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Bhatta, L., Leivseth, L., Mai, X. - M., Chen, Y., Henriksen, A. H., Langhammer, A., et al. (2018). Prevalence and trend of COPD from 1995-1997 to 2006-2008: The HUNT study, Norway. Respir Med, 138, 50–56.
Abstract: BACKGROUND: COPD is a major cause of morbidity and mortality across the world and new estimates of prevalence and trend are of great importance. We aimed to estimate the prevalence and trend of COPD from 1995-1997 to 2006-2008 in Norwegian adults >/=40 years from the Nord-Trondelag Health Study. MATERIAL AND METHODS: COPD was assessed using a fixed-ratio and lower limit of normal (LLN) criteria. Pre-bronchodilator spirometry was performed during 1995-1997 (n=7158) and 2006-2008 (n=8788). The prevalence of COPD was weighted using the inverse probability of selection and predicted probability of response. RESULTS: The prevalence of pre-bronchodilator COPD was 16.7% in 1995-1997 and 14.8% in 2006-2008 using fixed-ratio criteria, and 10.4% in 1995-1997 and 7.3% in 2006-2008 using LLN criteria. The prevalence of LLN COPD was higher among men (13.0% in 1995-1997, 7.7% in 2006-2008) than women (8.0% in 1995-1997, 6.9% in 2006-2008). From 1995-1997 to 2006-2008, the prevalence decreased among men but remained relatively stable among women. Over the 11-year period, the cumulative incidence of pre-bronchodilator COPD using LLN criteria was 3.3% and 2.7% among men and women respectively. The prevalence of self-reported asthma and respiratory symptoms increased. CONCLUSIONS: The prevalence declined in men but not in women from 1995-1997 to 2006-2008, and was consistently higher among men than women.
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Dalen, J. D., Huijts, T., Krokstad, S., & Eikemo, T. A. (2012). Are there educational differences in the association between self-rated health and mortality in Norway? The HUNT Study. Scand J Public Health, 40(7), 641–647.
Abstract: AIMS: The aim of this study was to test whether the association between self-rated health and mortality differs between educational groups in Norway, and to examine whether health problems and health-related behaviour can explain any of these differences within a previously unexplored contextual setting. METHODS: The study used data from the Nord-Trondelag Health Study 84-86 (HUNT) with a 20-year follow up. The analyses were performed for respondents between 25-101 years at baseline (n = 56,788). The association between self-rated health and mortality was tested using Cox regression. RESULTS: The results indicate that although self-rated health is associated with mortality there is no difference in the association between self-rated health and mortality between educational groups. Introducing health-related variables did not have an impact on the result. CONCLUSIONS: Given the small educational differences in the association between self-rated health and mortality, this supports the reliability of self-reported health as a measurement for objective health.
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Kvamme, J. - M., Holmen, J., Wilsgaard, T., Florholmen, J., Midthjell, K., & Jacobsen, B. K. (2012). Body mass index and mortality in elderly men and women: the Tromso and HUNT studies. J Epidemiol Community Health, 66(7), 611–617.
Abstract: BACKGROUND: The impact of body mass index (BMI; kg/m(2)) and waist circumference (WC) on mortality in elderly individuals is controversial and previous research has largely focused on obesity. METHODS: With special attention to the lower BMI categories, associations between BMI and both total and cause-specific mortality were explored in 7604 men and 9107 women aged >/= 65 years who participated in the Tromso Study (1994-1995) or the North-Trondelag Health Study (1995-1997). A Cox proportional hazards model adjusted for age, marital status, education and smoking was used to estimate HRs for mortality in different BMI categories using the BMI range of 25-27.5 as a reference. The impact of each 2.5 kg/m(2) difference in BMI on mortality in individuals with BMI < 25.0 and BMI >/= 25.0 was also explored. Furthermore, the relations between WC and mortality were assessed. RESULTS: We identified 7474 deaths during a mean follow-up of 9.3 years. The lowest mortality was found in the BMI range 25-29.9 and 25-32.4 in men and women, respectively. Mortality was increased in all BMI categories below 25 and was moderately increased in obese individuals. U-shaped relationships were also found between WC and total mortality. About 40% of the excess mortality in the lower BMI range in men was explained by mortality from respiratory diseases. CONCLUSIONS: BMI below 25 in elderly men and women was associated with increased mortality. A modest increase in mortality was found with increasing BMI among obese men and women. Overweight individuals (BMI 25-29.9) had the lowest mortality.
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Nordhaug, L. H., Hagen, K., Vik, A., Stovner, L. J., Follestad, T., Pedersen, T., et al. (2018). Headache following head injury: a population-based longitudinal cohort study (HUNT). J Headache Pain, 19(1), 8.
Abstract: BACKGROUND: Headache is the most frequent symptom following head injury, but long-term follow-up of headache after head injury entails methodological challenges. In a population-based cohort study, we explored whether subjects hospitalized due to a head injury more often developed a new headache or experienced exacerbation of previously reported headache compared to the surrounding population. METHODS: This population-based historical cohort study included headache data from two large epidemiological surveys performed with an 11-year interval. This was linked with data from hospital records on exposure to head injury occurring between the health surveys. Participants in the surveys who had not been hospitalized because of a head injury comprised the control group. The head injuries were classified according to the Head Injury Severity Scale (HISS). Multinomial logistic regression was performed to investigate the association between head injury and new headache or exacerbation of pre-existing headache in a population with known pre-injury headache status, controlling for potential confounders. RESULTS: The exposed group consisted of 294 individuals and the control group of 25,662 individuals. In multivariate analyses, adjusting for age, sex, anxiety, depression, education level, smoking and alcohol use, mild head injury increased the risk of new onset headache suffering (OR 1.74, 95% CI 1.05-2.87), stable headache suffering (OR 1.70, 95% CI 1.15-2.50) and exacerbation of previously reported headache (OR 1.93, 95% CI 1.24-3.02). The reference category was participants without headache in both surveys. CONCLUSION: Individuals hospitalized due to a head injury were more likely to have new onset and worsening of pre-existing headache and persistent headache, compared to the surrounding general population. The results support the entity of the ICHD-3 beta diagnosis “persistent headache attributed to traumatic injury to the head”.
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Rostad, B., Schmidt, L., Sundby, J., & Schei, B. (2013). Has fertility declined from mid-1990s to mid-2000s? Acta Obstet Gynecol Scand, 92(11), 1284–1289.
Abstract: OBJECTIVE: To assess changes in self-reported fertility from the mid-1990s to the mid-2000s. DESIGN: The study is a retrospective population-based study. SETTING: The study applied a dataset from two cross-sectional surveys conducted in the mid-1990s and some 10 years later, inviting all women in a county in Norway. POPULATION: Women aged 50-59 years enrolled in either survey constituted two cohorts. Data on 4468 women in the first survey (Cohort 1940) and 4951 women in the latter survey (Cohort 1950) were collected by structured questionnaires. MAIN OUTCOME MEASURES: Prevalence of fertility, infertility with subcategories subfertility and involuntary childlessness, as well as childlessness was estimated and compared between the surveys. Possible sociodemographic and lifestyle predictors of fertility were assessed at different points in time. RESULTS: Fertility declined over the two successive surveys; 87.8% of the women in Cohort 1940 were fertile compared with 84.2% of the women in Cohort 1950 (p = 0.000). The prevalence of infertility increased over time due to an increase in subfertility from 7.8 to 10.6% (p = 0.000). The level of education increased with time, as did at-risk alcohol consumption and smoking, and these factors were adversely associated with fertility. The proportion of childless women increased across surveys (p = 0.004) but relatively fewer women were involuntarily childless in Cohort 1950 than in Cohort 1940 (p = 0.543). CONCLUSION: Fertility, measured at 10-year intervals, declined significantly. The decline in fertility was related to changes in subfertility. Adjustments for sociodemographic and lifestyle factors did not fully explain the decline in fertility.
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Storeng, S. H., Krokstad, S., Westin, S., & Sund, E. R. (2018). Decennial trends and inequalities in healthy life expectancy: The HUNT Study, Norway. Scand J Public Health, 46(1), 124–131.
Abstract: AIMS: Norway is experiencing a rising life expectancy combined with an increasing dependency ratio – the ratio of those outside over those within the working force. To provide data relevant for future health policy we wanted to study trends in total and healthy life expectancy in a Norwegian population over three decades (1980s, 1990s and 2000s), both overall and across gender and educational groups. METHODS: Data were obtained from the HUNT Study, and the Norwegian Educational Database. We calculated total life expectancy and used the Sullivan method to calculate healthy life expectancies based on self-rated health and self-reported longstanding limiting illness. The change in health expectancies was decomposed into mortality and disability effects. RESULTS: During three consecutive decades we found an increase in life expectancy for 30-year-olds (~7 years) and expected lifetime in self-rated good health (~6 years), but time without longstanding limiting illness increased less (1.5 years). Women could expect to live longer than men, but the extra life years for females were spent in poor self-rated health and with longstanding limiting illness. Differences in total life expectancy between educational groups decreased, whereas differences in expected lifetime in self-rated good health and lifetime without longstanding limiting illness increased. CONCLUSIONS: The increase in total life expectancy was accompanied by an increasing number of years spent in good self-rated health but more years with longstanding limiting illness. This suggests increasing health care needs for people with chronic diseases, given an increasing number of elderly. Socioeconomic health inequalities remain a challenge for increasing pensioning age.
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Storeng, S. H., Krokstad, S., Westin, S., & Sund, E. R. (2018). Decennial trends and inequalities in healthy life expectancy: The HUNT Study, Norway. Scand J Public Health, 46(1), 124–131.
Abstract: AIMS: Norway is experiencing a rising life expectancy combined with an increasing dependency ratio – the ratio of those outside over those within the working force. To provide data relevant for future health policy we wanted to study trends in total and healthy life expectancy in a Norwegian population over three decades (1980s, 1990s and 2000s), both overall and across gender and educational groups. METHODS: Data were obtained from the HUNT Study, and the Norwegian Educational Database. We calculated total life expectancy and used the Sullivan method to calculate healthy life expectancies based on self-rated health and self-reported longstanding limiting illness. The change in health expectancies was decomposed into mortality and disability effects. RESULTS: During three consecutive decades we found an increase in life expectancy for 30-year-olds (~7 years) and expected lifetime in self-rated good health (~6 years), but time without longstanding limiting illness increased less (1.5 years). Women could expect to live longer than men, but the extra life years for females were spent in poor self-rated health and with longstanding limiting illness. Differences in total life expectancy between educational groups decreased, whereas differences in expected lifetime in self-rated good health and lifetime without longstanding limiting illness increased. CONCLUSIONS: The increase in total life expectancy was accompanied by an increasing number of years spent in good self-rated health but more years with longstanding limiting illness. This suggests increasing health care needs for people with chronic diseases, given an increasing number of elderly. Socioeconomic health inequalities remain a challenge for increasing pensioning age.
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