Drude Molbo

Prospective longitudinal cohort study on cumulative 5-year delivery and adoption rates among 1338 couples initiating infertility treatment

BACKGROUND The objective was to assess crude 5-year delivery rates after assisted reproductive technology (ART) treatment, intrauterine inseminations (IUI), spontaneous conceptions (SC) and adoptions in a large infertile cohort. METHODS A prospective longitudinal survey comprised 1338 infertile couples starting public infertility programmes offering IUIs and three free ART cycles during 2000-2001. The cohort was cross-linked with the National Medical Birth Register to obtain delivery rates for all 1338 couples. More detailed data were available from 817 women responding to a 5-year follow-up questionnaire (response rate 74.7%). Fifty-seven percent (466/817) of the couples had received treatment prior to inclusion in the study with an average of 4.1+/-2.8 infertility treatments before referral. RESULTS Of the 1338 couples, 69.4% had at least one delivery within 5-years of follow-up. For women <35 years 74.9% had delivered compared with 52.2% of those aged > or =35 years. The mean number of children was 1.6, and 52.1% had more than one child. Of the 817 women who provided questionnaire data, 18.2% (149/817) delivered after SC, two-thirds of these after a previous ART delivery. Adoption of a child occurred for 5.9% (48/817) of the women. Positive prognostic factors for delivery were male infertility, female age <35 years, <3 years of infertility and less than three previous treatment cycles. CONCLUSIONS A crude delivery rate of 69.4% in the total population 5 years after referral to tertiary hospital centres with 6.6% deliveries after SC in the subpopulation responding to the questionnaire indicates a high efficacy of modern infertility treatments.

Copenhagen Aging and Midlife Biobank (CAMB): an introduction

Since the early 1980s, a number of large-scale, population-based, epidemiologic studies have focused on the development of disability, cognitive impairment, dementia, long-term care, and other health issues with particular relevance to older adults. With few exceptions, these health issues have been investigated in older populations, usually defined on the basis of chronological age (e.g., older than 65). Examples are the Established Populations for Epidemiologic Studies of the Elderly (EPESE), Women’s Health and Aging Studies (WHAS), and several other American, Australian, Canadian, and

Social Class Differences in Physical Functions in Middle-Aged Men and Women:

Objective: The objective of the present study is to analyze gender differences and social class gradients in physical functions; and to study whether the social class gradients in physical functions in midlife differed between men and women. Method: This study used traditionally used physical performance tests and we added several tests of vigorous physical functioning (trunk muscle strength and power and sagittal flexibility). We measured reaction time, one-legged balance, sagittal flexibility, jump height, chair rise ability, trunk muscle- and handgrip strength in 5,412 participants aged 50 to 60 years (68.5% men). Results: We found gender differences and social class gradients for all physical performance tests. We did not find an interaction between social class and gender, indicating that the social gradient in physical functions did not differ between men and women. Discussion: Including measures of vigorous physical functioning may add to the existing knowledge on development of functional limitation and poorer functional health later in life.

The relationship between cognitive ability and demographic factors in late midlife

Objective: The aim of the article is to analyze associations between sex, age, education, and social class and cognitive ability in late midlife and to evaluate differences in cognitive ability among the three Copenhagen Aging and Midlife Biobank (CAMB) cohorts. Method: The sample comprised 5,417 CAMB participants from three cohorts with scores on the Intelligenz-Struktur-Test 2000 R (I-S-T 2000 R). Results: Independent associations of cognitive ability with age, sex, education, and occupational social class were observed. Particularly, strong associations with cognitive ability were obtained for school education, and consistent sex differences were observed with higher cognitive ability in men. Differences in cognitive ability among the three cohorts were small and primarily reflected demographic differences. Discussion: Late-midlife cognitive ability is associated with a number of demographic factors, and demographic differences may contribute to individual differences in health and early aging. In analyses of cognitive ability, the three CAMB cohorts can be combined provided the relevant demographic variables are included as covariates.

Smoking and Drinking as Risk Indicators for Tooth Loss in Middle-Aged Danes

Objectives: To investigate tobacco and alcohol consumption as risk indicators for missing teeth in late middle-aged Danes. Method: In all, 1,517 Copenhagen Aging and Midlife Biobank (CAMB) participants received a clinical oral examination that included number of teeth. Information on smoking, drinking, and various covariates was obtained using self-administered, structured questionnaires. Descriptive statistics and logistic regression (dependent variable: 6+ vs. <6 missing teeth) were used to investigate smoking and drinking in relation to missing teeth. Results: Current smokers, persons who currently or previously smoked >15 tobacco units/day, and persons who had smoked for 27+ years had elevated mean scores of missing teeth and associated odds ratios (OR) compared with never smokers. Relative to nondrinkers, alcohol consumption was associated with reduced odds of missing 6+ teeth. Discussion: Our findings suggest that smoking is positively associated, while alcoholic beverage consumption is inversely related to tooth loss in middle-aged Danes.

Personality in Late Midlife: Associations With Demographic Factors and Cognitive Ability

Objectives: To analyze associations in late midlife between sex, age, education and social class, and the Big Five personality traits; to analyze associations between personality traits and cognitive ability in late midlife; and to evaluate how these associations are influenced by demographic factors. Methods: The study sample comprised 5,397 late midlife participants from three cohorts who had completed the NEO Five-Factor Inventory (NEO-FFI) and a measure of cognitive ability. Results: Associations were demonstrated between the five NEO-FFI personality traits, and all included demographic factors. Cognitive ability and years of education correlated with several NEO-FFI personality traits in analyses adjusting for demographic variables. Cohort differences were observed for Extraversion and Openness. Discussion: Robust sex, educational, and social class differences in personality may contribute to late midlife social gradients in health and early aging. Demographic factors did not fully explain correlations between personality and cognitive ability or cohort differences in personality.

Associations of subjective vitality with DNA damage, cardiovascular risk factors and physical performance

To examine associations of DNA damage, cardiovascular risk factors and physical performance with vitality, in middle‐aged men. We also sought to elucidate underlying factors of physical performance by comparing physical performance parameters to DNA damage parameters and cardiovascular risk factors.

Disclosure patterns of mode of conception among mothers and fathers–5-year follow-up of the Copenhagen Multi-centre Psychosocial Infertility (COMPI) cohort

BACKGROUND Most studies on disclosure of mode of conception after fertility treatment have focused on donor insemination. We present a large, longitudinal cohort study of fertility patients who conceived through a variety of fertility treatments, including both non-donor and donor techniques. METHODS A cohort of 2812 women and men (n = 1406 couples) received questionnaires when initiating fertility treatment and at 1-year and 5-year follow-ups. At the 5-year follow up, the response rate was 69.4% and 1036 of the responding participants had at least one child born after fertility treatment. Around 66% of the children were conceived with in vitro fertilization or intrauterine insemination with partners semen, 26% with intracytoplasmic sperm injection, 7% with donor gametes and <1% with other treatments. The parents were asked whether they already had or intended to disclose the conception method to the child and to others. We used logistic regression to identify determinants among women and men for disclosure. RESULTS Most of the parents had disclosed or intended to disclose the mode of conception to the child, and almost everyone had disclosed to someone else. Not having used donor gametes was a significant determinant of disclosure both to the child and to other people among women and men. Having disclosed to other people was a significant predictor for having disclosed or intending to disclose to the child. Among women, low social class was a significant determinant of disclosure to the child. Among men, satisfaction with the medical treatment was a significant determinant of disclosure to other people. CONCLUSIONS We found a large majority who had or intended to disclose to the child how he/she was conceived. Non-disclosure was significantly related to the use of donor gametes.

Social Gradient in Allostatic Load Among Danish Men and Women in Late Midlife

Objective: The objective of the present study is to describe the prevalence of allostatic load (AL) among Danish men and women in late midlife, and if there is a social gradient in AL. Method: A total of 5,420 participants from the Copenhagen Aging and Midlife Biobank (CAMB) aged 48 to 63 years (68.5% men, 31.5% women) underwent a health examination including standardized measures of height, weight, body fat, and blood pressure in 2009-2011. AL (range 0-14) was established by summing the scores of the poorest quartile for each of 14 biological variables related to the metabolic and immune systems. Results: We found a social gradient in AL in late midlife among men and women living in Denmark. Discussion: AL may be a potential biomarker for early aging in countries with a strong social welfare system. It is important for intervention studies to be aware of this type of biological vulnerability already present in late midlife.