Abstract:
OBJECTIVES:To examine the individual and combined associations of unhealthy behaviours (low/intermediate physical activity, consuming fruit and vegetables less than once a day, current smoking/short term ex-smoking, never/former/heavy alcohol drinking), assessed at start of follow-up, with hazard of disability among older French adults and to assess the role of potential mediators, assessed repeatedly, of these associations. DESIGN:Population based cohort study. SETTING:Dijon centre of Three-City study. PARTICIPANTS:3982 (2410 (60.5%) women) French community dwellers aged 65 or over included during 1999-2001; participants were disability-free at baseline when health behaviours were assessed. MAIN OUTCOME MEASURE:Hierarchical indicator of disability (no, light, moderate, severe) combining data from three disability scales (mobility, instrumental activities of daily living, basic activities of daily living) assessed five times between 2001 and 2012. RESULTS:During the 12 year follow-up, 1236 participants (861 (69.7%) women) developed moderate or severe disability. Interval censored survival analyses (adjusted for age, sex, marital status, and education) showed low/intermediate physical activity (hazard ratio 1.72, 95% confidence interval 1.48 to 2.00), consuming fruit and vegetables less than once a day (1.24, 1.10 to 1.41), and current smoking/short term ex-smoking (1.26, 1.05 to 1.50) to be independently associated with an increased hazard of disability, whereas no robust association with alcohol consumption was found. The hazard of disability increased progressively with the number of unhealthy behaviours independently associated with disability (P<0.001); participants with three unhealthy behaviours had a 2.53 (1.86 to 3.43)-fold increased hazard of disability compared with those with none. Reverse causation bias was verified by excluding participants who developed disability in the first four years of follow-up; these analyses on 890 disability events yielded results similar to those in the main analysis. 30.5% of the association between the unhealthy behaviours score and disability was explained by body mass index, cognitive function, depressive symptoms, trauma, chronic conditions, and cardiovascular disease and its risk factors; the main contributors were chronic conditions and, to a lesser extent, depressive symptoms, trauma, and body mass index. CONCLUSIONS:An unhealthy lifestyle is associated with greater hazard of incident disability, and the hazard increases progressively with the number of unhealthy behaviours. Chronic conditions, depressive symptoms, trauma, and body mass index partially explained this association.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Artaud F,Dugravot A,Sabia S,Singh-Manoux A,Tzourio C,Elbaz Adoi
10.1136/bmj.f4240subject
Has Abstractpub_date
2013-07-23 00:00:00pages
f4240eissn
0959-8138issn
1756-1833journal_volume
347pub_type
杂志文章abstract:OBJECTIVE:To determine the relative importance of appropriate prescribing for asthma in explaining high rates of hospital admission for asthma among east London general practices. DESIGN:Poisson regression analysis describing relation of each general practice's admission rates for asthma with prescribing for asthma an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
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更新日期:1997-02-15 00:00:00
abstract:OBJECTIVE:To determine the risk factors for neonatal encephalopathy among term infants in a developing country. DESIGN:Unmatched case-control study. SETTING:Principal maternity hospital of Kathmandu, Nepal. SUBJECTS:All 131 infants with neonatal encephalopathy from a population of 21 609 infants born over an 18 mont...
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abstract:OBJECTIVE:To systematically evaluate the published evidence regarding the characteristics and effectiveness of disease management programmes. DESIGN:Meta-analysis. DATA SOURCES:Computerised databases for English language articles during 1987-2001. STUDY SELECTION:102 articles evaluating 118 disease management progra...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.325.7370.925
更新日期:2002-10-26 00:00:00
abstract:OBJECTIVE:To evaluate the clinical benefit of lipid lowering drug treatment in patients with and without diabetes mellitus, for primary and secondary prevention. DESIGN:Systematic review and meta-analysis. DATA SOURCES:Cochrane, Medline, Embase, and reference lists up to April 2004. STUDY SELECTION:Randomised, place...
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更新日期:2006-05-13 00:00:00
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abstract:OBJECTIVE:To estimate the costs of diagnosis and treatment of diabetes in Tanzania. DESIGN:Costs estimated from the reported and recorded experience of patients with newly presenting diabetes in 1989-90 and of diabetic patients first seen in 1981-2. SETTING:Muhimbili Medical Centre, Dar es Salaam. SUBJECTS:464 patie...
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doi:10.1136/bmj.304.6836.1215
更新日期:1992-05-09 00:00:00
abstract:OBJECTIVE:To evaluate the outcome of liver transplantation in patients with alcoholic cirrhosis with respect to selection criteria, survival, and evidence suggesting a return to harmful drinking. DESIGN:Nine year retrospective study. SETTING:Cambridge and King's College Hospital liver transplant programme. SUBJECTS:...
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更新日期:2003-05-03 00:00:00
abstract:OBJECTIVES:To compare patterns of admission to hospital and prognosis in white and South Asian patients newly admitted with heart failure, and to evaluate the effect of personal characteristics and comorbidity on outcome. DESIGN:Historical cohort study. SETTING:UK district health authority (population 960,000). PART...
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更新日期:2003-09-06 00:00:00
abstract:OBJECTIVE:To determine whether tobacco smoking causes increased DNA modification (adducts) in human cervical epithelium. DESIGN:Comparison of DNA adducts measured by the technique of postlabelling with phosphorus-32 in normal ectocervical epithelium of smokers and non-smokers. A questionnaire on smoking habit and a ur...
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doi:10.1136/bmj.306.6890.1444
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abstract:OBJECTIVE:To estimate the association between maternal age and fetal death (spontaneous abortion, ectopic pregnancy, stillbirth), taking into account a woman's reproductive history. DESIGN:Prospective register linkage study. SUBJECTS:All women with a reproductive outcome (live birth, stillbirth, spontaneous abortion ...
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更新日期:2000-06-24 00:00:00
abstract:OBJECTIVE:To assess predictors of mortality in a population of people prescribed methadone. DESIGN:Retrospective cohort study. SETTING:Geographically defined population in Tayside, Scotland. PARTICIPANTS:2378 people prescribed and dispensed liquid methadone between January 1993 and February 2004. MAIN OUTCOME MEASU...
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doi:10.1136/bmj.323.7308.320
更新日期:2001-08-11 00:00:00
abstract:OBJECTIVE:To determine whether total hip arthroplasty is associated with lower reoperation rates, mortality, and complications, and better function and quality of life than hemiarthroplasty for displaced fractures of the femoral neck in older patients. DESIGN:Systematic review and meta-analysis of randomised trials, q...
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pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.c2332
更新日期:2010-06-11 00:00:00
abstract:OBJECTIVE:To explore the factors that influence help seeking for mental distress by offenders. DESIGN:Qualitative study based on in-depth interviews with prisoners before and after release. SETTING:One category B local prison in southern England. PARTICIPANTS:35 male offenders aged 18-52, a quarter of whom had been ...
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doi:10.1136/bmj.39059.594444.AE
更新日期:2007-02-10 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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doi:10.1136/bmj.320.7245.1303
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更新日期:2020-06-16 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2006-02-11 00:00:00
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更新日期:2008-03-29 00:00:00
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更新日期:2020-02-19 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2010-01-14 00:00:00
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doi:10.1136/bmj.38202.364271.BE
更新日期:2004-09-11 00:00:00
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更新日期:2015-06-22 00:00:00
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doi:10.1136/bmj.c1594
更新日期:2010-04-20 00:00:00