Total white blood cell count or neutrophil count predict ischemic stroke events among adult Taiwanese: report from a community-based cohort study

BACKGROUND: Evidence about whether white blood cell (WBC) or its subtypes can act as a biomarker to predict the ischemic stroke events in the general population is scanty, particularly in Asian populations. The aim of this study is to establish the predictive ability of total WBC count or subtypes for long-term ischemic stroke events in the cohort population in Taiwan. METHODS: The Chin-Shan Community Cohort Study began from 1990 to 2007 by recruiting 1782 men and 1814 women of Chinese ethnicity. Following a total of 3416 participants free from ischemic stroke events at baseline for a median of 15.9 years; we documented 187 new incident cases. RESULTS: The multivariate relative risk for the comparison of the participants in the fifth and first WBC count quintiles was 1.67 (95% confidence interval [CI], 1.02–2.73; P for trend=0.03), and the corresponding relative risk for neutrophil count was 1.93 (95% CI, 1.13–3.29; P for trend=0.02). The discriminative ability by WBC and neutrophil counts were similar (area under the receiver operating characteristic curve, 0.600 for adding WBC, 0.610 for adding neutrophils, 0.595 for traditional risk factor model). In addition, the net reclassification improvement (NRI) values between the neutrophil and white blood cell count models were not significant (NRI, =-2.60%, P=0.35), indicating the similar discrimination performance for both WBC and neutrophil counts. CONCLUSIONS: WBC and neutrophil count had a similar ability to predict the long-term ischemic stroke events among Taiwanese

The impact of active community-based survey on dementia detection ratio in Taiwan: A cohort study with historical control

BackgroundAlthough early dementia detection is crucial to optimize the treatment outcomes and the management of associated symptoms, the published literature is scarce regarding the effectiveness of active screening protocols in enhancing dementia awareness and increasing the rate of early detection. The present study compared the detection ratio of an active community-based survey for dementia detection with the detection ratio of passive screening during routine clinical practice. Data for passive screening were obtained from the National Health Insurance (NHI) system, which was prospectively collected during the period from 2000 to 2003.DesignA population-based cohort study with historical control.SettingTaiwan.ParticipantsA total of 183 participants aged 65 years or older were involved in a community-based survey. Data from 1,921,308 subjects aged 65 years or older were retrieved from the NHI system.MeasurementsAn adjusted detection ratio, defined as a ratio of dementia prevalence to incidence was used.ResultsThe results showed that the dementia prevalence during the 2000–2003 period was 2.91% in the elderly population, compared with a prevalence of 6.59% when the active survey was conducted. The incidence of dementia in the active survey cohort was 1.83%. Overall, the dementia detection ratio was higher using active surveys [4.23, 95% confidence interval (CI): 2.68–6.69] than using passive detection (1.45, 95% CI: 1.43–1.47) for those aged 65–79 years. Similar findings were observed for those aged 80 years and older.ConclusionThe implementation of an active community-based survey led to a 3-fold increase in the detection rate of early dementia detection compared to passive screening during routine practice

Total white blood cell count or neutrophil count predict ischemic stroke events among adult Taiwanese: report from a community-based cohort study

Background: Evidence about whether white blood cell (WBC) or its subtypes can act as a biomarker to predict the ischemic stroke events in the general population is scanty, particularly in Asian populations. The aim of this study is to establish the predictive ability of total WBC count or subtypes for long-term ischemic stroke events in the cohort population in Taiwan. Methods: The Chin-Shan Community Cohort Study began from 1990 to 2007 by recruiting 1782 men and 1814 women of Chinese ethnicity. Following a total of 3416 participants free from ischemic stroke events at baseline for a median of 15.9 years; we documented 187 new incident cases. Results: The multivariate relative risk for the comparison of the participants in the fifth and first WBC count quintiles was 1.67 (95% confidence interval [CI], 1.02-2.73; P for trend=0.03), and the corresponding relative risk for neutrophil count was 1.93 (95% CI, 1.13-3.29; P for trend=0.02). The discriminative ability by WBC and neutrophil counts were similar (area under the receiver operating characteristic curve, 0.600 for adding WBC, 0.610 for adding neutrophils, 0.595 for traditional risk factor model). In addition, the net reclassification improvement (NRI) values between the neutrophil and white blood cell count models were not significant (NRI, =-2.60%, P=0.35), indicating the similar discrimination performance for both WBC and neutrophil counts. Conclusions: WBC and neutrophil count had a similar ability to predict the long-term ischemic stroke events among Taiwanese

Long-Term Mortality Assessment Using Biological Measures among Elderly People. Ten-Year Follow-up of 597 Healthy Elderly Subjects in Taiwan

Background. Identifying biological measures that are predictive of mortality for elderly people aged over 65 years has not been fully elucidated in oriental studies. Objective. The associations between these biological measures and long-term mortality were therefore investigated , and classifications for risk of death were developed among Taiwanese elderly people Methods. Data used in this study were derived from a total of 597 apparently healthy subjects aged over 65 years identified from a nationwide survey that was conducted between 1989 and 1991 in Taiwan. Each participant received a physical examination and a wide range of biological measures. These 597 apparently healthy subjects were followed to 31 December 1999 to determine the cause of death. The grouping technique using factor analysis was first used to aggregate similar characteristics of biological measures into reduced components. Risk of death for each subject was classified into four groups: good (A), fair (B) , modest (C) and poor (D). Hazard ratios for groups B, C, D against A were calculated. Results. The overall 10- year survival rate was 72% [95% confidence interval (CI) 68- 76%]. The adjusted hazard ratios for all- cause death in high and mid-level categories of haematological components versus the lowest group were 0.51 (95% CI 0.33-0.80) and 0. 56 (95% CI 0. 37-0.85), respectively. Group D had a 6-fold risk of death as compared with group A (relative risk = 6.34 , 95% CI 3.85-10.52). The corresponding figures were 2.48 ( 95% CI 1.43-4.29) and 1.60 (95% CI 2.88-6.89) for groups B and C, respectively. Conclusions. The relationships of biological measures to long-term mortality were elucidated. Information on classification for risk of death may be helpful for elderly people to pay attention to their health status after receiving a health check-up