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Ischemic heart disease (IHD) causes mortality and morbidity. High levels of occupational physical activity (OPA) increases IHD risk, and occupational lifting (OL) is suggested as a detrimental OPA exposure. This study investigated the association between accumulated OL throughout working life, and risk for IHD, and potential sex and hypertension differences. Data from Copenhagen Ageing and Midlife Biobank linked to register-based information on incident IHD during 9 years follow-up in the Danish National Patient Registry were included. The outcome was the odds of IHD from baseline (2009–2011) to end of follow-up (2018), among participants without IHD at baseline. Accumulated OL was assessed by linking occupational codes to a Job Exposure Matrix, creating a measure in ton-years (lifting 1,000 kg/day/year). Multivariable logistic regression tested associations between level of accumulated OL and IHD, among the 6,606 included individuals (68% men). During follow-up, 7.3% men and 3.6% women were hospitalized with IHD. Among all participants, the odds for IHD were 47% (OR 1.47, 95% CI 1.05–2.06) higher among those with ≥5 to <10 ton-years, 39% (OR 1.39, 95% CI 1.06–1.83) higher among those with ≥10 to <30 ton-years, and 62% (OR 1.62, 95% CI 1.18–2.22) higher among those with ≥30 ton-years, compared to no accumulated OL. However, these increased odds were in the same direction in the fully-adjusted model but statistically insignificant, ≥5 to <10 ton-years OR 1.28, 95% CI 0.88–1.88; ≥10 to <30 ton-years OR 1.20, 95% CI 0.85–1.69; and ≥30 ton-years OR 1.22, 95% CI 0.81–1.84. No statistically significant interactions, nor any associations, between OL and sex, or hypertension were seen. cardiovascular disease, cardiovascular risk, heavy lifting, IHD, occupational physical activity, occupational exposure, occupational medicine, prevention of cardiovascular disease, Ischemic heart disease (IHD) causes mortality and morbidity. High levels of occupational physical activity (OPA) increases IHD risk, and occupational lifting (OL) is suggested as a detrimental OPA exposure. This study investigated the association between accumulated OL throughout working life, and risk for IHD, and potential sex and hypertension differences. Data from Copenhagen Ageing and Midlife Biobank linked to register-based information on incident IHD during 9 years follow-up in the Danish National Patient Registry were included. The outcome was the odds of IHD from baseline (2009-2011) to end of follow-up (2018), among participants without IHD at baseline. Accumulated OL was assessed by linking occupational codes to a Job Exposure Matrix, creating a measure in ton-years (lifting 1,000 kg/day/year). Multivariable logistic regression tested associations between level of accumulated OL and IHD, among the 6,606 included individuals (68% men). During follow-up, 7.3% men and 3.6% women were hospitalized with IHD. Among all participants, the odds for IHD were 47% (OR 1.47, 95% CI 1.05-2.06) higher among those with ≥5 to <10 ton-years, 39% (OR 1.39, 95% CI 1.06-1.83) higher among those with ≥10 to <30 ton-years, and 62% (OR 1.62, 95% CI 1.18-2.22) higher among those with ≥30 ton-years, compared to no accumulated OL. However, these increased odds were in the same direction in the fully-adjusted model but statistically insignificant, ≥5 to <10 ton-years OR 1.28, 95% CI 0.88-1.88; ≥10 to <30 ton-years OR 1.20, 95% CI 0.85-1.69; and ≥30 ton-years OR 1.22, 95% CI 0.81-1.84. No statistically significant interactions, nor any associations, between OL and sex, or hypertension were seen.

Ischemic heart disease (IHD) causes mortality and morbidity. High levels of occupational physical activity (OPA) increases IHD risk, and occupational lifting (OL) is suggested as a detrimental OPA exposure. This study investigated the association between accumulated OL throughout working life, and risk for IHD, and potential sex and hypertension differences. Data from Copenhagen Ageing and Midlife Biobank linked to register-based information on incident IHD during 9 years follow-up in the Danish National Patient Registry were included. The outcome was the odds of IHD from baseline (2009–2011) to end of follow-up (2018), among participants without IHD at baseline. Accumulated OL was assessed by linking occupational codes to a Job Exposure Matrix, creating a measure in ton-years (lifting 1,000 kg/day/year). Multivariable logistic regression tested associations between level of accumulated OL and IHD, among the 6,606 included individuals (68% men). During follow-up, 7.3% men and 3.6% women were hospitalized with IHD. Among all participants, the odds for IHD were 47% (OR 1.47, 95% CI 1.05–2.06) higher among those with ≥5 to <10 ton-years, 39% (OR 1.39, 95% CI 1.06–1.83) higher among those with ≥10 to <30 ton-years, and 62% (OR 1.62, 95% CI 1.18–2.22) higher among those with ≥30 ton-years, compared to no accumulated OL. However, these increased odds were in the same direction in the fully-adjusted model but statistically insignificant, ≥5 to <10 ton-years OR 1.28, 95% CI 0.88–1.88; ≥10 to <30 ton-years OR 1.20, 95% CI 0.85–1.69; and ≥30 ton-years OR 1.22, 95% CI 0.81–1.84. No statistically significant interactions, nor any associations, between OL and sex, or hypertension were seen. cardiovascular disease, cardiovascular risk, heavy lifting, IHD, occupational physical activity, occupational exposure, occupational medicine, prevention of cardiovascular disease, Ischemic heart disease (IHD) causes mortality and morbidity. High levels of occupational physical activity (OPA) increases IHD risk, and occupational lifting (OL) is suggested as a detrimental OPA exposure. This study investigated the association between accumulated OL throughout working life, and risk for IHD, and potential sex and hypertension differences. Data from Copenhagen Ageing and Midlife Biobank linked to register-based information on incident IHD during 9 years follow-up in the Danish National Patient Registry were included. The outcome was the odds of IHD from baseline (2009-2011) to end of follow-up (2018), among participants without IHD at baseline. Accumulated OL was assessed by linking occupational codes to a Job Exposure Matrix, creating a measure in ton-years (lifting 1,000 kg/day/year). Multivariable logistic regression tested associations between level of accumulated OL and IHD, among the 6,606 included individuals (68% men). During follow-up, 7.3% men and 3.6% women were hospitalized with IHD. Among all participants, the odds for IHD were 47% (OR 1.47, 95% CI 1.05-2.06) higher among those with ≥5 to <10 ton-years, 39% (OR 1.39, 95% CI 1.06-1.83) higher among those with ≥10 to <30 ton-years, and 62% (OR 1.62, 95% CI 1.18-2.22) higher among those with ≥30 ton-years, compared to no accumulated OL. However, these increased odds were in the same direction in the fully-adjusted model but statistically insignificant, ≥5 to <10 ton-years OR 1.28, 95% CI 0.88-1.88; ≥10 to <30 ton-years OR 1.20, 95% CI 0.85-1.69; and ≥30 ton-years OR 1.22, 95% CI 0.81-1.84. No statistically significant interactions, nor any associations, between OL and sex, or hypertension were seen.

Background This study aims to describe demographics, social relations and health in an ethnically diverse social housing area selected to undergo large structural changes and compare it to the surrounding municipality. Furthermore, to explore the association between social relations and self-rated health (SRH) and the interaction with country of origin in both populations. Methods Data sources include a multilingual interviewer-driven survey study in a social housing area (N = 209) and a municipal health survey (N = 1,638) among residents aged 45 + years. Information on social relations include contact frequency with and support from family, friends, and neighbors. Descriptive and multivariate logistic regression analyses adjusted for age, sex, and country of origin are presented, as well as joint effect analyses of social relations and country of origin on SRH. Results In the social housing area, 38.8% of the respondents reported poor SRH compared to 19.5% in the municipality. In both study populations low contact frequency was associated with poor SRH, however insignificantly in the social housing area compared to the municipality sample, OR = 1.50 (0.65–3.46) vs. OR = 2.42 (1.70–3.45). Joint exposure to having non-Western background and low contact frequency was strongly associated with poor SRH in the social housing area, OR = 6.28 (1.80–21.89) but less so in the municipality, OR = 3.67 (1.55–8.69). The same tendency was seen regarding low support from social relations. Conclusions This study provides insight to a population that is generally underrepresented in survey studies. In the social housing area, approximately twice as many reported poor SRH compared to the municipality data. In both populations, low contact frequency and low support were associated with poor SRH. Residents with weak social relations and non-Western origin simultaneously were more likely to report poor SRH in the social housing area specificall, Background: This study aims to describe demographics, social relations and health in an ethnically diverse social housing area selected to undergo large structural changes and compare it to the surrounding municipality. Furthermore, to explore the association between social relations and self-rated health (SRH) and the interaction with country of origin in both populations. Methods: Data sources include a multilingual interviewer-driven survey study in a social housing area (N = 209) and a municipal health survey (N = 1,638) among residents aged 45 + years. Information on social relations include contact frequency with and support from family, friends, and neighbors. Descriptive and multivariate logistic regression analyses adjusted for age, sex, and country of origin are presented, as well as joint effect analyses of social relations and country of origin on SRH. Results: In the social housing area, 38.8% of the respondents reported poor SRH compared to 19.5% in the municipality. In both study populations low contact frequency was associated with poor SRH, however insignificantly in the social housing area compared to the municipality sample, OR = 1.50 (0.65–3.46) vs. OR = 2.42 (1.70–3.45). Joint exposure to having non-Western background and low contact frequency was strongly associated with poor SRH in the social housing area, OR = 6.28 (1.80–21.89) but less so in the municipality, OR = 3.67 (1.55–8.69). The same tendency was seen regarding low support from social relations. Conclusions: This study provides insight to a population that is generally underrepresented in survey studies. In the social housing area, approximately twice as many reported poor SRH compared to the municipality data. In both populations, low contact frequency and low support were associated with poor SRH. Residents with weak social relations and non-Western origin simultaneously were more likely to report poor SRH in the social housing area specifically but less so in the municipality, i

Objectives. Due to increasing pressure on healthcare resources, knowledge of factors that affect healthcare utilization (HCU) is important. However, the evidence of a longitudinal association between loneliness and social isolation respectively, and HCU is limited. The present prospective cohort study investigated the association of loneliness and social isolation with HCU in the general population over time. Method. Data from the 2013 Danish “How are you?” survey (n = 27.501) were combined with individual-level register data with almost complete follow-up over a 6-year follow-up period (2013–2018). Negative binomial regression analyses were performed while adjusting for baseline demographics and preexisting chronic disease. Results. Loneliness measured was significantly associated with more general practice contacts (incident rate ratio [IRR] = 1.03, 95% confidence interval [CI] [1.02, 1.04]), more emergency treatments (IRR = 1.06, [1.03, 1.10]), more emergency admissions (IRR = 1.06, [1.03, 1.10]), and hospital admission days (IRR = 1.05, [1.00, 1.11]) across the 6-year follow-up period. No significant associations were found between social isolation and HCU with one minor exception, in which social isolation was associated with fewer planned outpatient treatments (IRR = 0.97, [0.94, 0.99]). Wald test demonstrated that the association of loneliness with emergency admissions and hospital admissions days was not significantly different from the effects of social isolation on those outcomes. Conclusions. Our findings suggest that loneliness slightly increased the number of general practice contacts and emergency room treatments. Overall, the effects of loneliness and social isolation on HCU were small., OBJECTIVES: Due to increasing pressure on healthcare resources, knowledge of factors that affect healthcare utilization (HCU) is important. However, the evidence of a longitudinal association between loneliness and social isolation respectively, and HCU is limited. The present prospective cohort study investigated the association of loneliness and social isolation with HCU in the general population over time.METHOD: Data from the 2013 Danish "How are you?" survey (n = 27.501) were combined with individual-level register data with almost complete follow-up over a 6-year follow-up period (2013-2018). Negative binomial regression analyses were performed while adjusting for baseline demographics and preexisting chronic disease.RESULTS: Loneliness measured was significantly associated with more general practice contacts (incident rate ratio [IRR] = 1.03, 95% confidence interval [CI] [1.02, 1.04]), more emergency treatments (IRR = 1.06, [1.03, 1.10]), more emergency admissions (IRR = 1.06, [1.03, 1.10]), and hospital admission days (IRR = 1.05, [1.00, 1.11]) across the 6-year follow-up period. No significant associations were found between social isolation and HCU with one minor exception, in which social isolation was associated with fewer planned outpatient treatments (IRR = 0.97, [0.94, 0.99]). Wald test demonstrated that the association of loneliness with emergency admissions and hospital admissions days was not significantly different from the effects of social isolation on those outcomes.CONCLUSIONS: Our findings suggest that loneliness slightly increased the number of general practice contacts and emergency room treatments. Overall, the effects of loneliness and social isolation on HCU were small. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

BACKGROUND: Area deprivation is associated with adverse mental health outcomes. In Denmark, urban regeneration is being used to dissolve concentrated socio-economic area deprivation and ethnic segregation. However, evidence on how urban regeneration affects mental health of residents is ambiguous partly due to methodological challenges. This study investigates if urban regeneration affects users of antidepressant and sedative medication among residents in an exposed and control social housing area in Denmark.METHODS: Using a longitudinal quasi-experimental design we measured users of antidepressant and sedative medication in one area undergoing urban regeneration compared with a control area. We measured prevalent and incident users from 2015 to 2020 among non-Western and Western women and men and used logistic regression to measure annual change in users over time. Analyses are adjusted for a covariate propensity score estimated using baseline socio-demographic characteristics and general practitioner contacts.RESULTS: Urban regeneration did not affect the proportion of prevalent nor incident users of antidepressant and sedative medication. However, levels were high in both areas compared with the national average. Descriptive levels of prevalent and incident users were generally lower among residents in the exposed area compared with the control area for most years and stratified groups confirmed by the logistic regression analyses.CONCLUSION: Urban regeneration was not associated with users of antidepressant or sedative medication. We found lower levels of antidepressant and sedative medication users in the exposed area compared with the control area. More studies are needed to investigate the underlying reasons for these findings, and whether they could be related to underuse.

Urban regeneration often intends to improve the physical, economic, and social environment of disadvantaged neighborhoods. However, evidence on the consequences of such interventions on place-based social relations is limited in Scandinavia. This study investigates the relationship between urban regeneration and diverse forms of place-based social relations among middle-aged and older social housing residents in Denmark. A longitudinal multi-method design was applied using data from administrative registers and semi-structured individual interviews. The quantitative results showed small changes in household-restricted place-based social relations, whereas participants in the qualitative sample described the disruption of place-based social relations to negatively affect their well-being

Background This study aims to describe demographics, social relations and health in an ethnically diverse social housing area selected to undergo large structural changes and compare it to the surrounding municipality. Furthermore, to explore the association between social relations and self-rated health (SRH) and the interaction with country of origin in both populations. Methods Data sources include a multilingual interviewer-driven survey study in a social housing area (N = 209) and a municipal health survey (N = 1,638) among residents aged 45 + years. Information on social relations include contact frequency with and support from family, friends, and neighbors. Descriptive and multivariate logistic regression analyses adjusted for age, sex, and country of origin are presented, as well as joint effect analyses of social relations and country of origin on SRH. Results In the social housing area, 38.8% of the respondents reported poor SRH compared to 19.5% in the municipality. In both study populations low contact frequency was associated with poor SRH, however insignificantly in the social housing area compared to the municipality sample, OR = 1.50 (0.65–3.46) vs. OR = 2.42 (1.70–3.45). Joint exposure to having non-Western background and low contact frequency was strongly associated with poor SRH in the social housing area, OR = 6.28 (1.80–21.89) but less so in the municipality, OR = 3.67 (1.55–8.69). The same tendency was seen regarding low support from social relations. Conclusions This study provides insight to a population that is generally underrepresented in survey studies. In the social housing area, approximately twice as many reported poor SRH compared to the municipality data. In both populations, low contact frequency and low support were associated with poor SRH. Residents with weak social relations and non-Western origin simultaneously were more likely to report poor SRH in the social housing area specificall, Background: This study aims to describe demographics, social relations and health in an ethnically diverse social housing area selected to undergo large structural changes and compare it to the surrounding municipality. Furthermore, to explore the association between social relations and self-rated health (SRH) and the interaction with country of origin in both populations. Methods: Data sources include a multilingual interviewer-driven survey study in a social housing area (N = 209) and a municipal health survey (N = 1,638) among residents aged 45 + years. Information on social relations include contact frequency with and support from family, friends, and neighbors. Descriptive and multivariate logistic regression analyses adjusted for age, sex, and country of origin are presented, as well as joint effect analyses of social relations and country of origin on SRH. Results: In the social housing area, 38.8% of the respondents reported poor SRH compared to 19.5% in the municipality. In both study populations low contact frequency was associated with poor SRH, however insignificantly in the social housing area compared to the municipality sample, OR = 1.50 (0.65–3.46) vs. OR = 2.42 (1.70–3.45). Joint exposure to having non-Western background and low contact frequency was strongly associated with poor SRH in the social housing area, OR = 6.28 (1.80–21.89) but less so in the municipality, OR = 3.67 (1.55–8.69). The same tendency was seen regarding low support from social relations. Conclusions: This study provides insight to a population that is generally underrepresented in survey studies. In the social housing area, approximately twice as many reported poor SRH compared to the municipality data. In both populations, low contact frequency and low support were associated with poor SRH. Residents with weak social relations and non-Western origin simultaneously were more likely to report poor SRH in the social housing area specifically but less so in the municipality, i

Urban regeneration often intends to improve the physical, economic, and social environment of disadvantaged neighborhoods. However, evidence on the consequences of such interventions on place-based social relations is limited in Scandinavia. This study investigates the relationship between urban regeneration and diverse forms of place-based social relations among middle-aged and older social housing residents in Denmark. A longitudinal multi-method design was applied using data from administrative registers and semi-structured individual interviews. The quantitative results showed small changes in household-restricted place-based social relations, whereas participants in the qualitative sample described the disruption of place-based social relations to negatively affect their well-being

Area regeneration of deprived neighborhoods is being used to reduce health inequality, socioeconomic deprivation and ethnic segregation. This quasi-experimental study examines if long-term graded exposure to urban regeneration is associated with primary healthcare-seeking behavior among residents. We compared general practitioner (GP) contacts from 2015-2020 in two adjacent, deprived social housing areas, one exposed to area regeneration. Populations were into Western and non-Western males and females aged 15 years and older (N = 3,960). Mean annual GP contact frequency for each group were estimated and a difference-in-difference (DiD) analysis was conducted with adjustments for propensity scores based on baseline characteristics. GP contact frequency increased for all groups across time with a systematically higher level and faster increase in the control groups. In particular, the mean difference between the exposed and control area for non-Western women more than doubled from -0.61 to -1.47 annual contacts across the period. The mean differences in contact frequency increased for all groups but results of the DiD analyses were insignificant. In conclusion, an emerging gap in GP contact frequency, with the highest levels in the control area, was observed for all comparisons across time. More long-term research is needed to understand how the emerging gaps evolve.

Under coronapandemien har sundhedsmyndighederne oplevet udfordringer med at ’nå’ ældre borgere med ikke-vestlig baggrund. Via interviews og visuelle fortællinger har vi skabt viden om denne befolkningsgruppe og vil dele historien om, hvordan ældre borgere med ikke-vestlig baggrund, bosiddende i et alment boligområde, oplevede coronanedlukningen i foråret 2020. De visuelle fortællinger viser, hvordan de ældre støttede op om den officielle smittehåndteringsstrategi, gjorde deres bedste for at håndtere isolationen, og hvordan bekymringer for især familie i hjemlandet gjorde nedlukningen særlig smertefuld. Vores undersøgelse understreger, at der er behov for sundhedskommunikation udviklet særligt til, og med, denne målgruppe, og gerne med brug af visuelle greb for at håndtere sproglige og kulturelle barrierer.

Under coronapandemien har sundhedsmyndighederne oplevet udfordringer med at ’nå’ ældre borgere med ikke-vestlig baggrund. Via interviews og visuelle fortællinger har vi skabt viden om denne befolkningsgruppe og vil dele historien om, hvordan ældre borgere med ikke-vestlig baggrund, bosiddende i et alment boligområde, oplevede coronanedlukningen i foråret 2020. De visuelle fortællinger viser, hvordan de ældre støttede op om den officielle smittehåndteringsstrategi, gjorde deres bedste for at håndtere isolationen, og hvordan bekymringer for især familie i hjemlandet gjorde nedlukningen særlig smertefuld. Vores undersøgelse understreger, at der er behov for sundhedskommunikation udviklet særligt til, og med, denne målgruppe, og gerne med brug af visuelle greb for at håndtere sproglige og kulturelle barrierer.

Burning candles at home emit small particles and gases that pollute indoor air. Exposure to fine particles in outdoor air has been convincingly linked to cardiovascular and respiratory events, while the associations with fine and ultrafine particles from candle burning remain unexplored. We examined the association between the use of candles and incident cardiovascular and respiratory events. We collected data on 6757 participants of the Copenhagen Aging and Midlife Biobank cohort recruited in 2009 and followed them up for the first hospital contact for incident cardiovascular and respiratory events until 2018. We investigated an association between the self-reported frequency of candle use in wintertime and cardiovascular and respiratory events, using Cox regression models adjusting for potential confounders. During follow-up, 1462 and 834 were admitted for cardiovascular and respiratory events, respectively. We found null associations between candle use and a hospital contact due to cardiovascular and respiratory events, with hazard ratios (HRs) and 95% confidence intervals (CI) of 0.97 (95% CI: 0.84, 1.11) and 0.98 (95% CI: 0.81, 1.18), respectively, among those using candles >4 times/week compared with

This study reports on a health promotion intervention (HPI), where graphic facilitation (GF) was used as an innovative method to enable participation in a co-design process in a multi-ethnic and disadvantaged neighbourhood in Denmark. The aim was to enable middle-aged and older residents to participate in the research process of planning and evaluating the HPI, as well as in the activities it constituted. GF was used to document statements and inputs from residents through visual meeting minutes and resident experiences with coronavirus disease 2019 (COVID-19) lockdown were drawn by a graphic facilitator. We use the ladder of participation as a framework to unfold the participation enabled by GF. During the HPI, data were produced through ethnographic field studies in and outside the neighbourhood and in design workshops with residents. The study finds that GF helped in reaching a target group difficult to engage in research and that the engagement of a graphic facilitator shifted the power-balance between the researchers and the residents, redistributing expertise. Carrying out GF in a HPI is a collaborative endeavour and in addition to research competences, it requires the artistic and relational skills of a graphic facilitator. The co-created process of the visual minutes and COVID-19 experiences created a sense of ownership and encouraged the residents to reflect on their interaction with the researchers. The redistribution of expertise was conditioned by the power dynamics present and GF helped unfold these dynamics. This is especially important in an HPI engaging socio-economically vulnerable populations.

Aim: To document the challenges of developing and executing an interviewer-driven survey questionnaire in an ethnically diverse and deprived social housing area undergoing reconstruction in Denmark. Methods: The survey was initially planned to be conducted in three waves (before, during and after reconstruction of the housing area), based on a questionnaire covering health, wellbeing and social relations. The first two waves took place in 2018 and 2019 (invited n=~600 per wave) and the third wave will be conducted once the reconstruction is finalised. The approach to the third wave is under revision by the research team. The questionnaire was translated from Danish into the seven most common languages in the housing area. A bilingual interview team went door to door interviewing residents. Field notes were collected systematically during each wave to document the process. Results: The response rates were 35% (n=209) and 22% (n=132) for waves 1 and 2, respectively. There was an overall decrease in response rates between waves 1 and 2 for all language groups, but particularly for Arabic and Turkish-speaking men. The most frequently stated reasons for non-participation included illness and language barriers. The key lessons learnt were that overcoming linguistic and cultural barriers to conducting research among residents in this social housing area requires time and resources. Conclusions: Several challenges are associated with conducting a survey in ethnically diverse and deprived social housing areas. Documenting the challenges and learning from experience are both important, in order to include this hard-to-reach population in health research.

Frequent nighttime smartphone use can disturb healthy sleep patterns and may adversely affect mental health and wellbeing. This study aims at investigating whether nighttime smartphone use increases the risk of poor mental health, i.e. loneliness, depressive symptoms, perceived stress, and low life satisfaction among young adults. High-dimensional tracking data from the Copenhagen Network Study was used to objectively measure nighttime smartphone activity. We recorded more than 250,000 smartphone activities during self-reported sleep periods among 815 young adults (university students, mean age: 21.6 years, males: 77%) over 16 weekdays period. Mental health was measured at baseline using validated measures, and again at follow-up four months later. Associations between nighttime smartphone use and mental health were evaluated at baseline and at follow-up using multiple linear regression adjusting for potential confounding. Nighttime smartphone use was associated with a slightly higher level of perceived stress and depressive symptoms at baseline. For example, participants having 1-3 nights with smartphone use (out of 16 observed nights) had on average a 0.25 higher score (95%CI:0.08;0.41) on the Perceived stress scale ranging from 0 to 10. These differences were small and could not be replicated at follow-up. Contrary to the prevailing hypothesis, nighttime smartphone use is not strongly related to poor mental health, potentially because smartphone use is also a social phenomenon with associated benefits for mental health.

Background Findings about the relationship between individuals’ social relations and general practitioner (GP) contact are ambiguous as to whether weak social relations are associated with an increased or decreased consultation pattern. Furthermore, social relations may affect GP contact differently for men compared to women, between socioeconomic groups and according to perceived need. The overall aim of the study is to examine the association between functional aspects of social relations, perceived emotional and instrumental social support, the tendency to consult a GP and the frequency of GP contact. Methods The study comprised 6911 individuals aged 49–61 at baseline from the Copenhagen Aging and Midlife Biobank (CAMB). We conducted a two-part regression to explore the association between perceived emotional and instrumental social support and GP contact (tendency and frequency), controlling for age, sex, occupational social class, cohabitation status and number of morbidities. Results Results show no overall effect of the perceived social support aspects of social relations on GP contact independent of health-related needs. Conclusions Our results do not support that perceived social support, reflecting functional aspects of social relations, are associated with general practitioner contact among middle-aged people. Trial registration The study has been registered and approved by the Danish Data Protection Agency and the local ethical committee (approval No.H-A-2008-126 and No. 2013-41-1814).Keywords: social relations, perceived social support, healthcare utilisation, general practitioner, middle-aged

Background The ability to accurately predict survival in older adults is crucial as it guides clinical decision making. The added value of using various health indicators as well as changes in these indicators for predicting mortality remains unclear. The aim of this study was to investigate whether changes in health indicators such as frailty and physical performance improve mortality predictions in old age. Methods This is a population based prospective cohort study on 995 community-dwelling people aged 68-92 years from the Longitudinal Aging Study Amsterdam. Two measurements at a three-year interval (1995/1996 and 1998/1999) were available for the frailty index, frailty phenotype, grip strength, walking speed, and Mini-Mental State Examination (MMSE). Cox regression was used to analyze mortality risks associated with the current health status and changes in health, with mortality data up to 2017. The extent to which these health indicators improved mortality predictions compared to models with age and sex only was assessed by the area under the receiver operating characteristic curve (AUC). Results The AUC of age and sex for five-year mortality was 72.8% (95% CI 69.0 - 76.5) and was the lowest in the oldest old (age > 80.5 years). The added AUC of the current status of health indicators ranged from 0.7 to 3.3%. The added AUC of the three-year change was lower, ranging from -0.0 to 1.1%, whereas the added AUC of three-year change and current status combined was similar to current status alone, ranging from 0.6 to 3.2%. Across age, the added AUC of current status was highest in the oldest old, however there was no such pattern using three-year change. Overall, the frailty index appeared to improve mortality predictions the most, followed by the frailty phenotype, MMSE, grip strength, and walking speed. Conclusions Current health status improved mortality predictions better than changes in health. Its contribution was highest in the oldest old, but the added v

Frequent nighttime smartphone use can disturb healthy sleep patterns and may adversely affect mental health and wellbeing. This study aims at investigating whether nighttime smartphone use increases the risk of poor mental health, i.e. loneliness, depressive symptoms, perceived stress, and low life satisfaction among young adults. High-dimensional tracking data from the Copenhagen Network Study was used to objectively measure nighttime smartphone activity. We recorded more than 250,000 smartphone activities during self-reported sleep periods among 815 young adults (university students, mean age: 21.6 years, males: 77%) over 16 weekdays period. Mental health was measured at baseline using validated measures, and again at follow-up four months later. Associations between nighttime smartphone use and mental health were evaluated at baseline and at follow-up using multiple linear regression adjusting for potential confounding. Nighttime smartphone use was associated with a slightly higher level of perceived stress and depressive symptoms at baseline. For example, participants having 1-3 nights with smartphone use (out of 16 observed nights) had on average a 0.25 higher score (95%CI:0.08;0.41) on the Perceived stress scale ranging from 0 to 10. These differences were small and could not be replicated at follow-up. Contrary to the prevailing hypothesis, nighttime smartphone use is not strongly related to poor mental health, potentially because smartphone use is also a social phenomenon with associated benefits for mental health.

Background Findings about the relationship between individuals’ social relations and general practitioner (GP) contact are ambiguous as to whether weak social relations are associated with an increased or decreased consultation pattern. Furthermore, social relations may affect GP contact differently for men compared to women, between socioeconomic groups and according to perceived need. The overall aim of the study is to examine the association between functional aspects of social relations, perceived emotional and instrumental social support, the tendency to consult a GP and the frequency of GP contact. Methods The study comprised 6911 individuals aged 49–61 at baseline from the Copenhagen Aging and Midlife Biobank (CAMB). We conducted a two-part regression to explore the association between perceived emotional and instrumental social support and GP contact (tendency and frequency), controlling for age, sex, occupational social class, cohabitation status and number of morbidities. Results Results show no overall effect of the perceived social support aspects of social relations on GP contact independent of health-related needs. Conclusions Our results do not support that perceived social support, reflecting functional aspects of social relations, are associated with general practitioner contact among middle-aged people. Trial registration The study has been registered and approved by the Danish Data Protection Agency and the local ethical committee (approval No.H-A-2008-126 and No. 2013-41-1814).Keywords: social relations, perceived social support, healthcare utilisation, general practitioner, middle-aged

Background The ability to accurately predict survival in older adults is crucial as it guides clinical decision making. The added value of using various health indicators as well as changes in these indicators for predicting mortality remains unclear. The aim of this study was to investigate whether changes in health indicators such as frailty and physical performance improve mortality predictions in old age. Methods This is a population based prospective cohort study on 995 community-dwelling people aged 68-92 years from the Longitudinal Aging Study Amsterdam. Two measurements at a three-year interval (1995/1996 and 1998/1999) were available for the frailty index, frailty phenotype, grip strength, walking speed, and Mini-Mental State Examination (MMSE). Cox regression was used to analyze mortality risks associated with the current health status and changes in health, with mortality data up to 2017. The extent to which these health indicators improved mortality predictions compared to models with age and sex only was assessed by the area under the receiver operating characteristic curve (AUC). Results The AUC of age and sex for five-year mortality was 72.8% (95% CI 69.0 - 76.5) and was the lowest in the oldest old (age > 80.5 years). The added AUC of the current status of health indicators ranged from 0.7 to 3.3%. The added AUC of the three-year change was lower, ranging from -0.0 to 1.1%, whereas the added AUC of three-year change and current status combined was similar to current status alone, ranging from 0.6 to 3.2%. Across age, the added AUC of current status was highest in the oldest old, however there was no such pattern using three-year change. Overall, the frailty index appeared to improve mortality predictions the most, followed by the frailty phenotype, MMSE, grip strength, and walking speed. Conclusions Current health status improved mortality predictions better than changes in health. Its contribution was highest in the oldest old, but the added v

This study aimed to examine the extent to which allostatic load (AL), measured in midlife, mediates the association between educational attainment in young adulthood and self-rated health (SRH) in midlife among women and men. The study used data from the Copenhagen Aging and Midlife Biobank (CAMB; n = 5467 participants, aged 48-62 years, 31.5% women). Educational attainment was assessed as years of education. SRH was assessed with one item: 'In general, how would you say your health is?' with response options from "excellent" to "poor". AL mediated 31.7% and 19.7% of the association between educational attainment and SRH in women and men, respectively. We observed that higher educational attainment was associated with better SRH and lower AL in both women and men. Our study showed that AL partly mediates the association between educational attainment in young adulthood and SRH in adulthood among both men and women. This study indicates that educational attainment in young adulthood affects health throughout life. Such knowledge of a potential mediator may be important in breaking the social heritage.

Background Partnership breakups and living alone are associated with several adverse health outcomes. The aim of this study, carried out in Denmark, is to investigate whether accumulated numbers of divorces/partnership breakups or years lived alone across 26 years of adult life are associated with levels of inflammation, and if vulnerability with regards to gender or educational level can be identified. Methods 4835 participants from the Copenhagen Aging and Midlife Biobank (CAMB) aged 48-62 years were included. Data on accumulated numbers of partnership breakups and years living alone were retrieved from a national standardised annual register. Inflammatory markers interleukin 6 (IL-6) and high sensitivity C-reactive protein (hsCRP) were measured in blood samples. Multivariate linear regression analyses were adjusted for age, educational level, early major life events, body mass index, chronic diseases, medicinal intake affecting inflammation, acute inflammation and personality scores. Results For men, an association was found between an increasing number of partnership breakups or number of years living alone and higher levels of inflammatory markers. No such association was found for women, and no evidence of partnership breakups and educational level having a joint effect was found for either gender. Conclusion The findings suggest a strong association between years lived alone or accumulated number of partnership breakups and low-grade inflammation for middle-aged men, but not for women. Among those of either sex with a lower level of education, no specific vulnerability to accumulated years lived alone or number of breakups was identified.

Graphic novel on older adults with ethnic minority background experiences of COVID-19 lockdown in a disadvantaged neighbourhood

Aims: To investigate the effects of objectively measured smartphone interactions on indicators of mental well-being among men and women in a population of young adults. Methods: A total of 816 young adults (mean±SD age 21.6±2.6 years; 77% men) from the Copenhagen Network Study were followed with objective recordings of smartphone interactions from calls, texts and social media. Participants self-reported on loneliness, depressive symptoms and disturbed sleep at baseline and in a four-month (interquartile range 75–163 days) follow-up survey. Multiple linear regression was used to analyse the association between smartphone interactions and mental well-being separately for men and women. Results: A higher number of smartphone interactions was associated with lower levels of loneliness at baseline and the same pattern appeared for depressive symptoms, although this was less pronounced. A high level of smartphone interaction was associated with lower levels of disturbed sleep for men, but not for women. In follow-up analyses, a high versus low level of smartphone interaction was associated with an increase in loneliness and depressive symptoms over time for women, but not for men. Conclusions: Smartphone interactions are related to better mental well-being, which may be attributed to the beneficial effects of an underlying social network. Over time, accommodating a large network via smartphone communication might, however, have negative effects on mental well-being for women.

Background The potential association between level of education and age-related cognitive decline remains an open question, partly because of a lack of studies including large subsamples with low education and follow-up intervals covering a substantial part of the adult lifespan. Objectives To examine cognitive decline assessed by a comprehensive clinical test of intelligence over a 35-year period of follow-up from ages 50 to 85 and to analyze the effect of education on trajectories of cognitive decline, including the effects of selective attrition. Methods A longitudinal cohort study with a 35-year follow-up of community dwelling members of the Glostrup 1914 cohort. The study sample comprised 697 men and women at the 50-year baseline assessment and additional participants recruited at later follow-ups. Verbal, Performance, and Full Scale IQs were assessed using the Wechsler Adult Intelligence Scale at ages 50, 60, 70, 80, and 85. To be able to track cognitive changes between successive WAIS assessments, all IQs were based on the Danish 50-year norms. Information on school education was self-reported. The association between education and cognitive decline over time was examined in growth curve models. Selective attrition was investigated in subsamples of participants who dropped out at early or later follow-ups. Results The trajectories for Verbal, Performance, and Full Scale IQ showed higher initial cognitive performance, but also revealed steeper decline among participants with a formal school exam compared to participants without a formal exam. Verbal IQ showed the largest difference in level between the two educational groups, whereas the interaction between education and age was stronger for Performance IQ than for Verbal IQ. In spite of the difference in trajectories, higher mean IQ was observed among participants with a formal school exam compared to those without across all ages, including the 85-year follow-up. Further analyses revealed that early dropo

Background An association between education and dementia is well-established but it is unclear whether education is associated with dementia after accounting for early life cognitive ability and whether there is a joint effect, such that the risk associated with one of the exposures depends on the value of the other. We examined separate and joint associations of adolescent cognitive ability and educational attainment with risk of dementia among Danish men born between 1939 and 1959. Methods Men (N = 477,421) from the Danish Conscription Database were followed for dementia from the age 60 for up to 17 years via patient and prescription registry linkages. Exposure measures included cognitive ability assessed at the conscript board examination around age 18 and highest educational level (low: 0-10 year, medium: 10-13 years, high: >= 13 years) at age 30 from registry records. Associations with dementia diagnosis were estimated in Cox proportional hazards models adjusted for birth year and age at conscript board examination. Interaction was assessed on the multiplicative scale by including a product term between the two exposure measures and on the additive scale by calculating relative excess risk due to interaction (RERI) between different levels of the exposure measures. Results Compared to men in the high education group hazard ratio [HR] for men in the medium and low group were 1.21 (95% confidence interval [CI]: 1.13, 1.30) and 1.34 (95% CI: 1.24, 1.45), respectively when not adjusting for cognitive ability. Additional adjustment for cognitive ability attenuated the magnitude of the associations, but they remained significant (education medium: HR = 1.10, 95% CI: 1.02, 1.19 and education low: HR = 1.12, 95% CI: 1.02, 1.22). A 10% higher cognitive ability score was associated with a 3.8% lower hazard of dementia (HR = 0.962; 95% CI: 0.957, 0.967), and the magnitude of the association only changed marginally after adjustment for education. Men in the low educa

Background The potential association between level of education and age-related cognitive decline remains an open question, partly because of a lack of studies including large subsamples with low education and follow-up intervals covering a substantial part of the adult lifespan. Objectives To examine cognitive decline assessed by a comprehensive clinical test of intelligence over a 35-year period of follow-up from ages 50 to 85 and to analyze the effect of education on trajectories of cognitive decline, including the effects of selective attrition. Methods A longitudinal cohort study with a 35-year follow-up of community dwelling members of the Glostrup 1914 cohort. The study sample comprised 697 men and women at the 50-year baseline assessment and additional participants recruited at later follow-ups. Verbal, Performance, and Full Scale IQs were assessed using the Wechsler Adult Intelligence Scale at ages 50, 60, 70, 80, and 85. To be able to track cognitive changes between successive WAIS assessments, all IQs were based on the Danish 50-year norms. Information on school education was self-reported. The association between education and cognitive decline over time was examined in growth curve models. Selective attrition was investigated in subsamples of participants who dropped out at early or later follow-ups. Results The trajectories for Verbal, Performance, and Full Scale IQ showed higher initial cognitive performance, but also revealed steeper decline among participants with a formal school exam compared to participants without a formal exam. Verbal IQ showed the largest difference in level between the two educational groups, whereas the interaction between education and age was stronger for Performance IQ than for Verbal IQ. In spite of the difference in trajectories, higher mean IQ was observed among participants with a formal school exam compared to those without across all ages, including the 85-year follow-up. Further analyses revealed that early dropo

Background An association between education and dementia is well-established but it is unclear whether education is associated with dementia after accounting for early life cognitive ability and whether there is a joint effect, such that the risk associated with one of the exposures depends on the value of the other. We examined separate and joint associations of adolescent cognitive ability and educational attainment with risk of dementia among Danish men born between 1939 and 1959. Methods Men (N = 477,421) from the Danish Conscription Database were followed for dementia from the age 60 for up to 17 years via patient and prescription registry linkages. Exposure measures included cognitive ability assessed at the conscript board examination around age 18 and highest educational level (low: 0-10 year, medium: 10-13 years, high: >= 13 years) at age 30 from registry records. Associations with dementia diagnosis were estimated in Cox proportional hazards models adjusted for birth year and age at conscript board examination. Interaction was assessed on the multiplicative scale by including a product term between the two exposure measures and on the additive scale by calculating relative excess risk due to interaction (RERI) between different levels of the exposure measures. Results Compared to men in the high education group hazard ratio [HR] for men in the medium and low group were 1.21 (95% confidence interval [CI]: 1.13, 1.30) and 1.34 (95% CI: 1.24, 1.45), respectively when not adjusting for cognitive ability. Additional adjustment for cognitive ability attenuated the magnitude of the associations, but they remained significant (education medium: HR = 1.10, 95% CI: 1.02, 1.19 and education low: HR = 1.12, 95% CI: 1.02, 1.22). A 10% higher cognitive ability score was associated with a 3.8% lower hazard of dementia (HR = 0.962; 95% CI: 0.957, 0.967), and the magnitude of the association only changed marginally after adjustment for education. Men in the low educa

OBJECTIVES: The aims of this study were to describe changes in height during childhood and to investigate potential changes in the proportion of children attaining final height in childhood and in correlations between child and adult height across birth cohorts.METHODS: We included 363 059 children (179 906 girls) from the Copenhagen School Health Records Register, who were born between 1930 and 1989, with height measurements at ages 7, 10, or 13 years. Linkages to data resources containing adult height values between ages 18 and 69 years were possible for a subpopulation of 96 133 individuals (23 051 women). Birth years were categorized as 1930 to 1939, 1940 to 1949, and 1950 to 1989. Descriptive height statistics were estimated by birth years and birth cohorts. Height correlations were examined using sex- and age-specific partial Pearson correlation analyses and meta-regression techniques.RESULTS: Across 60 birth years, mean child heights at age 7 increased by 2.9 cm in girls and 3.0 cm in boys, and adult heights increased as well. The proportions of children attaining final height by age 13 remained low across the birth cohorts; nonetheless, there was a significant increase from 0.7% to 1.5% in girls only (P < .0001). Both child-child and child-adult height correlations were strong and remained relatively stable across birth cohorts.CONCLUSIONS: Mean child and adult height increased during the study period, but the proportion of children attaining final height at age 13 remained low. Child-child and child-adult height correlations were largely unchanged across birth cohorts.

OBJECTIVES: The aims of this study were to describe changes in height during childhood and to investigate potential changes in the proportion of children attaining final height in childhood and in correlations between child and adult height across birth cohorts.METHODS: We included 363 059 children (179 906 girls) from the Copenhagen School Health Records Register, who were born between 1930 and 1989, with height measurements at ages 7, 10, or 13 years. Linkages to data resources containing adult height values between ages 18 and 69 years were possible for a subpopulation of 96 133 individuals (23 051 women). Birth years were categorized as 1930 to 1939, 1940 to 1949, and 1950 to 1989. Descriptive height statistics were estimated by birth years and birth cohorts. Height correlations were examined using sex- and age-specific partial Pearson correlation analyses and meta-regression techniques.RESULTS: Across 60 birth years, mean child heights at age 7 increased by 2.9 cm in girls and 3.0 cm in boys, and adult heights increased as well. The proportions of children attaining final height by age 13 remained low across the birth cohorts; nonetheless, there was a significant increase from 0.7% to 1.5% in girls only (P < .0001). Both child-child and child-adult height correlations were strong and remained relatively stable across birth cohorts.CONCLUSIONS: Mean child and adult height increased during the study period, but the proportion of children attaining final height at age 13 remained low. Child-child and child-adult height correlations were largely unchanged across birth cohorts.

OBJECTIVE: How are trajectories of mobility limitations (MLs) among older adults associated with mortality? Do social factors modify these associations?METHOD: Group-based trajectory modeling was used to identify four trajectories of MLs over a period of 4.5 years among 3,055 older Danes. Mortality analyses were conducted using additive hazard regression models.RESULTS: Compared to older adults without MLs, older adults with high level of MLs who experienced further increase in MLs were associated with the most additional deaths followed by older adults with no MLs at baseline who later experienced limitations and older adults with a medium ML level at baseline who later experienced further increase in limitations. Men and 80-year olds experienced more additional deaths following adverse ML trajectories than women and 75-year olds.DISCUSSION: Trajectories that led to higher ML levels were associated with most additional deaths especially among men and in the oldest age group.

OBJECTIVES: We investigated whether midlife forgetfulness was prospectively associated with changes in social relations at work (SRW) among occupationally active individuals in Denmark.METHODS: We analyzed data of 2,339 men and women participating in the first (1990) and second (1995) survey of the Danish Work Environment Cohort Study, responding to questions on working environment, SRW and forgetfulness. We used multiple linear regression analysis while adjusting for potential confounders.RESULTS: At baseline (1990), 517 (22.1%) study participants were categorized as forgetful. Forgetfulness was prospectively associated with a decline in one of the investigated items reflecting a negative aspect of SRW (experiencing teasing, regression coefficient = 0.07, 95% CI: 0.03-0.11), while no association was observed with positive aspects of SRW.CONCLUSIONS: Our findings did not support the hypothesis that memory problems such as midlife forgetfulness negatively affect SRW.

Background: Microbial exposures early in life have been found to be associated with lower levels of inflammation in adulthood; however, the role of prenatal exposure to infection on offspring inflammatory profiles is unexplored. The aim was to study if maternal infections during pregnancy are associated with inflammation among offspring in later life and to determine if there are sensitive periods of exposure.Methods: The study was comprised of 1719 participants in the Copenhagen Aging and Midlife Biobank (CAMB) who were also members of the Copenhagen Perinatal Cohort (CPC). When the CPC was established, information on maternal infections during pregnancy was prospectively collected by a trained medical doctor. The inflammatory measures collected in late midlife included, C-reactive protein (CRP), Interleukin-6 (IL-6), TNF-alpha (TNF-α) and Interleukin-10 (IL-10). Multivariable ordinary least squared regression models were implemented to explore associations between maternal infection and inflammatory measures in offspring, controlling for maternal smoking, pre-pregnancy body mass index, age, marital status and parity.Results: Maternal infection was associated with a 7% lower CRP level (95% CI, - 17,5%) among offspring compared with offspring born to women without an infection and similarly an 8% lower level of IL-6 (95% CI -15,1%), and a 9% lower level of IL-10 (95% CI, - 23,20%). However, differences did not reach significance. The effects of infection during the first trimester did not differ from infections later in the pregnancy.Conclusions: Our results suggested that prenatal exposure to infection may be associated with lower levels of inflammatory markers among adult offspring. Additional prospective studies are needed to further explore this finding.

Background: The concept of social foreground describes how adult offspring's socioeconomic resources may influence older adults' health and several studies have shown an association between socioeconomic position of adult offspring and the health of their older parents. However, little is known about the factors that generate these associations. We study 1) how adult offspring's social class is associated with physical function (PF) among older adults, 2) whether geographical closeness and contact frequency with offspring modify the association, and 3) whether intergenerational social mobility of offspring is associated with PF of older adults. Method: Data are obtained from the 2002 (n = 621) and 2011 (n = 931) waves of the Swedish Panel Study of Living Conditions of the Oldest Old. Multivariable linear regression models were employed and adjusted for own and partner's prior social class and offspring's age and gender. Results: Compared to offspring with non-manual occupation, offsprings with manual occupation was associated with poorer PF in older adults ( -0.14, CI95%: -0.28;0.00). In stratified analyses, offspring's social class was only associated with older adults' PF among those who lived geographically close. Contact frequency between the offspring and the older adults did not modify the associations. Older adults whose offspring experienced downward intergenerational social mobility were associated with the poorest PF. Conclusion: This study supports evidence of a relationship between social foreground and older adults' PF where geographical closeness and social mobility are important components.

Purpose: To assess the association between exposure to physical workload throughout working life and risk of mobility limitations in midlife in a population-based Danish cohort. Methods: The study was cross-sectional with a retrospective exposure assessment, and data were from a questionnaire used in the Copenhagen Aging and Biobank. Cumulative physical workload was estimated by combining information about the participants’ employments and data from a job exposure matrix. Daily amount of lifting was standardised in ton-years (lifting 1000 kg/day/year) and grouped in 5 exposure groups (no/minor (1–2 ton-years)/low (3–10 ton-years)/moderate (11–20 ton-years)/high exposure (> 20 ton-years)). The outcome was self-reports of mobility limitations (running 100 m, walking 400 m, and climbing stairs to the 2nd floor) in midlife. The association between exposure and outcome was analysed using logistic regression models. Results: We included 4996 men and 2247 women, mean age 56 years. 21% of men and 10% of women were in the highest exposure-group (> 20 ton-years). Higher cumulative exposure was associated with higher odds for mobility limitations. Exposure to more than 20 ton-years compared to no exposure increased the odds for limitations in walking, age-adjusted odds ratio (OR) 3.2 (95% CI: 2.4–4.3) for men, 2.3 (1.4–3.8) for women. Corresponding results for running: 2.5 (2.2–3.0) for men, 1.6 (1.2–2.2) for women, and for limitations in climbing stairs: 4.2 (3.3–5.2) for men, 1.7 (1.2–2.4) for women. Results were attenuated when confounders were added. Conclusions: Exposure to physical workload throughout working life is associated with higher odds for mobility limitations in midlife.

First, to investigate associations between mobility limitations and use of general practitioners and hospitalizations of acute care sensitive conditions, respectively. Second, to investigate whether these associations vary by socio-demographic factors.