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Article ; Online: Accounting for the Origins and Toll of COVID 19 The key role of Overweight in COVID-19.

Adams, Mary L

American journal of health promotion : AJHP

2022 Volume 36, Issue 2, Page(s) 385–387

Abstract: Both global and US data show associations between COVID-19 death rates and overweight or obesity, which are also risk factors for several other outcomes. Evidence suggests that among the strategies to reduce overweight and obesity are the simple actions ... ...

Abstract	Both global and US data show associations between COVID-19 death rates and overweight or obesity, which are also risk factors for several other outcomes. Evidence suggests that among the strategies to reduce overweight and obesity are the simple actions of increasing fruit and vegetable consumption and physical activity. Potential benefits include saving thousands of lives and billions of dollars in a future pandemic and reduced risk of other chronic conditions.
MeSH term(s)	COVID-19 ; Diet ; Fruit ; Humans ; Overweight/epidemiology ; Overweight/prevention & control ; SARS-CoV-2 ; Vegetables
Language	English
Publishing date	2022-01-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	645160-3
ISSN	2168-6602 ; 0890-1171
ISSN (online)	2168-6602
ISSN	0890-1171
DOI	10.1177/08901171211064006
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Article ; Online: Similarities between long COVID and cognitive impairment and potential implications; Results from the 2022 BRFSS

Adams, Mary L. / Grandpre, Joseph

medRxiv

Abstract: Background: COVID has been linked to cognitive issues with brain fog a common complaint among adults reporting long COVID (symptoms lasting 3 or more months). Objective: To study similarities and differences between cognitive impairment (CI) (the ... ...

Abstract	Background: COVID has been linked to cognitive issues with brain fog a common complaint among adults reporting long COVID (symptoms lasting 3 or more months). Objective: To study similarities and differences between cognitive impairment (CI) (the cognitive disability measure) and long COVID. Methods: Using 2022 BRFSS data from 50 states and 169,894 respondents in 29 states with COVID vaccine data, respondents with CI and long COVID were compared in unadjusted analysis and logistic regression. Apparent vaccine effectiveness was compared in the 29 states. Results: Prevalence of long COVID was 7.4% (95% CI 7.3-7.6) and CI was 13.4% (13.2-13.6) with both rates higher among women, ages 18-64 years, Hispanics, American Indians, ever smokers, those with depression, e-cigarette users, and those with more of the co-morbidities of diabetes, asthma, COPD, and obesity. The strong association between long COVID and CI was confirmed. Apparent vaccine effectiveness of 3 or more doses vs <3 was 38% for long COVID and 35% for CI, in both cases reducing rates for 3 or more doses to those comparable to adults with 0 comorbidities and showing dose response gradients. For CI, apparent vaccine effectiveness was similar for respondents with or without long COVID. Logistic regression confirmed most results except the magnitude of vaccine effectiveness on CI was reduced in some models while vaccine effectiveness for long COVID was confirmed. Conclusions: More research is needed to understand the apparent effectiveness of COVID vaccines on CI but, if confirmed, results could expand the list of non-infectious outcomes for which mRNA vaccines can be effective.
Keywords	covid19
Language	English
Publishing date	2024-04-05
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2024.04.02.24305215
Database	COVID19

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Article ; Online: Global association of obesity and COVID-19 death rates

Adams, Mary L

medRxiv

Abstract: Importance: COVID-19 was responsible for an enormous global death toll with large variation among countries. Objective: To examine the possible impact of obesity on COVID-19 death rates. Design: Measure associations between obesity rates in 2016 and ... ...

Abstract	Importance: COVID-19 was responsible for an enormous global death toll with large variation among countries. Objective: To examine the possible impact of obesity on COVID-19 death rates. Design: Measure associations between obesity rates in 2016 and COVID-19 deaths/million population through 2/25/2021, across countries. Setting: Global Participants: 167 countries for which obesity and death data were available, grouped by population size, with multiples of 10 countries in each of 8 groups plus a group including all 57 countries with obesity rates <15%. Outcome and measures: Using Excel, COVID-19 deaths/million were regressed on the obesity rate for each country, based on obesity being a key factor in COVID hospitalizations and deaths. Using the least squares formula for the best fit for each model, R2, components of the formula, and the percentage of world population represented, were recorded for each group. Results: Obesity rates ranged from 2.1% to 37.9% and death rates ranged from 0.4/million to 1,892/million for groups representing up to 91% of global population. Results for the 8 population groups had R2 from 0.30 to 0.90 with slopes of the fitted line ranging from 27.9-51.0. Countries with obesity rates <15% had consistently low death rates (≤233/million), R2 of 0.003 and slope of the line=1.01. Conclusions: For most countries about one-third of the difference in COVID death rates was due to obesity while in countries with obesity <15%, consistently low death rates were not associated with obesity. Reduced obesity rates could potentially have lowered the COVID death toll.
Keywords	covid19
Language	English
Publishing date	2021-03-12
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2021.03.09.21253222
Database	COVID19

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Article ; Online: Prevalence of COVID-19 and long COVID - Results from the 2022 Behavioral Risk Factor Surveillance System, 50 states

Adams, Mary L. / Grandpre, Joseph

medRxiv

Abstract: Recent MMWR results estimate long COVID prevalence at 6.0% in June 2023, while the percentage of those with COVID reporting long COVID was 11.0%. The 2022 Behavioral Risk Factor Surveillance System addressed COVID (positive test) and long COVID (symptoms ...

Abstract	Recent MMWR results estimate long COVID prevalence at 6.0% in June 2023, while the percentage of those with COVID reporting long COVID was 11.0%. The 2022 Behavioral Risk Factor Surveillance System addressed COVID (positive test) and long COVID (symptoms lasting ≥3 months) in a population-based sample from each state and DC. Results for 385,617 adults indicated 34.4% had ever had COVID, 21.9% of whom reported long COVID, representing 7.4% of all adults. State rates ranged from 25.4% - 40.8% for COVID and 4.1%-11.1% for long COVID. Groups with high rates for both included women, younger adults, those with children in the household, plus those reporting obesity, asthma, chronic obstructive pulmonary disease (COPD), diabetes, or cardiovascular disease (CVD). Highest adjusted odds ratios for COVID were 2.34 (95% CI 2.20-2.49) for age 18-24 years vs. age 65+ while for long COVID it was 2.81 (2.53-3.13) for 3+ of the 5 conditions. Most frequently reported problems for those with long COVID were fatigue (26.0%), shortness of breath (18.8%), loss of taste or smell (17.2%), and memory problems (9.9%). Results show the need for state-based data and suggest a focus on younger adults is needed to address COVID and long COVID.
Keywords	covid19
Language	English
Publishing date	2023-09-29
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2023.09.29.23296352
Database	COVID19

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Article ; Online: Differences Between Younger and Older US Adults With Multiple Chronic Conditions.

Adams, Mary L

Preventing chronic disease

2017 Volume 14, Page(s) E76

Abstract: Introduction: Adults with multiple (≥2) chronic conditions (MCCs) account for a large portion of US health care costs. Despite the increase in MCC rates with age, most people with MCCs are working age. The study objective was to compare adults with MCCs ...

Abstract	Introduction: Adults with multiple (≥2) chronic conditions (MCCs) account for a large portion of US health care costs. Despite the increase in MCC rates with age, most people with MCCs are working age. The study objective was to compare adults with MCCs who were younger than 65 years with those aged 65 years or older on selected measures to better understand the differences between groups and inform interventions that could lower health care costs. Methods: Data from respondents to the 2015 Behavioral Risk Factor Surveillance System data (N = 201,711) were used to compare adults aged 65 or older with MCCs with those younger than 65 with MCCs in unadjusted and adjusted analyses on chronic conditions, quality of life measures, disability status, access to health care, and modifiable risk factors. MCCs were based on up to 12 chronic conditions (heart disease, stroke, asthma, arthritis, chronic obstructive pulmonary disease, high cholesterol, cognitive impairment, diabetes, depression, chronic kidney disease, cancer other than skin, and hypertension). Results: Consistent with 80% of all adults being younger than 65, more than 60% of adults with MCCs were younger than 65 years. Compared with adults aged 65 or older with MCCs, those younger than 65 were more likely to report asthma, cognitive impairment, depression, smoking, obesity, poorer access to health care, disability, and worse quality of life in both unadjusted and adjusted analysis. Conclusion: To decrease the burden of chronic diseases, adults younger than 65 with MCCs should get the treatment they need to reduce the chance of developing more chronic conditions as they age. The ultimate goal is to improve health status and reduce health care costs for everyone with MCCs.
Language	English
Publishing date	2017-09-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2135684-1
ISSN	1545-1151 ; 1545-1151
ISSN (online)	1545-1151
ISSN	1545-1151
DOI	10.5888/pcd14.160613
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Article ; Online: Updated Estimates of Chronic Conditions Affecting Risk for Complications from Coronavirus Disease, United States.

Adams, Mary L / Katz, David L / Grandpre, Joseph

Emerging infectious diseases

2020 Volume 26, Issue 9

Abstract: We updated estimates of adults at risk for coronavirus disease complications on the basis of data for China by using recent US hospitalization data. This update to our previous publication substitutes obesity for cancer as an underlying condition and ... ...

Abstract	We updated estimates of adults at risk for coronavirus disease complications on the basis of data for China by using recent US hospitalization data. This update to our previous publication substitutes obesity for cancer as an underlying condition and increases adults reporting any of the conditions from 45.4% to 56.0%.
MeSH term(s)	Adult ; Aged ; Behavioral Risk Factor Surveillance System ; Betacoronavirus ; COVID-19 ; Chronic Disease/epidemiology ; Coronavirus Infections/complications ; Coronavirus Infections/epidemiology ; Coronavirus Infections/virology ; Female ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/virology ; Risk Factors ; SARS-CoV-2 ; United States/epidemiology
Keywords	covid19
Language	English
Publishing date	2020-07-03
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid2609.202117
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Article ; Online: Population-Based Estimates of Chronic Conditions Affecting Risk for Complications from Coronavirus Disease, United States.

Adams, Mary L / Katz, David L / Grandpre, Joseph

Emerging infectious diseases

2020 Volume 26, Issue 8, Page(s) 1831–1833

Abstract: We estimated that 45.4% of US adults are at increased risk for complications from coronavirus disease because of cardiovascular disease, diabetes, respiratory disease, hypertension, or cancer. Rates increased by age, from 19.8% for persons 18-29 years of ...

Abstract	We estimated that 45.4% of US adults are at increased risk for complications from coronavirus disease because of cardiovascular disease, diabetes, respiratory disease, hypertension, or cancer. Rates increased by age, from 19.8% for persons 18-29 years of age to 80.7% for persons >80 years of age, and varied by state, race/ethnicity, health insurance status, and employment.
MeSH term(s)	Adult ; Age Factors ; Aged ; Aged, 80 and over ; Betacoronavirus/pathogenicity ; COVID-19 ; COVID-19 Testing ; Cardiovascular Diseases/complications ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Chronic Disease ; Clinical Laboratory Techniques/methods ; Coronavirus Infections/complications ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Coronavirus Infections/transmission ; Diabetes Complications ; Diabetes Mellitus/diagnosis ; Diabetes Mellitus/epidemiology ; Female ; Humans ; Incidence ; Lung Diseases/complications ; Lung Diseases/diagnosis ; Lung Diseases/epidemiology ; Male ; Middle Aged ; Models, Statistical ; Neoplasms/complications ; Neoplasms/diagnosis ; Neoplasms/epidemiology ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Pneumonia, Viral/transmission ; Risk Factors ; SARS-CoV-2 ; Severity of Illness Index ; United States/epidemiology
Keywords	covid19
Language	English
Publishing date	2020-04-23
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	1380686-5
ISSN	1080-6059 ; 1080-6040
ISSN (online)	1080-6059
ISSN	1080-6040
DOI	10.3201/eid2608.200679
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Article ; Online: Dose-response gradients between a composite measure of six risk factors and cognitive decline and cardiovascular disease.

Adams, Mary L / Grandpre, Joseph

Preventive medicine

2016 Volume 91, Page(s) 329–334

Abstract: We created a composite risk factor index which includes 6 risk factors (diabetes, hypertension, obesity, depression, sedentary lifestyle, and current smoking) previously shown to be associated with cognitive decline (CD) and Alzheimer's disease (AD) as ... ...

Abstract	We created a composite risk factor index which includes 6 risk factors (diabetes, hypertension, obesity, depression, sedentary lifestyle, and current smoking) previously shown to be associated with cognitive decline (CD) and Alzheimer's disease (AD) as well as cardiovascular disease (CVD). Using 2011 Behavioral Risk Factor Surveillance System results for 95,147 adults ages ≥45years we found that 77.3% of study adults reported ≥1 risk factor (RF) while <1% reported all 6. Reporting any RFs increased risk for CD and CVD, with a dose-response gradient shown for increasing numbers of RFs from 0 to 6. Number of RFs, % of adults with CD and CVD respectively were: 0 RF: 5.8% w/CD, 4.4% w/CVD; 1 RF: 9.6% w/CD, 10.8% w/CVD; 2 RF: 12.7% w/CD, 17.6% w/CVD; 3 RF: 19.3% w/CD, 23.7% w/CVD; 4 RF: 24.6% w/CD, 29.7% w/CVD: 5 RF: 39.0% w/CD. 32.2% w/CVD; and all 6 RF: 54.4% w/CD and 43.7% w/CVD. Adjusted odds ratios (ORs) were similar except they tended to be higher for CVD compared with CD, with ORs for all 6 RF compared with 0 RF of 11.2 (95% confidence interval 5.2-24.3) for CD and 16.3 (8.5-31.2) for CVD. While dose-response gradients had been reported for individual RFs, our study found dose-response gradients for increasing numbers of RFs and similar strengths of associations for CD and CVD, plus adds prevalence results from a representative survey. The similarity between CVD and CD results supports evidence from other studies and suggests potential benefits of coordinating CVD and CD/AD prevention efforts.
Language	English
Publishing date	2016-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	184600-0
ISSN	1096-0260 ; 0091-7435
ISSN (online)	1096-0260
ISSN	0091-7435
DOI	10.1016/j.ypmed.2016.09.004
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Article ; Online: Cognitive Impairment and Cardiovascular Disease: A Comparison of Risk Factors, Disability, Quality of Life, and Access to Health Care.

Adams, Mary L / Grandpre, Joseph / Katz, David L / Shenson, Douglas

Public health reports (Washington, D.C. : 1974)

2019 Volume 135, Issue 1, Page(s) 132–140

Abstract: Objectives: Cognitive difficulties or impairment may be an early step in the development of dementia. Several modifiable risk factors for cardiovascular disease (CVD) may also increase the risk of dementia. The objective of our study was to compare ... ...

Abstract	Objectives: Cognitive difficulties or impairment may be an early step in the development of dementia. Several modifiable risk factors for cardiovascular disease (CVD) may also increase the risk of dementia. The objective of our study was to compare adults with subjective cognitive impairment (SCI), using the Behavioral Risk Factor Surveillance System (BRFSS) cognitive disability measure, with adults who reported CVD. Methods: We examined data on 3 key outcomes among 302 008 adult respondents aged ≥45 in the 2017 BRFSS: respondents with SCI only, respondents with CVD only, and respondents with both conditions. We compared measures of disability, quality of life, access to health care, and a composite measure of the following 7 risk factors: current smoking, diabetes, high cholesterol, hypertension, inadequate fruit and vegetable consumption, obesity, and sedentary lifestyle. We also estimated population-attributable risk (PAR). Results: Among respondents, 7.9% reported SCI only, 11.1% reported CVD only, and 3.2% reported both conditions, with differences by age and sex. Adults with SCI only were more likely than adults with CVD only to report other disability, worse access to health care, and poorer quality of life, even though adults with CVD were older. Compared with adults with neither condition, adults with any of the 3 outcomes were more likely to report having each of the 7 risk factors; we found a linear association with an increasing number of risk factors. Five or 6 risk factors contributed to PARs for each of the 3 key outcomes. PARs for SCI only were highest for ever smoking (17.2%) and sedentary lifestyle (12.8%), whereas for CVD only, PARs were highest for hypertension (35.5%) and high cholesterol (22.9%). Conclusion: Despite differences between adults with SCI and adults with CVD in several demographic and health-related measures, the overall similarity in PARs for SCI and CVD suggests potential benefits from using effective CVD interventions to address SCI.
MeSH term(s)	Age Factors ; Aged ; Aged, 80 and over ; Behavioral Risk Factor Surveillance System ; Blood Pressure ; Cardiovascular Diseases/epidemiology ; Cognitive Dysfunction/epidemiology ; Diabetes Mellitus/epidemiology ; Diet ; Disabled Persons/statistics & numerical data ; Female ; Health Behavior ; Health Services Accessibility/statistics & numerical data ; Humans ; Lipids/blood ; Male ; Middle Aged ; Obesity/epidemiology ; Quality of Life ; Risk Factors ; Sedentary Behavior ; Severity of Illness Index ; Sex Factors ; Smoking/epidemiology ; Socioeconomic Factors
Chemical Substances	Lipids
Language	English
Publishing date	2019-12-13
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	120953-x
ISSN	1468-2877 ; 0033-3549
ISSN (online)	1468-2877
ISSN	0033-3549
DOI	10.1177/0033354919893030
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Article ; Online: The impact of key modifiable risk factors on leading chronic conditions.

Adams, Mary L / Grandpre, Joseph / Katz, David L / Shenson, Douglas

Preventive medicine

2019 Volume 120, Page(s) 113–118

Abstract: We studied associations between 7 cardiovascular disease (CVD) risk factors (RFs) and 9 chronic conditions and estimated population-attributable risk. Data (N = 358,218) were from the 2017 Behavioral Risk Factor Surveillance System. Outcomes included ... ...

Abstract	We studied associations between 7 cardiovascular disease (CVD) risk factors (RFs) and 9 chronic conditions and estimated population-attributable risk. Data (N = 358,218) were from the 2017 Behavioral Risk Factor Surveillance System. Outcomes included asthma, arthritis, chronic obstructive pulmonary disease (COPD), cognitive impairment, CVD, and kidney disease. Risk factors (RF) were obesity, ever smoking, sedentary lifestyle, and inadequate fruit and vegetable consumption, while hypertension, high cholesterol, and diabetes were considered in both categories. Stata was used to study associations in both unadjusted and adjusted analysis. Population-attributable risk was estimated in Excel using adjusted odds ratios (AORs) and compared results using all RFs versus only those where causality was confirmed by other studies. RF prevalence rates ranged from 10.8% (95% CI 10.6, 11.0) for diabetes to 84.1% (83.8, 84.3) for inadequate fruit and vegetable consumption. Almost all adults (95.2%) reported ≥1 RF. Highest total PARs for RFs with confirmed causality were for obesity and ever smoking, and for hypertension when all RFs were considered. Total PARs for the 9 outcomes averaged 37.2-41.5% when results were limited to RFs with confirmed causality. Although the number of risk factors for which causality had been confirmed ranged from 1 to 6, all 9 outcomes showed linear dose response gradients with added risk factors. While all 7 RFs appeared important to address, targeting smoking and obesity with programs that have shown previous success offers the greatest potential for reducing burden for these 9 chronic diseases.
MeSH term(s)	Adult ; Aged ; Asthma/epidemiology ; Behavioral Risk Factor Surveillance System ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Chronic Disease/epidemiology ; Cognitive Dysfunction/epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Hypertension/epidemiology ; Hypertension/physiopathology ; Incidence ; Linear Models ; Male ; Middle Aged ; Obesity/diagnosis ; Obesity/epidemiology ; Odds Ratio ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology ; Risk Factors ; Survival Analysis ; United States/epidemiology
Language	English
Publishing date	2019-01-15
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	184600-0
ISSN	1096-0260 ; 0091-7435
ISSN (online)	1096-0260
ISSN	0091-7435
DOI	10.1016/j.ypmed.2019.01.006
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