Merete Osler

Aarhus University, Aarhus, Central Jutland, Denmark

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Publications (244)871.29 Total impact

  • International Journal of Epidemiology 07/2015; DOI:10.1093/ije/dyv149 · 9.20 Impact Factor
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    ABSTRACT: Little is known about the influence of lifetime socio-economic position (SEP) on adult depression. We examined the association of SEP during the life course with depressive mood in late midlife and explored whether cognitive function at age 20, health-related behaviour and inflammatory biomarkers explained any associations. A cohort of 2482 Danish men born in 1953 with information from birth, and conscript board examinations was followed-up with assessment of depressive mood and blood sampling in 2010. Simple and multiple linear regression were used to investigate associations among variables. Social circumstances during the life course were associated with depressive mood. Further, low lifetime SEP was associated with lower cognitive score, smoking, alcohol use, high body mass index (BMI) and increased level of high sensitive ProReactive Protein and Interleukin-6. These covariables were also associated with depressive mood and when they were included into the regression model together with life time SEP, the β-estimates for the latter attenuated, when smoking, alcohol and BMI were entered, while the inclusion of cognitive function and the inflammatory biomarkers had limited effect on the relation between lifetime SEP and depressive mood. Lifetime SEP was associated with depressive mood and health-related behaviour explained a part of the relation. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
    The European Journal of Public Health 07/2015; DOI:10.1093/eurpub/ckv134 · 2.46 Impact Factor
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    ABSTRACT: Insights into the causes of variances in physical performance are important to prevent mobility limitations in old age. We examined associations between intelligence in early adulthood and midlife physical performance. Data from the Copenhagen Aging and Midlife Biobank were analyzed using linear regression. In total, 2,848 male cohort members had intelligence scores from conscription and physical performance measures from midlife. In adjusted models, a 1 SD increase in intelligence resulted in 1.10 more chair-rises (p < .001), a 1.03 cm higher jump (p < .001), a 3.69% smaller balance area (p < .001), a 0.71 kg increase in handgrip strength (p < .001), and a 5.03 N increase in back force (p < .001). Results for flexibility and abdominal force were not significant. Public health interventions should focus on addressing people with different cognitive abilities and bear in mind that prevention of mobility limitations might need to start early in life. © The Author(s) 2015.
    Journal of Aging and Health 07/2015; DOI:10.1177/0898264315594139 · 1.56 Impact Factor
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    ABSTRACT: In order to reduce social inequality in cancer survival, knowledge is needed about where in the cancer trajectory disparities occur, and how social and health-related aspects may interact. We aimed to determine whether socioeconomic factors are related to cancer diagnosis stage, and whether socioeconomic disparities in survival after ovarian cancer can be explained by socioeconomic differences in cancer stage, comorbidity, treatment or lifestyle factors. In the Danish Gynaecological Cancer Database we identified 2873 cases of ovarian cancer diagnosed between 2005 and 2010. From this data we retrieved information on prognostic factors, treatment information and lifestyle factors. Age, vital status, comorbidity, education, income and cohabitation status were ascertained from nationwide administrative registers. Associations were analyzed with logistic regression and Cox regression models. Educational level was weakly associated with cancer stage. Short education, lower income and living without a partner were related to poorer survival after ovarian cancer. Among women with early cancer stage, HR (95% CI) for death was 1.75 (1.20-2.54) in shorter compared to longer educated women. After adjustment for comorbid conditions, cancer stage, tumour histology, operation status and lifestyle factors, socioeconomic differences in survival persisted. Socioeconomic disparities in survival after ovarian cancer were to some extent, but not fully explained by differences in important prognostic factors, suggesting further investigations into this problem, however implying that socially less advantaged ovarian cancer patients should receive attention during cancer treatment and rehabilitation. Copyright © 2015 Elsevier Ltd. All rights reserved.
    04/2015; 39(3). DOI:10.1016/j.canep.2015.03.011
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    ABSTRACT: PurposeThe aim of this Cohort study of 10 527 Danish men was to investigate the extent to which the association between hypnotics and mortality is confounded by several markers of disease and living conditions.Methods Exposure was purchases of hypnotics 1995–1999 (“low users” (150 or less defined daily dose (DDD)) or “high users” (151 or more DDD)). Follow-up for all-cause mortality was from 1 Jan 2000 to 19 June 2010. Cox proportional hazard models were used to study the association. Covariates were entered one at a time and simultaneously. Results were reported using hazard ratio (HR) and 95% confidence intervals (CI).ResultsWhen covariates were entered one at a time, the changes in HR estimates showed that psychiatric disease, socioeconomic position and substance abuse reduced the excess risk by 17–36% in the low user group and by 45–52% in the high user group. Somatic disease, intelligence score and cohabitation reduced the excess risk by 2–11% in the low user group and 8–24% in the high user group. When adjusting for all covariates, the HR was reduced to 1.22 95% CI (0.97–1.54) in the low user group and 1.43 95% CI (1.11–1.85) in the high user group.Conclusions The results of this study point at psychiatric disease, substance abuse and socioeconomic position as potential confounding factors partly explaining the association between use of hypnotics and all-cause mortality. Copyright © 2015 John Wiley & Sons, Ltd.
    Pharmacoepidemiology and Drug Safety 02/2015; 24(7). DOI:10.1002/pds.3745 · 3.17 Impact Factor
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    ABSTRACT: To estimate the association between educational status and alcohol-related somatic and non-somatic morbidity and mortality among full siblings in comparison with non-related individuals. Cohort study. Denmark. Approximately 1.4 million full siblings born in Denmark between 1950 and 1979 were followed from age 28 until age 58 or censoring due to alcohol-related hospitalization and mortality. Cox-regression analyses were used to estimate associations of educational status with alcohol-related outcomes. Results from cohort analyses based on non-related individuals and inter-sibling analyses were compared. A lower educational status was associated with a higher rate of alcohol-related outcomes, especially among the youngest (28-37 years of age) and individuals born 1970-1979. Compared with the cohort analyses, the associations attenuated slightly in the inter-sibling analysis. For example in the cohort analysis, females with a basic school education born 1970-1979 had an increased rate of alcohol-related non-somatic morbidity and mortality (Hazard rate ratio (HR) =4.05, CI 95% 3.27-5.02) compared to those with a vocational education. In the inter-sibling analysis, the HR attenuated (HR = 2.66, CI 95% 1.95-3.63). For alcohol-related somatic outcomes the corresponding figures were HR = 3.47 (CI 95% 2.63-4.58) and HR = 3.36 (CI 95% 2.10-5.38), respectively. In general, the associations were stronger among females than males (aged 28-37) in the analyses on alcohol-related non-somatic outcomes. Health conditions earlier in life explained only a minor part of the associations. The association between educational status and alcohol-related somatic and non-somatic morbidity and mortality is only to a small degree driven by familial factors. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Addiction 12/2014; 110(3). DOI:10.1111/add.12823 · 4.60 Impact Factor
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    ABSTRACT: Background An educational gradient in preterm birth has been observed in many countries. The distribution of education and other characteristics of women giving birth are the end result of complex processes that play out over the life course. If these processes play out differently in different contexts, cross-cohort comparisons may be helpful in understanding the educational gradient in preterm birth. We performed a cross-cohort comparison of educational disparities in preterm birth based on European birth cohort data. Methods The study included individual-level data from 12 European cohorts from Denmark, England, France, Lithuania, the Netherlands, Norway, Italy, Portugal and Spain. The studies covered the period 1990 to 2012 and included between 2434 and 99,655 pregnancies each. The association between maternal education and preterm birth for singleton live births was examined separately in each cohort by linear and logistic regression and reported as risk ratios, risk differences and slope indexes of inequality. Results The percentage of singleton preterm live births varied between 3.7% and 7.5%. There were large variations between the cohorts in the distribution of education and other maternal characteristics. In spite of this, there were similar educational differences in risk of preterm birth in 8 of the 12 cohorts. In these cohorts, the slope index of inequality varied between 2.2 and 3.2 per 100 singleton live births, and relative risk between the lowest and highest education group varied from 1.4 to 1.9. In the remaining 4 cohorts from England, France, Italy and Portugal, one showed a weaker gradient (Slope Index of Inequality =1.5 (-1.0, 3.9)), two showed no educational differences (SII=-0.3 (-2.0, 1.5) and SII=0.9 (-1.3, 3.1)), and the gradient was reversed in the last cohort (SII=-1.2 (-4.6, 2.3)). Conclusion Educational disparities in risk of preterm birth were found in birth cohorts from all over Europe. Despite differences in the distribution of education and level of preterm birth, the results were remarkably similar across the cohorts. For those few cohorts that did not follow the pattern, study and country characteristics were unable to explain the differences.
    Journal of Epidemiology &amp Community Health 09/2014; 68(Suppl 1):A60-A60. DOI:10.1136/jech-2014-204726.129 · 3.29 Impact Factor
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    ABSTRACT: Cognitive abilities decline with age, but with considerable individual variation. The neurobiological correlate of this variation is not well described. Functional brain imaging studies have demonstrated reduced task-induced deactivation (TID) of the brain's default mode network (DMN) in a wide range of neurodegenerative diseases involving cognitive symptoms, in conditions with increased risk of Alzheimer's disease, and even in advanced but healthy aging. Here, we investigated brain activation and deactivation during a visual-motor task in 185 clinically healthy males from a Danish birth cohort, whose cognitive function was assessed in youth and midlife. Using each individual as his own control, we defined a group with a large degree of cognitive decline, and a control group. When correcting for effects of total cerebral blood flow and hemoglobin level, we found reduced TID in the posterior region of the DMN in the cognitive decline group compared to the control group. Furthermore, increased visual activation response was found in the cognitive decline group, indicating that the TID reduction was not exclusively due to overall impaired vascular reactivity. These results suggest a neurobiological basis for subclinical cognitive decline in late midlife, which includes TID alterations similar to the pattern seen in patients with AD and mild cognitive impairment. Hence, TID reduction might be suggested as an early marker for subtle cognitive decline in aging. Hum Brain Mapp, 2014. © 2014 Wiley Periodicals, Inc.
    Human Brain Mapping 09/2014; 35(9). DOI:10.1002/hbm.22489 · 6.92 Impact Factor
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    ABSTRACT: Background and Purpose-Combined effects of socioeconomic position and well-established risk factors on stroke incidence have not been formally investigated. Methods-In a pooled cohort study of 68 643 men and women aged 30 to 70 years in Denmark, we examined the combined effect and interaction between socioeconomic position (ie, education), smoking, and hypertension on ischemic and hemorrhagic stroke incidence by the use of the additive hazards model. Results-During 14 years of follow-up, 3613 ischemic strokes and 776 hemorrhagic strokes were observed. Current smoking and hypertension were more prevalent among those with low education. Low versus high education was associated with greater ischemic, but not hemorrhagic, stroke incidence. The combined effect of low education and current smoking was more than expected by the sum of their separate effects on ischemic stroke incidence, particularly among men: 134 (95% confidence interval, 49-219) extra cases per 100 000 person-years because of interaction, adjusted for age, cohort study, and birth cohort. There was no clear evidence of interaction between low education and hypertension. The combined effect of current smoking and hypertension was more than expected by the sum of their separate effects on ischemic and hemorrhagic stroke incidence. This effect was most pronounced for ischemic stroke among women: 178 (95% confidence interval, 103-253) extra cases per 100 000 person-years because of interaction, adjusted for age, cohort study, and birth cohort. Conclusions-Reducing smoking in those with low socioeconomic position and in those with hypertension could potentially reduce social inequality stroke incidence.
    Stroke 08/2014; 45(9). DOI:10.1161/STROKEAHA.114.005252 · 6.02 Impact Factor
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    Alzheimer's and Dementia 07/2014; 10(4):P3. DOI:10.1016/j.jalz.2014.04.022 · 17.47 Impact Factor
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    ABSTRACT: Objective: The cyclin dependent kinase inhibitor p16ink4a, one of the two gene products of the ink4a/ARF (cdkn2a) locus on chromosome 9q21, is an important cell-cycle inhibitor and tumorsuppressor. p16ink4a upregulation has been linked to cellular senescence and results from studies on mammalian tissues suggest that p16ink4a may be biomarker of organismal versus chronological age. The objective of the present study was to determine the pattern in which p16ink4a is expressed by cells of human labial salivary glands and to analyse whether the level of its expression is associated with decline in midlife cognitive performance. Methods: The expression of p16ink4a was analysed by qRT-PCR in samples of labial salivary gland tissue from 181 middle-aged male study participants all born in 1953 and selected on the basis of change in midlife cognitive scores. The participants were divided into one group of men with high versus one group of men with declined cognitive performance at approximately age 57. The localization pattern of p16ink4a in the tissue was evaluated by immunohistochemistry. Results: Human labial salivary glands express p16ink4a in a selective pattern. The p16ink4a expression level is slightly up-regulated in labial salivary gland tissue samples taken from a group of men with decline in midlife cognitive performance. Conclusions: p16ink4a may constitute a potential peripheral biomarker candidate for future studies of different trajectories of cognitive aging. Human labial salivary glands are a suitable model organ for the investigation of organismal versus chronological age.
    IADR General Session and Exhibition 2014; 06/2014
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    ABSTRACT: The Danish Conscription Database (DCD) was established to enable studies of the influence of early physical and mental exposures on adverse health and social outcomes from a life-course perspective. In Denmark, all young men are requested to appear before the conscription board when they turn 18 years, to be assessed for military service. The DCD was established by digitizing information from conscription board register cards on the height, weight, educational level, intelligence test score and examination details of Danish conscripts. The DCD contains information on 728 160 men born from 1939 through 1959 and examined by the conscription board from 1957 through 1984. The unique Danish personal identification number of each individual conscript has been traced, and this allows linkage of the DCD to all Danish health and socioeconomic registers. More than 130 000 deaths have been identified in a recent linkage to the Danish Register of Cause of Death. We encourage collaboration, and interested researchers should contact:
    International Journal of Epidemiology 06/2014; 44(2). DOI:10.1093/ije/dyu114 · 9.20 Impact Factor
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    ABSTRACT: One aim of the present study was to investigate whether symptoms of oral dryness (xerostomia) during daytime, assessed in a study group of middle-aged male positive and negative outliers in cognition scores, were associated with age-related degenerative changes in human labial salivary glands and with quantitative measures of the glandular autonomic innervation. Another aim was to study the relation between the autonomic innervation and loss of secretory acinar cells in these glands.
    Experimental Gerontology 06/2014; 57. DOI:10.1016/j.exger.2014.06.004 · 3.53 Impact Factor
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    ABSTRACT: In an increasingly aged population, sleep disturbances and neurodegenerative disorders have become a major public health concern. Poor sleep quality and cognitive changes are complex health problems in aging populations that are likely to be associated with increased frailty, morbidity, and mortality, and to be potential risk factors for further cognitive impairment. We aimed to evaluate whether sleep quality and excessive daytime sleepiness may be considered as early predictors of cognitive impairment. The objective of this study was to examine whether subjective sleep quality and daytime sleepiness are associated with cognition in middle-aged males. A total of 189 healthy males born in 1953 were considered as participants for the study. Based on previous cognitive assessments, the participants were selected for the study as cognitively improved (N = 97) or cognitively impaired (N = 92). The Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale measured subjective sleep quality and daytime sleepiness, respectively. Depressive symptoms were determined using Beck's Depression Inventory (BDI-II). A neuropsychological battery was administered to confirm group differences in cognitive functioning at the time when sleep data were collected. Compared with cognitively improved males, the cognitively impaired group reported significantly lower subjective sleep quality (5.40 ± 3.81 vs. 4.39 ± 2.40, p = 0.03). Forty-one percent of the sample exhibited poor sleep quality and 15% experienced excessive daytime sleepiness. There were few correlations between sleep parameters and cognitive test performance in the combined sample. Self-reported poor sleep quality was related to cognitive changes, whereas daytime sleepiness was not related. Our results suggest that sleep quality may be an early marker of cognitive decline in midlife. Copyright © 2015 Elsevier B.V. All rights reserved.
    Clinical Neurophysiology 06/2014; 125:S101. DOI:10.1016/S1388-2457(14)50335-5 · 2.98 Impact Factor
  • Clinical Neurophysiology 06/2014; 125:S101. DOI:10.1016/S1388-2457(14)50333-1 · 2.98 Impact Factor
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    ABSTRACT: Objective To investigate the association between socioeconomic position (assessed by education, employment, and income) and complications following hysterectomy and assess the role of lifestyle, co-morbidity and clinical conditions on the relation.DesignRegister-based cohort study.Setting and populationThe study included nearly all Danish women (n=22,150) registered with a benign elective hysterectomy in the Danish Hysterectomy Database in the 2004-2008 period.Main outcome measuresData were analyzed using logistic regression models estimating the odds ratio with 95% confidence intervals.Methods Complications following hysterectomy.ResultsSeventeen percent of the women experienced complications in relation to the hysterectomy. Women with less than high school education and women not employed had higher odds of infection, complications and readmission than women with more than high school education and employed women. Furthermore, non-employed women had higher odds of hospitalization >4 days than women in employment. Lifestyle factors (smoking and body mass index) and co-morbidity status seemed to explain most of the social differences. However, an association between women with less than high school education and all complications remained unexplained. Furthermore, differences in lifestyle and co-morbidity status only partially explained the higher odds of infection, complications and hospitalization >4 days for women out of employment compared to women in employment.Conclusion Women with low socioeconomic position have significantly higher odds of complications following hysterectomy than women with high socioeconomic position. Unhealthy lifestyle and presence of co-morbidity in women with low socioeconomic position partially explains the differences in complications.This article is protected by copyright. All rights reserved.
    Acta Obstetricia Et Gynecologica Scandinavica 06/2014; 70(1). DOI:10.1111/aogs.12444 · 1.99 Impact Factor
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    ABSTRACT: To isolate the effect of education from the influence of potential underlying factors, we investigated the association of education with the risk of cardiovascular disease (CVD) and ischemic heart disease (IHD) using twin data to adjust for familial factors shared within twins, including genetic make-up and childhood environment. The study was based on data from the Danish Twin Registry linked to administrative and heath registers in Statistics Denmark. A total of 11,968 monozygotic and 20,464 dizygotic same sexed twins were followed from 1980 to 2009, including more than 8000 events of CVD. Unpaired and intra-pair analyses were compared. In the unpaired analyses, an inverse educational gradient in CVD- and IHD risk was observed. This association was not replicated in the intra-pair analyses that control for shared familial factors exploiting that twins share their intrauterine- and childhood environment and are matched partly or fully on genetic setup. The attenuation of association of education with CVD and IHD in the intra-pair analyses suggests that shared familial factors account for a substantial part of the observed association of education with CVD and IHD in Denmark.
    Social Science [?] Medicine 04/2014; 118. DOI:10.1016/j.socscimed.2014.04.016 · 2.56 Impact Factor
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    ABSTRACT: AimTo 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.Methods We studied 2487 participants from the Metropolit Cohort of 11,532 men born in 1953 in the Copenhagen Metropolitan area. The vitality level was estimated using the SF-36 vitality scale. Cardiovascular risk factors were determined by body mass index (BMI) and hematological biochemistry tests obtained from non-fasting participants. DNA damage parameters were measured in peripheral blood mononuclear cells (PBMCs) from as many participants as possible from a representative subset of 207 participants.ResultsVitality was inversely associated with spontaneous DNA breaks (measured by comet assay) (P = 0.046) and BMI (P = 0.002), and positively associated with all of the physical performance parameters (all P < 0.001). Also, we found several associations between physical performance parameters and cardiovascular risk factors. In addition, the load of short telomeres was inversely associated with maximum jump force (P = 0.018), with lowered significance after exclusion of either arthritis sufferers (P = 0.035) or smokers (P = 0.031).Conclusion Here we show that self-reported vitality is associated with DNA breaks, BMI and objective (measured) physical performance in a cohort of middle aged men. Several other associations in this study verify clinical observations in medical practice. In addition, the load of short telomeres may be linked to peak performance in certain musculoskeletal activities.This article is protected by copyright. All rights reserved.
    Acta Physiologica 04/2014; 213(1). DOI:10.1111/apha.12296 · 4.25 Impact Factor
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    ABSTRACT: The Social Inequality in Cancer (SIC) cohort study was established to determine pathways through which socioeconomic position affects morbidity and mortality, in particular common subtypes of cancer. Data from seven well-established cohort studies from Denmark were pooled. Combining these cohorts provided a unique opportunity to generate a large study population with long follow-up and sufficient statistical power to develop and apply new methods for quantification of the two basic mechanisms underlying social inequalities in cancer—mediation and interaction. The SIC cohort included 83 006 participants aged 20–98 years at baseline. A wide range of behavioural and biological risk factors such as smoking, physical inactivity, alcohol intake, hormone replacement therapy, body mass index, blood pressure and serum cholesterol were assessed by self-administered questionnaires, physical examinations and blood samples. All participants were followed up in nationwide demographic and healthcare registries. For those interested in collaboration, further details can be obtained by contacting the Steering Committee at the Department of Public Health, University of Copenhagen, at inan{at}
    International Journal of Epidemiology 02/2014; 43(6). DOI:10.1093/ije/dyu003 · 9.20 Impact Factor

Publication Stats

6k Citations
871.29 Total Impact Points


  • 2012–2015
    • Aarhus University
      • Danish Pain Research Center
      Aarhus, Central Jutland, Denmark
    • Danish Cancer Society
      København, Capital Region, Denmark
  • 1995–2015
    • Glostrup Hospital
      • • Research Centre for Prevention and Health
      • • Department of Medicine
      • • Centre for Preventive Medicine
      • • Medical Department C
      Glostrup, Capital Region, Denmark
  • 1993–2015
    • IT University of Copenhagen
      København, Capital Region, Denmark
  • 2006–2014
    • University of Southern Denmark
      • • Aging Research Center
      • • Institute of Public Health
      Odense, South Denmark, Denmark
  • 2013
    • Odense Zoo
      Odense, South Denmark, Denmark
    • København Zoo
      København, Capital Region, Denmark
  • 2008
    • National Institute of Public Health
      København, Capital Region, Denmark
  • 2007
    • Statens Serum Institut
      • Department of Epidemiology Research
      Copenhagen, Capital Region, Denmark
  • 1997–2003
    • Copenhagen University Hospital Hvidovre
      • Department of Cardiology
      Hvidovre, Capital Region, Denmark
  • 1998–2002
    • Copenhagen University Hospital
      København, Capital Region, Denmark
  • 1996–2000
    • University of Copenhagen
      København, Capital Region, Denmark
  • 1996–1997
    • London School of Hygiene and Tropical Medicine
      Londinium, England, United Kingdom
  • 1990
    • Royal Agricultural University
      Cicester, England, United Kingdom