Night Owls Risk Dying Early

MedicalResearch.com Interview with:
“Sleep” by Spencer Smith is licensed under CC BY 2.0Kristen L. Knutson, PhD

Associate Professor
Center for Circadian and Sleep Medicine
Department of Neurology
Northwestern University Feinberg School of Medicine
Chicago, IL  60611​

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous research has shown that “night owls” (people who prefer the evening) have higher rates of diseases such as diabetes or high blood pressure.  We wanted to determine whether mortality risk was also higher in night owls. We used data from the UK Biobank of almost a half million people who were asked whether they were morning or evening types.

We found that the night owls had a 10% increased risk of dying over a 6 ½ year period compared to the morning types, even after taking into account existing health problems.

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2015 Marked First Decline In Life Expectancy in Over 20 Years

MedicalResearch.com Interview with:

Francesco Acciai PhD Postdoctoral Research Associate Food Policy and Environmental Research Group School of Nutrition and Health Promotion University of Arizona

Dr. Acciai

Francesco Acciai PhD
Postdoctoral Research Associate
Food Policy and Environmental Research Group
School of Nutrition and Health Promotion
Arizona State University

MedicalResearch.com: What is the background for this study?

Response: In 2015 life expectancy at birth (e0) in the United States was lower than it was in 2014. In the previous 30 years, a reduction in life expectancy at the national level had occurred only one time, in 1993, during the HIV/AIDS epidemic. The decrease in life expectancy observed in 2015 is particularly worrisome because it was not generated by an anomalous spike in a specific cause of death (like HIV/AIDS in 1993). Instead, age-adjusted death rates increased for 8 of the 10 leading causes of death—heart disease, chronic lower respiratory diseases, accidents, stroke, Alzheimer’s, diabetes, kidney disease, and suicide, according to the CDC.

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Wearable Device Study Confirms Moderate-to-Vigorous Physical Activity Linked To Decreased Mortality

MedicalResearch.com Interview with:

I-Min Lee, MD, ScD Professor of Medicine, Harvard Medical School Professor of Epidemiology, Harvard T.H. Chan School of Public Health Brigham and Women's Hospital Boston, MA 02215

Dr. Lee

I-Min Lee, MD, ScD
Professor of Medicine, Harvard Medical School
Professor of Epidemiology, Harvard T.H. Chan School of Public Health
Brigham and Women’s Hospital
Boston, MA 02215

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The fact that physical activity lowers the risk of premature mortality is not a new fact – we have many studies showing this.  However, previous studies have primarily relied on self-reported physical activity, and self-reports tend to be imprecise.  Based on these self-report studies, we know that physical activity is associated with a 20-30% reduction in mortality rates.  And, these self-report studies also have focused on moderate-to-vigorous intensity physical activity, since they are more reliably reported than lighter intensity activity.  We have little information on whether light-intensity activities (e.g., light household chores, very slow walking such as when strolling and window shopping) are associated with lower mortality rates.

We now have “wearables” – devices that can more precisely measure physical activity at low (as well as higher) intensities, and sedentary behavior.  The present study, conducted between 2011 and 2015, investigated a large cohort of older women (n=16,741; mean age, 72 years)  who were asked to wear these devices for a week – thus, providing detailed physical activity and sedentary behavior measures.  During an average follow-up of about two-and-a-half years, 207 women died.  The study confirmed that physical activity is related to lower mortality rates.

What is new and important is how strong this association is when we have more precise measures of physical activity – the most active women had a 60-70% reduction in mortality rates, compared with the least active, during the study.  For context, non-smokers have about a 50% risk reduction, compared to smokers, which is why patients (and doctors) should pay attention to being physically active.

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Poor Functional Status Predicts Increased Mortality After Dialysis Initiation

MedicalResearch.com Interview with:

Silvi Shah, MD, FACP, FASN Assistant Professor, Division of Nephrology University of Cincinnati Cincinnati, OH

Dr. Shah

Silvi Shah, MD, FACP, FASN|
Assistant Professor
Division of Nephrology
University of Cincinnati
Cincinnati, OH

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Elderly represent the fastest growing segment of incident dialysis patients in Unites States. The annual mortality in end stage renal disease (ESRD) patients is very high ~ 20%.

Since most of the deaths occur in the first year of dialysis, it is possible that health conditions present prior to initiation of dialysis may impact long-term outcomes. In this study, we determined the impact of poor functional status at the time of dialysis initiation and pre-dialysis health status on type of dialysis modality, type of hemodialysis access and one-year mortality in elderly dialysis patients. We evaluated 49,645 adult incident dialysis patients (1/1/2008 to 12/31/2008) from the United Data Renal Data System (USRDS) with linked Medicare data for at least 2 years prior to dialysis initiation. Mean age of our study population was 72 years. At dialysis initiation, 18.7% reported poor functional status, 88.9% has pre-dialysis hospitalization, and 27.8% did not receive pre-dialysis nephrology care. Patients with poor functional status had higher odds of being initiated on hemodialysis than peritoneal dialysis, lower odds of using arteriovenous access as compared to central venous catheter for dialysis and higher risk of one-year mortality.

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Premature Midlife Deaths Increase in US Whites and Native Americans

Dr. Meredith Shiels

Dr. Meredith Shiels

MedicalResearch.com Interview with:
Dr Meredith S Shiels

Division of Cancer Epidemiology and Genetics
National Cancer Institute
Bethesda, MD

MedicalResearch.com: What is the background for this study?

Response: In most high-income countries, premature death rates have been declining, due to the overwhelming successes of public health efforts to prevent and treat chronic disease. The US is a major outlier, where death rates overall have plateaued, or even increased, as reported recently by our sister agency, the Centers for Disease Control and Prevention. Of particular concern are recent reports of increasing death rates among Americans during mid-life.

To expand upon prior findings, we focused on premature death, which we defined as death occurring between the ages of 25 and 64. We examined finely detailed death certificate data for the entire U.S. population and described changes in death rates during 1999-2014 by cause of death, sex, race, ethnicity, and geography. To provide context to our findings, we compared trends in death rates in the U.S. to England and Wales and Canada.

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Early Menopause Linked To Increased Risk of Heart Disease and Carotid Atherosclerosis

MedicalResearch.com Interview with:
Taulant Muka, MD, MPH, PhD
Postdoctoral Researcher
Erasmus University, Rotterdam

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Menopause marks a major life transition for women, resulting in the loss of ovarian follicle development. Although menopause is a universal phenomenon among women, the timing of the final menstrual period differ greatly between women, and is considered a marker of aging. By quantifying data of nearly 310,329 non-overlapping women, we found that women who experienced an early menopause (i.e. younger than 45 years) have an excess risk of CHD, CVD-mortality and all-cause mortality. Furthermore, being 45-49 years at menopause compared to ≥50 years was associated with increased risk of carotid atherosclerosis.

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All-Cause Mortality Increased in Women With History of Child Abuse

MedicalResearch.com Interview with:

Edith Chen, Ph.D. Professor Faculty Fellow, Institute for Policy Research Northwestern University Department of Psychology Evanston, IL 60208-2710

Dr. Edith Chen

Edith Chen, Ph.D. Professor
Faculty Fellow, Institute for Policy Research
Northwestern University
Department of Psychology
Evanston, IL 60208-2710

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous research has documented psychiatric consequences of childhood abuse, but less is known about possible physical health consequences.

The main finding is that women who self-reported childhood abuse (in adulthood) were at greater risk for all-cause mortality compared to those who did not report abuse.

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Being Unhappy Doesn’t Shorten Your Life

Dr Bette Liu MD PhD University of New South Wales Sydney, NSW

Dr. Bette Liu

MedicalResearch.com Interview with:
Dr Bette Liu MD PhD
University of New South Wales
Sydney, NSW

Medical Research: What is the background for this study? What are the main findings?

Dr. Liu: There is a generally held belief that being happier makes you live longer. We wanted to look at this question. We examined over 700,000 women enrolled in the UK Million Women Study. We found that being in poor health was associated with being unhappy but after accounting for an individuals poor health, unhappiness in itself was not associated with an increased risk of death. This finding was true for overall deaths, for deaths from heart disease and from cancer and it was true for stress as well as for unhappiness. 

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US Continues To Make Progress in Mortality Reduction

Jiemin Ma, PhD, MHS Director of Surveillance and Health Services Research American Cancer SocietyMedicalResearch.com Interview with:
Jiemin Ma, PhD, MHS
Director of Surveillance and Health Services Research
American Cancer Society

Medical Research: What is the background for this study? What are the main findings?

Dr. Ma: This study is an analysis of long-term trends in mortality for all causes combined and for 6 leading causes of death, including heart disease, cancer, stroke, chronic obstructive pulmonary disease (COPD), unintentional injuries, and diabetes, in the United States from 1969 through 2013. We found that death rates for all causes and for five of these 6 leading causes (except COPD) decreased during this time period, although the rate of decrease appears to have slowed for heart disease, stroke, and diabetes. COPD death rates doubled during this time period, although the rate began to decrease in men since 1999.

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Improving Diabetes Control Means Decreasing Mortality

Marcus Lind, M.D., Ph.D Department of Medicine, Uddevalla Hospital Uddevalla, Swede

MedicalResearch.com Interview with:
Marcus Lind, M.D., Ph.D
Department of Medicine, Uddevalla Hospital
Uddevalla, Swede


Medical Research: What is the background for this study?

Dr. Lind:  One of the main goals of the diabetes care is to reduce excess mortality in individuals with type 2 diabetes close to that of the general population. We want patients to have a similar life expectancy as individuals in the general population. Earlier studies have shown that targeting good glucose levels, blood lipid and blood pressure levels are beneficial with respect to decrease cardiovascular disease being the main cause for mortality. We wanted to evaluate the prognosis for individuals with type 2 diabetes today in Sweden.

Further, earlier population-based studies have generally assessed mortality rates only on a group level whereas we believe the prognosis differs greatly depending on various factors such as how well risk factor control is obtained in clinical practice. The Swedish Diabetes Registry include more than 90% of all individuals with type 2 diabetes in Sweden and information of e.g. the glycaemic control, measured by a biomarker called A1c exists for most persons. There were 97% who had at least 1 measurement. Also most patients had information of other risk factors, among others renal complications which we believed were of special concern.  Continue reading