Reaction time and incident cancer: 25 years of follow-up of study members in the UK Health and Lifestyle Survey

<b>Objectives</b><p></p> To investigate the association of reaction time with cancer incidence.<p></p> <b>Methods</b><p></p> 6900 individuals aged 18 to 94 years who participated in the UK Health and Lifestyle Survey in 1984/1985 and were followed for a cancer registration for 25 years.<p></p> <b>Results</b><p></p> Disease surveillance gave rise to 1015 cancer events from all sites. In general, there was essentially no clear pattern of association for either simple or choice reaction time with cancer of all sites combined, nor specific malignancies. However, selected associations were found for lung cancer, colorectal cancer and skin cancer.<p></p> <b>Conclusions</b><p></p> In the present study, reaction time and its components were not generally related to cancer risk

Employment status and health after privatisation in white collar civil servants: prospective cohort study

Objectives To determine whether employment status after job loss due to privatisation influences health and use of health services and whether financial strain, psychosocial measures, or health related behaviours can explain any findings.Design Data collected before and 18 months after privatisation.Setting One department of the civil service that was sold to the private sector,Participants 666 employees during baseline screening in the department to be privatised.Main outcome measures Health and health service outcomes associated with insecure re-employment, permanent exit from paid employment, and unemployment after privatisation compared with outcomes associated with secure re-employmentResults Insecure re-employment and unemployment were associated with relative increases in minor psychiatric morbidity (mean difference 1.56 (95% confidence intervals interval 1.0 to 2.2) and 1.25 (0.6 to 2.0) respectively) and having four or more consultations with a general practitioner in the past year (odds ratio 2.04 (1.1 to 3.8) and 2.39 (1.3 to 4.7) respectively). Health outcomes for respondents permanently out of paid employment closely resembled those in secure re-employment, except for a substantial relative increase in longstanding illness (2.25; 1.1 to 4.4), Financial strain and change in psychosocial measures and health related behaviours accounted for little of the observed associations. Adjustment for change in minor psychiatric morbidity attenuated the association between insecure re-employment or unemployment and general practitioner consultations by 26% and 27%, respectively.Conclusions Insecure re-employment and unemployment after privatisation result in increases in minor psychiatric morbidity and consultations with a general practitioner, which are possibly due to the increased minor psychiatric morbidity

Examining the Long-Term Association of Personality With Cause-Specific Mortality in London: Four Decades of Mortality Surveillance in the Original Whitehall Smoking Cessation Trial

The personality domains of extraversion and neuroticism are regarded as being stable individual psychological characteristics, yet it remains unclear whether they are associated with chronic disease over an extended period of time. In a randomized controlled trial of smoking cessation nested within the original prospective Whitehall Study (1967–2012), the Eysenck Personality Questionnaire was administered to 832 male self-declared smokers who had undergone a medical examination during which their levels of extraversion and neuroticism were quantified. In the 42-year follow-up period, there were 781 deaths. In analyses in which participants from both trial arms were pooled, there was little evidence of a robust relation of either personality domain with death from all causes, coronary heart disease, stroke, respiratory disease, or cancer in any of our analyses. We therefore found no support for a role of either extraversion or neuroticism as determinants of long-term mortality risk

Reaction Time and Mortality from the Major Causes of Death:The NHANES-III Study

Studies examining the relation of information processing speed, as measured by reaction time, with mortality are scarce. We explored these associations in a representative sample of the US population

Adherence to healthy dietary guidelines and future depressive symptoms: evidence for sex differentials in the Whitehall II study.

It has been suggested that dietary patterns are associated with future risk of depressive symptoms. However, there is a paucity of prospective data that have examined the temporality of this relation

Association of change in cognitive function from early adulthood to middle age with risk of cause-specific mortality: the Vietnam Experience Study

BACKGROUND: Studies with single baseline measurements of cognitive function consistently reveal inverse relationships with mortality risk. The relation of change in functioning, particularly from early in the life course, which may offer additional insights into causality, has not, to the best of our knowledge, been tested. AIMS: To examine the association of change in cognition between late adolescence and middle age with cause-specific mortality using data from a prospective cohort study. METHODS: The analytical sample consisted of 4289 former US male military personnel who were administered the Army General Technical Test in early adulthood (mean age 20.4 years) and again in middle age (mean age 38.3 years). RESULTS: A 15-year period of mortality surveillance subsequent to the second phase of cognitive testing gave rise to 237 deaths. Following adjustment for age, a 10-unit increase in cognitive function was related to a reduced risk of death from all causes (HR 0.84; 95% CI 0.75 to 0.93) and cardiovascular disease (HR 0.78; 95% CI 0.64 to 0.95) but not from all cancers (HR 1.14; 95% CI 0.88 to 1.47) nor injury (HR 1.02; 95% CI 0.81 to 1.29). Adjustment for markers of socioeconomic status in middle age resulted in marked attenuation in the magnitude of these associations and statistical significance at conventional levels was lost in all analyses. CONCLUSIONS: In the present study, the apparent link between increased cognition and mortality was mediated by socioeconomic status

Underweight as a risk factor for respiratory death in the Whitehall cohort study: exploring reverse causality using a 45-year follow-up

Underweight adults have higher rates of respiratory death than the normal weight but it is unclear whether this association is causal or reflects illness-induced weight loss (reverse causality). Evidence from a 45-year follow-up of underweight participants for respiratory mortality in the Whitehall study (N=18 823; 2139 respiratory deaths) suggests that excess risk among the underweight is attributable to reverse causality. The age-adjusted and smoking-adjusted risk was 1.55-fold (95% CI 1.32 to 1.83) higher among underweight compared with normal weight participants, but attenuated in a stepwise manner to 1.14 (95% CI 0.76 to 1.71) after serial exclusions of deaths during the first 5-35 years of follow-up (Ptrend<0.001)

Validity of Cardiovascular Disease Event Ascertainment Using Linkage to UK Hospital Records

BACKGROUND: Use of electronic health records for ascertainment of disease outcomes in large population-based studies holds much promise due to low costs, diminished study participant burden, and reduced selection bias. However, the validity of cardiovascular disease endpoints derived from electronic records is unclear. METHODS: Participants were 7860 study members of the UK Whitehall II cohort study. We compared cardiovascular disease ascertainment using linkage to the National Health Service's Hospital Episode Statistics database records (hereafter, 'HES-ascertainment') against repeated biomedical examinations - our gold-standard ascertainment method ('Whitehall-ascertainment'). Follow-up for both methods was from 1997 to 2013 for coronary heart disease and from 1997 to 2009 for stroke. RESULTS: We identified 950 prevalent or incident non-fatal coronary heart disease cases and 118 prevalent or incident non-fatal stroke cases using Whitehall-ascertainment. The corresponding figures for HES ascertainment were 926 and 107. For coronary heart disease, the sensitivity of HES-ascertainment was 70%, positive predictive value 72%, specificity 96%, and the negative predictive value 96%. The pattern of results for stroke was similar. These statistics did not differ in analyses stratified by age, sex, baseline risk factor status, or after exclusion of prevalent cases. Estimates of risk factor-disease associations were similar between the two ascertainment methods. Including fatal cardiovascular disease in the outcomes improved the agreement between the methods. CONCLUSION: Our analyses support the validity of cardiovascular disease ascertainment using linkage to the UK Hospital Episode Statistics database records by showing agreement with high resolution disease data collected in the Whitehall II cohort.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Diabetes Risk Factors, Diabetes Risk Algorithms, and the Prediction of Future Frailty: The Whitehall II Prospective Cohort Study

Objective: To examine whether established diabetes risk factors and diabetes risk algorithms are associated with future frailty. / Design: Prospective cohort study. Risk algorithms at baseline (1997–1999) were the Framingham Offspring, Cambridge, and Finnish diabetes risk scores. / Setting: Civil service departments in London, United Kingdom. / Participants: There were 2707 participants (72% men) aged 45 to 69 years at baseline assessment and free of diabetes. / Measurements: Risk factors (age, sex, family history of diabetes, body mass index, waist circumference, systolic and diastolic blood pressure, antihypertensive and corticosteroid treatments, history of high blood glucose, smoking status, physical activity, consumption of fruits and vegetables, fasting glucose, HDL-cholesterol, and triglycerides) were used to construct the risk algorithms. Frailty, assessed during a resurvey in 2007–2009, was denoted by the presence of 3 or more of the following indicators: self-reported exhaustion, low physical activity, slow walking speed, low grip strength, and weight loss; “prefrailty” was defined as having 2 or fewer of these indicators. / Results: After a mean follow-up of 10.5 years, 2.8% of the sample was classified as frail and 37.5% as prefrail. Increased age, being female, stopping smoking, low physical activity, and not having a daily consumption of fruits and vegetables were each associated with frailty or prefrailty. The Cambridge and Finnish diabetes risk scores were associated with frailty/prefrailty with odds ratios per 1 SD increase (disadvantage) in score of 1.18 (95% confidence interval: 1.09–1.27) and 1.27 (1.17–1.37), respectively. / Conclusion: Selected diabetes risk factors and risk scores are associated with subsequent frailty. Risk scores may have utility for frailty prediction in clinical practice

Validating a widely used measure of frailty: are all sub-components necessary? Evidence from the Whitehall II cohort study

There is growing interest in the measurement of frailty in older age. The most widely used measure (Fried) characterizes this syndrome using five components: exhaustion, physical activity, walking speed, grip strength, and weight loss. These components overlap, raising the possibility of using fewer, and therefore making the device more time- and cost-efficient. The analytic sample was 5,169 individuals (1,419 women) from the British Whitehall II cohort study, aged 55 to 79 years in 2007–2009. Hospitalization data were accessed through English national records (mean follow-up 15.2 months). Age- and sex-adjusted Cox models showed that all components were significantly associated with hospitalization, the hazard ratios (HR) ranging from 1.18 (95 % confidence interval = 0.98, 1.41) for grip strength to 1.60 (1.35, 1.90) for usual walking speed. Some attenuation of these effects was apparent following mutual adjustment for frailty components, but the rank order of the strength of association remained unchanged. We observed a dose–response relationship between the number of frailty components and the risk for hospitalization [1 component—HR = 1.10 (0.96, 1.26); 2—HR = 1.52 (1.26, 1.83); 3–5—HR = 2.41 (1.84, 3.16), P trend <0.0001]. A concordance index used to evaluate the predictive power for hospital admissions of individual components and the full scale was modest in magnitude (range 0.57 to 0.58). Our results support the validity of the multi-component frailty measure, but the predictive performance of the measure is poor