Background Social networks are associated with better cognitive health in older people, but the role of specific aspects of the social network remains unclear. This is especially the case in Central and Eastern Europe. This study examined associations between three aspects of the social network (network size of friends and relatives, contact frequency with friends and relatives, and social activity participation) with cognitive functions (verbal memory, learning ability, verbal fluency, processing speed, and global cognitive function) in older Czech, Polish, and Russian adults. Methods Linear regression estimated associations between baseline social networks and cognitive domains measured at both baseline and follow-up (mean duration of follow-up, 3.5 ± 0.7 years) in 6691 participants (mean age, 62.2 ± 6.0 years; 53.7% women) from the Health, Alcohol and Psychosocial factors In Eastern Europe (HAPIEE) study. Results Cross-sectional analyses, adjusted for country, age, and sex, showed positive associations of global cognitive function with social activity participation and network size of friends and relatives, but not with contact frequency in either network. Further adjustment for sociodemographic, behavioural, and health characteristics attenuated the associations with network size of relatives (P-trend = 0.074) but not with network size of friends (P-trend = 0.036) or social activities (P-trend< 0.001). In prospective analyses, network size and social activity participation were also linked with better cognition in simple models, but the associations were much stronger for social activities (P-trend< 0.001) than for network size of friends (P-trend = 0.095) and relatives (P-trend = 0.425). Adjustment for baseline cognition largely explained the prospective associations with network size of friends (P-trend = 0.787) and relatives (P-trend = 0.815), but it only slightly attenuated the association with social activities (P-trend< 0.001). The prospective effect of social activities was largely explained by sociodemographic, health behavioural, and health covariates (P-trend = 0.233). Analyses of specific cognitive domains generally replicated the cross-sectional and prospective findings for global cognitive function. Conclusions Older Central and Eastern European adults with larger social networks and greater social activities participation had better cognitive function, but these associations were stronger at baseline than over the short-term follow-up.
Objective: Automated oscillometric devices are increasingly replacing auscultation for assessment of systolic (SBP) and diastolic (DBP) blood pressure, but determine mean pressure (MAP) and extrapolate SBP and DBP. Major adverse cardiovascular events (MACE) are closest associated with 24 H blood pressure levels. We determined outcome-driven 24 H MAP thresholds and assessed association of MAP, SBP and DBP with MACE. Design and method: In a population-based cohort (n = 11,596), blood pressure and risk factors were measured at baseline. Office MAP, computed from SBP and DBP, was categorized according to the 2017 American guideline. 24 H MAP was recorded oscillometrically. Statistics included multivariable Cox regression and the log-likelihood ratio test. Results: Baseline office and 24 H MAP averaged 97.4 and 90.1 mm Hg. Over 13.6 years (median), 2034 MACE occurred. 24 H MAP levels of < 90, 90–92, 93–96 and = > 96 mm Hg yielded equivalent 10 year MACE risks as the office MAP standard and delineated normotension (n = 6304), elevated 24 H MAP (n = 1074), and hypertension stages 1 (n = 1732) and 2 (n = 2484). MACE rates per 1000 person-years increased (P < 0.001) with higher 24 H MAP category from 11.9 (95% CI, 11.1–13.2) to 12.5 (10.7–14.7), 16.2 (14.6–18.1) and 22.0 (20.4–24.1). Compared with 24 H MAP normotension, the corresponding hazard ratios were 1.06 (0.88–1.25), 1.43 (1.26–1.63) and 1.78 (1.59–2.00). Adding 24 H MAP to covariables, SBP and DBP improved the model fit (P < 0.001). On top of MAP, higher SBP increased, whereas higher DBP attenuated risk (P < 0.001). Conclusions: The oscillometrically determined 24 H MAP used in conjunction with SBP and DBP substantially refined estimates of MACE risk.
It is unclear whether the dose–response relationship between lung function and all-cause and cardiovascular mortality in the Central and Eastern European populations differ from that reported in the Western European and American populations. We used the prospective population-based HAPIEE cohort that includes randomly selected people with a mean age of 59 ± 7.3 years from population registers in Czech, Polish, Russian and Lithuanian urban centres. The baseline survey in 2002–2005 included 36,106 persons of whom 24,944 met the inclusion criteria. Cox proportional hazards models were used to estimate the dose–response relationship between lung function defined as FEV1 divided by height cubed and all-cause and cardiovascular mortality over 11–16 years of follow-up. Mortality rate increased in a dose–response manner from highest to lower FEV1/height3 deciles. Adjusted hazard ratios (HR) of all-cause mortality for persons in the 8th best, the 5th and the worst deciles were 1.27 (95% CI 1.08‒1.49), 1.37 (1.18–1.60) and 2.15 (1.86‒2.48), respectively; for cardiovascular mortality, the respective HRs were 1.84 (1.29–2.63), 2.35 (1.67–3.28) and 3.46 (2.50‒4.78). Patterns were similar across countries, with some statistically insignificant variation. FEV1/height3 is a strong predictor of all-cause and cardiovascular mortality, across full distribution of values, including persons with preserved lung function.
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