 13 controls with normal chronotropic competence. INTERVENTIONS: Submaximal exercise protocol with 6 minutes walking and continuous recording of electrocardiogram. MAIN OUTCOME MEASURES: Achieved distance and scored degree of exertion during walking in the four settings in the patients with a pacemaker; differences in rate behaviour in VVIR mode between the two pacemaker types; comparison of the pacing rate with the heart rate of the control population. RESULTS: The six minute walk was performed better in VVIR than VVI 60. In VVI 85 the distance was also significantly longer than in VVI 60. The rise in pacing rate of activity pacemakers was steeper than that of the dual sensor pacemakers and differed from the heart rate in the controls at 90 seconds. CONCLUSIONS: The studied test protocol was able to show differences in exercise capacity between pacing modes. Different rate responses between the evaluated sensor types could be established. The six minute walking test gives enough information to program and reprogram single chamber rate responsive pacemakers.

Aged↗
PubMed2005

Lack of an association between the angiotensin-converting enzyme insertion/deletion polymorphism and intracranial aneurysms in a Caucasian population in the United States.

OBJECT: The identification of polymorphisms associated with an increase in the risk of developing disease is integral to the development of genetic biomarkers to identify individuals at risk. Based on reports indicating a role for angiotensin-converting enzyme (ACE) in the pathogenesis of intracranial aneurysms (IAs) as well as hypertension, an independent risk factor for IAs, the authors investigated the association between an insertion/deletion (I/D) polymorphism in the ACE gene and IAs in a Caucasian population in the US. METHODS: The patient population consisted of 162 randomly selected Caucasian patients who underwent surgical repair of an IA at Memorial-Hermann Hospital (Houston, TX) and had no family history of the disease. The ACE I/D polymorphism was typed using polymerase chain reaction amplification of genomic DNA, and allele and genotype frequencies were compared between the patients with IAs and 143 healthy Caucasian volunteers (control group) by performing logistic regression and chi-square tests. The ACE I/D allele frequencies did not differ significantly between the patient and control populations. There were similar allele and genotype frequencies in male and female study participants in both patient and control populations. The authors found no evidence of an association between the allelic or genotypic distribution of the ACE I/D polymorphism and aneurysmal subarachnoid hemorrhage or unruptured IAs. CONCLUSIONS: Contrary to findings in two European Caucasian populations (one British and one Polish), this polymorphism did not contribute to the risk of developing IAs in a Caucasian population in the US.

Adult↗
PubMed1996

Increased risk of autoimmune hypothyroidism in patients affected by retinitis pigmentosa.

Patients with Retinitis Pigmentosa (RP) show hemeralopia, restricted field of vision and reduced visual acuity, owing to the degeneration and proliferation of photoreceptors and a retinal pigment epithelium. The prevalence in Italy is 1:4,000. A certain number of "syndromic" associations have been described, and, in particular, also that with hypothyroidism, but very few cases have been studied. We describe a family of 40 people, spanning four generations, in which we have recorded the presence of autosomic dominant RP, associated with autoimmune hypothyroidism or with circulating antithyroid autoantibodies (ATA), currently considered as the expression of active autoimmune thyroiditis or a risk factor for this complaint. We measured, in all members, TSH, FT3, FT4, antithyroglobulin and antithyroperoxidase autoantibodies. A fundus oculi examination was performed in every subject, as well as a careful examine of the anterior region on the neck. A control population of 100 healthy people was also studied. Our data show a higher prevalence of ATA, statistically significant, in the patients with RP and in their relatives, compared with the control population and the data from the literature (13 cases over 40 = 32.5%; p < 0.01). 3 patients with RP and ATA were affected by clinically evident hypothyroidism. 10 patients with ATA were clinically euthyroid; 8 patients affected by RP did not show circulating ATA at the time of the study. The interest for the physician in this "syndromic" retinal distrophy reflects the need, emerging from our data, to test the thyroid function in the subjects with RP and in members of their families, since circulating ATA are considered a risk factor for the development of autoimmune hypothyroidism.

Autoantibodies↗
PubMed1989

The effects of exercise training on mental well-being in the normal population: a controlled trial.

This study was designed to compare the effects of two aerobic training programmes of differing intensities on mood and mental well-being with those of a credible attention-placebo condition. One hundred and nine sedentary adult volunteers from the local population were assigned to four conditions: high intensity aerobic training, moderate intensity aerobic training, attention-placebo and waiting list. Training was carried out over a 10 week period. Subjects were assessed before and after training with psychological measures and the 12 min walk-run test, and follow-up evaluations were undertaken after 3 months. Ninety-four subjects began the programme and the adherence rate averaged 80%, with no significant differences in number of drop-outs between conditions. Appropriate changes in estimated maximum oxygen consumption were observed in the three active conditions with the 12 min walk-run test. Psychological benefits were seen with the moderate exercise condition but not in the high exercise or attention-placebo conditions. These effects were manifest immediately after training on measures of tension/anxiety and confusion, and at follow-up on measures of perceived coping ability. The mechanisms underlying this pattern of results are discussed and the relative importance for health of vigorous activity and physical fitness is considered.

Adaptation, Psychological↗
PubMed1988

Clinical experience with intrauterine contraceptive devices (IUDs) inserted with and without tail.

Between 1982 and 1984, two comparative clinical trial for testing new types of IUDs, were initiated at the Family Planning Center (Debrecen, Hungary) in collaboration with the Leiras Research Laboratories (Turku, Finland). 685 Nova T and 500 TCu 200Ag IUDs with and without tail were inserted in a randomized manner in order to study the possible role of the thread of the device in generating pelvic inflammatory disease (PID). Because there were no statistically significant differences between the corresponding rates of the devices, the data regardless of the type of the IUD, were pooled, then separated into two new groups: the study group (IUD without tail) consisted of 581 cases, while the control population (IUD with tail) included 602 insertions. The age and parity distribution was the same in both groups (mean age 29.4, mean parity 1.9). In the study group 300 patients completed the two-year follow-up, and 9675 womanmonths of use were evaluated. The corresponding figures for the control population were 304 and 9935, respectively. The two-year gross cumulative termination rates for the study and the control group were as follows: pregnancy 4.4 and 4.6; expulsion 1.9 and 2.9; bleeding/pain removals 6.3 and 6.0, removal for infection 0.2 and 2.7; removal for other medical reason 2.1 and 1.9; removal for planning pregnancy 4.6 and 6.6; removal for other personal reason 1.6 and 0.6. The pregnancy, expulsion and removal rates, except infection, were almost the same in both groups. There was a statistically significant difference only between the rates of removals for PID (p less than 0.05): during the two-year period of use 12 devices were removed for infection and out of these only 1 was inserted without tail! Although these findings are promising, to draw a final conclusion more cases and a longer follow-up are needed.

Adult↗
PubMed2006

Birth length and weight in congenital adrenal hyperplasia according to the different phenotypes.

UNLABELLED: The aims of this study were to: (1) retrospectively investigate the birth length and weight of our patients with congenital adrenal hyperplasia (CAH); (2) compare these parameters with standards for birth length and weight recently assessed in an Italian control population; (3) evaluate whether neonatal auxological data may change depending on the different clinical forms of CAH. Birth length and weight were retrospectively evaluated in 101 children with different clinical forms of CAH and compared with standards for birth length and weight assessed in an Italian control population. In both sexes the average birth length of patients with classical CAH was greater than the mean birth length of the controls, and both length and weight were greater in children with classical CAH than in those with the non-classical form. Among the patients with classical CAH, those with the salt-wasting form were longer but also weighed less than those with the simple-virilizing form. CONCLUSIONS: (1) fetal length velocity in patients with CAH may be increased only in those infants with classical forms of the syndrome, while it is unaffected in those with the non-classical form; (2) the greater the enzymatic activity impairment, the longer the birth length of newborns with CAH.

Adrenal Hyperplasia, Congenital↗
PubMed2003

An intron splice acceptor polymorphism in hMSH2 and risk of leukemia after treatment with chemotherapeutic alkylating agents.

PURPOSE: We sought to determine whether the -6 exon 13 T>C polymorphism in the DNA mismatch repair gene hMSH2 modulates susceptibility to acute myeloid leukemia after therapy and particularly after O(6)-guanine alkylating chemotherapy. We also determined the extent of microsatellite instability (MSI) in therapy-related acute myeloid leukemia (t-AML) as a marker of dysfunctional DNA mismatch repair. EXPERIMENTAL DESIGN: Using a novel restriction fragment length polymorphism, verified by direct sequencing, we have genotyped 91 t-AML cases, 420 de novo acute myeloid leukemia cases, and 837 controls for the hMSH2 -6 exon 13 polymorphism. MSI was evaluated in presentation bone marrow from 34 cases using the mononucleotide microsatellite markers BAT16, BAT25, and BAT26. RESULTS: Distribution of the hMSH2 -6 exon 13 polymorphism was not significantly different between de novo acute myeloid leukemia cases and controls, with heterozygotes and homozygotes for the variant (C) allele representing 12.2 and 1.6%, respectively, of the control population. However, the variant (C) hMSH2 allele was significantly overrepresented in t-AML cases that had previously been treated with O(6)-guanine alkylating agents, including cyclophosphamide and procarbazine, compared with controls (odds ratio, 4.02; 95% confidence interval, 1.40-11.37). Thirteen of 34 (38%) t-AML cases were MSI positive, and 2 of these 13 cases were homozygous for the variant (C) allele, a frequency substantially higher than in the control population. CONCLUSIONS: Association of the hMSH2 -6 exon 13 variant (C) allele with leukemia after O(6)-guanine alkylating agents implicates this allele in conferring a nondisabling DNA mismatch repair defect with concomitant moderate alkylation tolerance, which predisposes to the development of t-AML via the induction of DNA mismatch repair-disabling mutations and high-grade MSI. Homozygosity for the hMSH2 variant in 2 of 13 MSI-positive t-AML cases provides some support for this model.

Adolescent↗
PubMedDate not supplied

The foot in Marfan syndrome: clinical findings and weight-distribution patterns.

The feet of Marfan patients are typically described as pes planovalgus. We evaluated the single-leg-stance footprint of 124 feet in 63 patients with the Marfan syndrome by using pressure-sensitive film and a Harris mat. Forty feet in 21 people with no history of foot problems were evaluated as normal controls. The medial and lateral aspects of the fore-, mid-, and hindfoot were assessed. The midfoot was further analyzed by dividing the medial midfoot force by the total midfoot force. The mean medial midfoot force/total midfoot force (MM/TM) in the control population was 11.1% (SD, 6.5%). Pes planus was defined as the MM/TM force > 24.0% (mean + 2 SD). The mean MM/TM force in the Marfan group was not statistically different (16.0%) from controls. The distribution, however, revealed two distinct types of weight-bearing patterns. Of the Marfan group, 74.8% had medial forces within the standard distribution of the normal control population. Only 25.2% of the Marfan patients had forces that were outside the range of normal midfoot forces and were defined as pes planus. Analysis of the patient's ligamentous laxity and the foot function in the Marfan population revealed no statistically significant correlation to the type of weight-bearing pattern of the foot.

Adult↗
PubMed2001

Life events and psychosocial factors in elderly suicides--a case-control study.

BACKGROUND: Stressful life events, such as family conflicts, separation, bereavement, somatic illness and financial problems are common antecedents of suicide. Studies on suicide among younger persons dominate the literature, despite the fact that a large proportion of suicides occur among elderly persons. METHODS: The occurrence of stressful life events was investigated among elderly suicide cases and population controls. The study was conducted in the southwestern part of Sweden and included 85 persons (46 males and 39 females) 65 years and above who had committed suicide from January 1994 to May 1996. Population controls (84 males and 69 females) were randomly selected. Interviews were carried out with the controls and with informants for the suicide cases. Questions on sociodemographic background, mental and somatic health status, and life events (0-6, 7-12 and 13-24 months preceding suicide/interview) were included in the interviews. RESULTS: Somatic illness, family discord and financial trouble were significant risk factors during all three time periods. Other risk factors were mental disorder, lower education, feelings of loneliness and previous suicide in the family. Factors associated with a decreased risk included active participation in organizations and having a hobby. Variables that remained in the multivariate logistic regression model were mental disorder (men, odds ratio (OR) = 62.4, 95% CI 17.9-217.5; women, OR = 55.9, 95% CI 14.1-222.3) and family discord (men, OR = 10.0. 95% CI 1.7-59.8; women, OR = 9.2, 95% CI 1.9-44.8). CONCLUSIONS: Mental disorder and family discord were the two major risk factors for suicide among elderly men and women.

Aged↗