Publications from 2014

JS, Tyrrell; MS, Taylor; D, Whinney; NJ., Osborne

Associations of Leg Length, Trunk Length, and Total Adult Height With Ménière’s: Cross-Sectional Analysis in the UK Biobank. Journal Article

Ear & Hearing, 2014.

McCormack, Abby; Edmondson-Jones, Mark; Mellor, Duane; Dawes, Piers; Munro, Kevin J; Moore, David R; Fortnum, Heather

Association of Dietary Factors with Presence and Severity of Tinnitus in a Middle-Aged UK Population Journal Article

PLOS One, 9 (12), 2014.

@article{McCormack2014b,
title = {Association of Dietary Factors with Presence and Severity of Tinnitus in a Middle-Aged UK Population},
author = {Abby McCormack and Mark Edmondson-Jones and Duane Mellor and Piers Dawes and Kevin J. Munro and David R. Moore and Heather Fortnum},
url = {http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0114711},
year = {2014},
date = {2014-12-12},
journal = {PLOS One},
volume = {9},
number = {12},
abstract = {Objective

The impact of dietary factors on tinnitus has received limited research attention, despite being a considerable concern among people with tinnitus and clinicians. The objective was to examine the link between dietary factors and presence and severity of tinnitus.

Design

This study used the UK Biobank resource, a large cross-sectional study of adults aged 40–69. 171,722 eligible participants were asked questions specific to tinnitus (defined as noises such as ringing or buzzing in the head or ears). Dietary factors included portions of fruit and vegetables per day, weekly fish consumption (oily and non-oily), bread type, cups of caffeinated coffee per day, and avoidance of dairy, eggs, wheat and sugar. We controlled for lifestyle, noise exposure, hearing, personality and comorbidity factors.

Results

Persistent tinnitus, defined as present at least a lot of the time, was elevated with increased: (i) fruit/vegetable intake (OR = 1.01 per portion/day), (ii) bread (wholemeal/wholegrain, OR = 1.07; other bread, 1.20) and (iii) dairy avoidance (OR = 1.27). Persistent tinnitus was reduced with: (i) fish consumption (non-oily, OR = 0.91; oily, 0.95), (ii) egg avoidance (OR = 0.87) and (iii) caffeinated coffee consumption (OR = 0.99 per cup/day). Reports of “bothersome” tinnitus (moderate-severe handicap) increased with wholemeal/wholegrain bread intake (OR = 0.86). Reports of less frequent transient tinnitus increased with dairy avoidance (OR = 1.18) and decreased with caffeinated coffee (OR = 0.98 per cup/day) and brown bread (OR = 0.94).

Conclusions

This is the first population study to report the association between dietary factors and tinnitus. Although individually dietary associations are mostly modest, particular changes in diet, such as switching between foodstuffs, may result in stronger associations. These findings offer insights into possible dietary associations with tinnitus, and this may be useful when discussing management options in combination with other lifestyle changes and therapies.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}

Objective

The impact of dietary factors on tinnitus has received limited research attention, despite being a considerable concern among people with tinnitus and clinicians. The objective was to examine the link between dietary factors and presence and severity of tinnitus.

Design

This study used the UK Biobank resource, a large cross-sectional study of adults aged 40–69. 171,722 eligible participants were asked questions specific to tinnitus (defined as noises such as ringing or buzzing in the head or ears). Dietary factors included portions of fruit and vegetables per day, weekly fish consumption (oily and non-oily), bread type, cups of caffeinated coffee per day, and avoidance of dairy, eggs, wheat and sugar. We controlled for lifestyle, noise exposure, hearing, personality and comorbidity factors.

Results

Persistent tinnitus, defined as present at least a lot of the time, was elevated with increased: (i) fruit/vegetable intake (OR = 1.01 per portion/day), (ii) bread (wholemeal/wholegrain, OR = 1.07; other bread, 1.20) and (iii) dairy avoidance (OR = 1.27). Persistent tinnitus was reduced with: (i) fish consumption (non-oily, OR = 0.91; oily, 0.95), (ii) egg avoidance (OR = 0.87) and (iii) caffeinated coffee consumption (OR = 0.99 per cup/day). Reports of “bothersome” tinnitus (moderate-severe handicap) increased with wholemeal/wholegrain bread intake (OR = 0.86). Reports of less frequent transient tinnitus increased with dairy avoidance (OR = 1.18) and decreased with caffeinated coffee (OR = 0.98 per cup/day) and brown bread (OR = 0.94).

Conclusions

This is the first population study to report the association between dietary factors and tinnitus. Although individually dietary associations are mostly modest, particular changes in diet, such as switching between foodstuffs, may result in stronger associations. These findings offer insights into possible dietary associations with tinnitus, and this may be useful when discussing management options in combination with other lifestyle changes and therapies.

Nicholl, Barbara I; Mackay, Daniel; Cullen, Breda; Martin, Daniel J; Ul-Haq, Zia; Mair, Frances S; Evans, Jonathan; McIntosh, Andrew; Gallacher, John; Roberts, Beverly; Deary, Ian J; Pell, Jill P; Smith, Daniel J

Chronic multisite pain in major depression and bipolar disorder: cross-sectional study of 149,611 participants in UK Biobank. Journal Article

BMC Psychiatry, 14 (350), 2014.

BackgroundChronic pain has a strong association with major depressive disorder (MDD), but there is a relative paucity of studies on the association between chronic multisite pain and bipolar disorder (BD). Such studies are required to help elucidate the complex biological and psychological overlap between pain and mood disorders. The aim of this study is to investigate the relationship between chronic multisite pain and mood disorder across the unipolar-bipolar spectrum.MethodsWe conducted a cross-sectional study of 149,611 UK Biobank participants. Self-reported depressive and bipolar features were used to categorise participants into MDD and BD groups and a non-mood disordered comparison group. Multinomial logistic regression was used to establish whether there was an association between extent of chronic pain (independent variable) and mood disorder category (dependent variable), using no pain as the referent category, and adjusting for a wide range of potential sociodemographic, lifestyle and comorbidity confounders.ResultsMultisite pain was significantly more prevalent in participants with BD and MDD, for example, 4?7 pain sites: BD 5.8%, MDD 4.5%, and comparison group 1.8% (p?<?0.001). A relationship was observed between extent of chronic pain and risk of BD and persisted after adjusting for confounders (relative to individuals with no chronic pain): 2?3 sites RRR of BD 1.84 (95% CI 1.61, 2.11); 4?7 sites RRR of BD 2.39 (95%CI 1.88, 3.03) and widespread pain RRR of BD 2.37 (95%CI 1.73, 3.23). A similar relationship was observed between chronic pain and MDD: 2?3 sites RRR of MDD 1.59 (95%CI 1.54, 1.65); 4?7 sites RRR of MDD 2.13 (95%CI 1.98, 2.30); widespread pain RRR of MDD 1.86 (95%CI 1.66, 2.08).ConclusionsIndividuals who report chronic pain and multiple sites of pain are more likely to have MDD and are at higher risk of BD. These findings highlight an important aspect of comorbidity in MDD and BD and may have implications for understanding the shared neurobiology of chronic pain and mood disorders.

Cumberland, Phillippa M; Rahi, Jugnoo S

Visual health inequalities: findings from UK Biobank Conference

384 , 2014.

@conference{Cumberland2014,
title = {Visual health inequalities: findings from UK Biobank},
author = {Phillippa M Cumberland and Jugnoo S Rahi},
url = {http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2814%2962153-X/fulltext},
year = {2014},
date = {2014-11-19},
journal = {The Lancet },
volume = {384},
pages = {S27},
abstract = {Background
Little is known about inequalities in eye health. Between 2009 and 2010, 117 908 UK Biobank participants (aged 40—69 years) undertook an ophthalmic assessment, which included distance visual acuity. UK Biobank was not designed to be a fully representative population sample so prevalence estimation is precluded. However, the size and diversity of the sample provide a unique opportunity for investigation of socioeconomic influences on visual health in UK adults.
Methods
Habitual (usual optical correction) distance acuity was measured with a standardised computer-based system. 112 314 participants were reliably assigned, on the basis of acuity in the better eye, into one of six categories spanning the spectrum of vision from bilateral normal vision (log of minimum angle of resolution [logMAR] 0·2 or better) to low-vision—blind (≤0·5, WHO taxonomy). Socioeconomic information included educational qualifications and Townsend Index. Multinomial and ordinal regression analyses were undertaken.
Findings
The frequency of normal bilateral vision decreased with age (age 40—49 years, 86% [21 934/25 645]; 50—59 years, 77% [27 482/35 786]; and 60—70 years, 72% [36 461/50 883]). Overall, risk of visual impairment across severity categories was associated with an increasing gradient of key demographic and socioeconomic variables, indicating deprivation. These patterns of visual health inequalities were not explained by risk of underlying eye disease. For example, compared with normal vision, socially significant visual impairment (SSVI), a mid-range category of visual impairment, was associated with increasing age (risk ratio 1·05, 95% CI 1·046—1·06), being female (1·09, 1·01—1·16), no educational qualifications (1·7, 1·4—1·9), a higher deprivation score (1·08, 1·07—1·09), and being part of any minority ethnic group (eg, Asian 2·5, 2·1—2·9). Participants unable to work or unemployed were at least 30% more likely to be in the SSVI category than were those with normal vision and, if employed, at least 9% more likely to have a lower status job.
Interpretation
There are consistent patterns of associations between visual impairment across the full spectrum including, importantly, people with mild impairment, and known health determinants as well as key social outcomes. To our knowledge, our study provides evidence for the first time that policies tackling health inequalities as well as initiatives to address inequalities in ophthalmological clinical settings have the potential to improve visual health outcomes.
Funding
This work was funded by the National Eye Research Centre. PMC is funded by the Ulverscroft Foundation and JSR receives part funding from the National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and University College London Institute of Ophthalmology. The study was undertaken at University College London Institute of Child Health, which receives a proportion of its funding from the Department of Health's NIHR Biomedical Research Centres funding scheme.},
keywords = {},
pubstate = {published},
tppubtype = {conference}
}

Background
Little is known about inequalities in eye health. Between 2009 and 2010, 117 908 UK Biobank participants (aged 40—69 years) undertook an ophthalmic assessment, which included distance visual acuity. UK Biobank was not designed to be a fully representative population sample so prevalence estimation is precluded. However, the size and diversity of the sample provide a unique opportunity for investigation of socioeconomic influences on visual health in UK adults.
Methods
Habitual (usual optical correction) distance acuity was measured with a standardised computer-based system. 112 314 participants were reliably assigned, on the basis of acuity in the better eye, into one of six categories spanning the spectrum of vision from bilateral normal vision (log of minimum angle of resolution [logMAR] 0·2 or better) to low-vision—blind (≤0·5, WHO taxonomy). Socioeconomic information included educational qualifications and Townsend Index. Multinomial and ordinal regression analyses were undertaken.
Findings
The frequency of normal bilateral vision decreased with age (age 40—49 years, 86% [21 934/25 645]; 50—59 years, 77% [27 482/35 786]; and 60—70 years, 72% [36 461/50 883]). Overall, risk of visual impairment across severity categories was associated with an increasing gradient of key demographic and socioeconomic variables, indicating deprivation. These patterns of visual health inequalities were not explained by risk of underlying eye disease. For example, compared with normal vision, socially significant visual impairment (SSVI), a mid-range category of visual impairment, was associated with increasing age (risk ratio 1·05, 95% CI 1·046—1·06), being female (1·09, 1·01—1·16), no educational qualifications (1·7, 1·4—1·9), a higher deprivation score (1·08, 1·07—1·09), and being part of any minority ethnic group (eg, Asian 2·5, 2·1—2·9). Participants unable to work or unemployed were at least 30% more likely to be in the SSVI category than were those with normal vision and, if employed, at least 9% more likely to have a lower status job.
Interpretation
There are consistent patterns of associations between visual impairment across the full spectrum including, importantly, people with mild impairment, and known health determinants as well as key social outcomes. To our knowledge, our study provides evidence for the first time that policies tackling health inequalities as well as initiatives to address inequalities in ophthalmological clinical settings have the potential to improve visual health outcomes.
Funding
This work was funded by the National Eye Research Centre. PMC is funded by the Ulverscroft Foundation and JSR receives part funding from the National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and University College London Institute of Ophthalmology. The study was undertaken at University College London Institute of Child Health, which receives a proportion of its funding from the Department of Health's NIHR Biomedical Research Centres funding scheme.

Rönnberg, Jerker; Hygge, Staffan; Keidser, Gitte; Rudner, Mary

The Effect of Functional Hearing Loss and Age on Long- and Short-term Visuospatial Memory: Evidence from the UK Biobank Resource Journal Article

Frontiers in Aging and Neuroscience, 6 , pp. 326, 2014.

Moore, David R; Edmondson-Jones, Mark; Dawes, Piers; Fortnum, Heather; McCormack, Abby; Pierzycki, Robert H; Munro, Kevin J

Relation between Speech-in-Noise Threshold, Hearing Loss and Cognition from 40–69 Years of Age Journal Article

PLOS One, 9 (9), pp. e107720, 2014.

@article{Moore2014,
title = {Relation between Speech-in-Noise Threshold, Hearing Loss and Cognition from 40–69 Years of Age},
author = {David R. Moore and Mark Edmondson-Jones and Piers Dawes and Heather Fortnum and Abby McCormack and Robert H. Pierzycki and Kevin J. Munro},
url = {http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0107720#pone-0107720-g001},
year = {2014},
date = {2014-09-17},
journal = {PLOS One},
volume = {9},
number = {9},
pages = {e107720},
abstract = {Healthy hearing depends on sensitive ears and adequate brain processing. Essential aspects of both hearing and cognition decline with advancing age, but it is largely unknown how one influences the other. The current standard measure of hearing, the pure-tone audiogram is not very cognitively demanding and does not predict well the most important yet challenging use of hearing, listening to speech in noisy environments. We analysed data from UK Biobank that asked 40–69 year olds about their hearing, and assessed their ability on tests of speech-in-noise hearing and cognition.

Methods and Findings

About half a million volunteers were recruited through NHS registers. Respondents completed ‘whole-body’ testing in purpose-designed, community-based test centres across the UK. Objective hearing (spoken digit recognition in noise) and cognitive (reasoning, memory, processing speed) data were analysed using logistic and multiple regression methods. Speech hearing in noise declined exponentially with age for both sexes from about 50 years, differing from previous audiogram data that showed a more linear decline from <40 years for men, and consistently less hearing loss for women. The decline in speech-in-noise hearing was especially dramatic among those with lower cognitive scores. Decreasing cognitive ability and increasing age were both independently associated with decreasing ability to hear speech-in-noise (0.70 and 0.89 dB, respectively) among the population studied. Men subjectively reported up to 60% higher rates of difficulty hearing than women. Workplace noise history associated with difficulty in both subjective hearing and objective speech hearing in noise. Leisure noise history was associated with subjective, but not with objective difficulty hearing.

Conclusions

Older people have declining cognitive processing ability associated with reduced ability to hear speech in noise, measured by recognition of recorded spoken digits. Subjective reports of hearing difficulty generally show a higher prevalence than objective measures, suggesting that current objective methods could be extended further.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}

Healthy hearing depends on sensitive ears and adequate brain processing. Essential aspects of both hearing and cognition decline with advancing age, but it is largely unknown how one influences the other. The current standard measure of hearing, the pure-tone audiogram is not very cognitively demanding and does not predict well the most important yet challenging use of hearing, listening to speech in noisy environments. We analysed data from UK Biobank that asked 40–69 year olds about their hearing, and assessed their ability on tests of speech-in-noise hearing and cognition.

Methods and Findings

About half a million volunteers were recruited through NHS registers. Respondents completed ‘whole-body’ testing in purpose-designed, community-based test centres across the UK. Objective hearing (spoken digit recognition in noise) and cognitive (reasoning, memory, processing speed) data were analysed using logistic and multiple regression methods. Speech hearing in noise declined exponentially with age for both sexes from about 50 years, differing from previous audiogram data that showed a more linear decline from <40 years for men, and consistently less hearing loss for women. The decline in speech-in-noise hearing was especially dramatic among those with lower cognitive scores. Decreasing cognitive ability and increasing age were both independently associated with decreasing ability to hear speech-in-noise (0.70 and 0.89 dB, respectively) among the population studied. Men subjectively reported up to 60% higher rates of difficulty hearing than women. Workplace noise history associated with difficulty in both subjective hearing and objective speech hearing in noise. Leisure noise history was associated with subjective, but not with objective difficulty hearing.

Conclusions

Older people have declining cognitive processing ability associated with reduced ability to hear speech in noise, measured by recognition of recorded spoken digits. Subjective reports of hearing difficulty generally show a higher prevalence than objective measures, suggesting that current objective methods could be extended further.

Ntuk, UE; Gill, JM; Mackay, DF; Sattar, N; Pell, JP

Ethnic-specific obesity cutoffs for diabetes risk: cross-sectional study of 490,288 UK biobank participants. Journal Article

Diabetes Care, 37 (9), pp. 2500-7, 2014.

@article{Ntuk2014,
title = {Ethnic-specific obesity cutoffs for diabetes risk: cross-sectional study of 490,288 UK biobank participants.},
author = {UE Ntuk and JM Gill and DF Mackay and N Sattar and JP Pell},
url = {http://www.ncbi.nlm.nih.gov/pubmed/24974975},
year = {2014},
date = {2014-09-01},
journal = {Diabetes Care},
volume = {37},
number = {9},
pages = {2500-7},
abstract = {OBJECTIVE:
To compare the relationship between adiposity and prevalent diabetes across ethnic groups in the UK Biobank cohort and to derive ethnic-specific obesity cutoffs that equate to those developed in white populations in terms of diabetes prevalence.
RESEARCH DESIGN AND METHODS:
UK Biobank recruited 502,682 U.K. residents aged 40-69 years. We used baseline data on the 490,288 participants from the four largest ethnic subgroups: 471,174 (96.1%) white, 9,631 (2.0%) South Asian, 7,949 (1.6%) black, and 1,534 (0.3%) Chinese. Regression models were developed for the association between anthropometric measures (BMI, waist circumference, percentage body fat, and waist-to-hip ratio) and prevalent diabetes, stratified by sex and adjusted for age, physical activity, socioeconomic status, and heart disease.
RESULTS:
Nonwhite participants were two- to fourfold more likely to have diabetes. For the equivalent prevalence of diabetes at 30 kg/m(2) in white participants, BMI equated to the following: South Asians, 22.0 kg/m(2); black, 26.0 kg/m(2); Chinese women, 24.0 kg/m(2); and Chinese men, 26.0 kg/m(2). Among women, a waist circumference of 88 cm in the white subgroup equated to the following: South Asians, 70 cm; black, 79 cm; and Chinese, 74 cm. Among men, a waist circumference of 102 cm equated to 79, 88, and 88 cm for South Asian, black, and Chinese participants, respectively.
CONCLUSIONS:
Obesity should be defined at lower thresholds in nonwhite populations to ensure that interventions are targeted equitably based on equivalent diabetes prevalence. Furthermore, within the Asian population, a substantially lower obesity threshold should be applied to South Asian compared with Chinese groups.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}

Macfarlane, Tatiana V; Beasley, Marcus; Macfarlane, Gary J

Self-Reported Facial Pain in UK Biobank Study: Prevalence and Associated Factors Journal Article

Journal Of Oral and Maxillofacial Research, 5 (3), pp. e2, 2014.

@article{Macfarlane2014,
title = {Self-Reported Facial Pain in UK Biobank Study: Prevalence and Associated Factors},
author = {Tatiana V. Macfarlane and Marcus Beasley and Gary J. Macfarlane},
url = {http://www.ejomr.org/JOMR/archives/2014/3/e2/v5n3e2ht.pdf},
year = {2014},
date = {2014-08-29},
journal = {Journal Of Oral and Maxillofacial Research},
volume = {5},
number = {3},
pages = {e2},
abstract = {Objectives: To determine the prevalence of facial pain and to examine the hypothesis that symptoms are associated with
socio-demographic, dental, adverse psychological factors and pain elsewhere in the body.
Material and Methods: Cross-sectional population data were obtained from UK Biobank (www.ukbiobank.ac.uk/) study
which was conducted in 2006 - 2010 and recruited over 500,000 people.
Results: The overall prevalence of facial pain (FP) was 1.9% (women 2.4%, men 1.2%) of which 48% was chronic.
The highest prevalence was found in the 51 - 55 age group (2.2%) and the lowest in the 66 - 73 age group (1.4%). There was
a difference in prevalence by ethnicity (0.8% and 2.7% in persons reporting themselves as Chinese and Mixed respectively).
Prevalence of FP significantly associated with all measures of social class with the most deprived and on lowest income
showing the highest prevalence (2.5% and 2.4% respectively). FP was more common in individuals who rated themselves
as extremely unhappy, had history of depression and reported sleep problems. Smoking associated with increase in reporting
FP while alcohol consumption had inverse association. FP associated with history of painful gums, toothache and all types of
regional pain.
Conclusions: This is the largest ever study to provide estimates of facial pain prevalence. It demonstrates unique features
(lower prevalence than previously reported) and common features (more common in women) and confirms multifactorial
aetiology of facial pain. Significant association with psychological d},
keywords = {},
pubstate = {published},
tppubtype = {article}
}

Gaye, Amadou; Peakman, Tim; Tobin, Martin D; Burton, Paul R

Understanding the impact of pre-analytic variation in haematological and clinical chemistry analytes on the power of association studies Journal Article

International Journal of Epidemiology, 10.1093/ije/dyu127 , 2014.

@article{Gaye2014,
title = {Understanding the impact of pre-analytic variation in haematological and clinical chemistry analytes on the power of association studies},
author = {Amadou Gaye and Tim Peakman and Martin D Tobin and Paul R Burton},
url = {http://ije.oxfordjournals.org/content/early/2014/07/31/ije.dyu127.short?rss=1},
year = {2014},
date = {2014-08-01},
journal = {International Journal of Epidemiology},
volume = {10.1093/ije/dyu127},
abstract = {Background: Errors, introduced through poor assessment of physical measurement or because of inconsistent or inappropriate standard operating procedures for collecting, processing, storing or analysing haematological and biochemistry analytes, have a negative impact on the power of association studies using the collected data. A dataset from UK Biobank was used to evaluate the impact of pre-analytical variability on the power of association studies.

Methods: First, we estimated the proportion of the variance in analyte concentration that may be attributed to delay in processing using variance component analysis. Then, we captured the proportion of heterogeneity between subjects that is due to variability in the rate of degradation of analytes, by fitting a mixed model. Finally, we evaluated the impact of delay in processing on the power of a nested case-control study using a power calculator that we developed and which takes into account uncertainty in outcome and explanatory variables measurements.

Results: The results showed that (i) the majority of the analytes investigated in our analysis, were stable over a period of 36 h and (ii) some analytes were unstable and the resulting pre-analytical variation substantially decreased the power of the study, under the settings we investigated.

Conclusions: It is important to specify a limited delay in processing for analytes that are very sensitive to delayed assay. If the rate of degradation of an analyte varies between individuals, any delay introduces a bias which increases with increasing delay. If pre-analytical variation occurring due to delays in sample processing is ignored, it affects adversely the power of the studies that use the data.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}

Tyrrell, Jessica ; Whinney, David J; Ukoumunne, Obioha ; Fleming, Lora ; Osborne, Nicholas

Prevalence, Associated Factors, and Comorbid Conditions for Ménière’s Disease Journal Article

Ear and Hearing, 35 (4), 2014.

@article{Tyrrell2014,
title = {Prevalence, Associated Factors, and Comorbid Conditions for Ménière’s Disease},
author = {Tyrrell, Jessica and Whinney, David J. and Ukoumunne, Obioha and Fleming, Lora and Osborne, Nicholas},
url = {http://journals.lww.com/ear-hearing/Citation/2014/07000/Prevalence,_Associated_Factors,_and_Comorbid.18.aspx},
year = {2014},
date = {2014-07-01},
journal = {Ear and Hearing},
volume = {35},
number = {4},
abstract = {Objectives:

The aims of this study were to estimate the prevalence of Ménière’s disease and investigate its relationship with: demographic factors; symptoms and conditions that are known or hypothesized to be associated with Ménière’s disease; other physical diseases; mental health.

Design:

The authors used cross-sectional data from the UK Biobank to compare 1376 self-reported Ménière’s participants with over 500,000 without Ménière’s. The data set has comprehensive anthropometric measures, questionnaire data investigating health, well-being, diet, and medical and drug-prescribing history for each participant. The authors used logistic regression models to investigate the relationship of Ménière’s disease with: demographic factors; symptoms and conditions that are known or hypothesized to be associated with Ménière’s disease; other physical diseases; and mental health.

Results:

Ménière’s disease was more common in participants who were older (adjusted odds ratio per 10-year increase: 1.5 [95% confidence interval:1.4–1.6]), white (odds ratio: 1.7;1.2–2.3), female (1.4;1.3–1.6), and having higher body mass index categories (p < 0.001). The Ménière’s group had greater odds of hearing difficulty (10.9;9.6–12.5), current tinnitus (68.3;47.8–97.5), and had fallen more than once in the last year (2.1;1.8–2.5). Ménière’s participants had greater odds of reporting at least one disease from each grouping of allergic, immune dysfunction, or autonomic dysfunction (2.2;1.8–2.6), and poor mental health (2.1;1.8–2.5).

Conclusions:

This study provides an evidence base that improves understanding of Ménière’s disease. Associations were noted with a number of diseases, and the authors hypothesize a role for the autonomic nervous system and immune system dysfunction in Ménière’s etiology. The study also highlights the physical and mental health correlates of the condition},
keywords = {},
pubstate = {published},
tppubtype = {article}
}

Tyrrell, JS; Whinney, DJ; Ukoumunne, OC; Fleming, LE; Osborne, NJ

Prevalence, Associated Factors, and Comorbid Conditions for Ménière's Disease Journal Article

Ear and Hearing, 2014.

@article{Tyrrell2014b,
title = {Prevalence, Associated Factors, and Comorbid Conditions for Ménière's Disease},
author = {JS Tyrrell and DJ Whinney and OC Ukoumunne and LE Fleming and NJ Osborne },
url = {https://www.ncbi.nlm.nih.gov/pubmed/24732693},
year = {2014},
date = {2014-07-01},
journal = {Ear and Hearing},
abstract = {OBJECTIVES:

The aims of this study were to estimate the prevalence of Ménière's disease and investigate its relationship with: demographic factors; symptoms and conditions that are known or hypothesized to be associated with Ménière's disease; other physical diseases; mental health.

DESIGN:

The authors used cross-sectional data from the UK Biobank to compare 1376 self-reported Ménière's participants with over 500,000 without Ménière's. The data set has comprehensive anthropometric measures, questionnaire data investigating health, well-being, diet, and medical and drug-prescribing history for each participant. The authors used logistic regression models to investigate the relationship of Ménière's disease with: demographic factors; symptoms and conditions that are known or hypothesized to be associated with Ménière's disease; other physical diseases; and mental health.

RESULTS:

Ménière's disease was more common in participants who were older (adjusted odds ratio per 10-year increase: 1.5 [95% confidence interval:1.4-1.6]), white (odds ratio: 1.7;1.2-2.3), female (1.4;1.3-1.6), and having higher body mass index categories (p < 0.001). The Ménière's group had greater odds of hearing difficulty (10.9;9.6-12.5), current tinnitus (68.3;47.8-97.5), and had fallen more than once in the last year (2.1;1.8-2.5). Ménière's participants had greater odds of reporting at least one disease from each grouping of allergic, immune dysfunction, or autonomic dysfunction (2.2;1.8-2.6), and poor mental health (2.1;1.8-2.5).

CONCLUSIONS:

This study provides an evidence base that improves understanding of Ménière's disease. Associations were noted with a number of diseases, and the authors hypothesize a role for the autonomic nervous system and immune system dysfunction in Ménière's etiology. The study also highlights the physical and mental health correlates of the condition.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}

Franssen, FM; Rutten, EP; Groenen, MT; Vanfleteren, LE; Wouters, EF; Spruit, MA

New reference values for body composition by bioelectrical impedance analysis in the general population: results from the UK Biobank Journal Article

Journal of the American Medical Directors Association, 15 (6), pp. 448, 2014.

@article{Franssen2014,
title = {New reference values for body composition by bioelectrical impedance analysis in the general population: results from the UK Biobank},
author = {FM Franssen and EP Rutten and MT Groenen and LE Vanfleteren and EF Wouters and MA Spruit},
url = {http://www.ncbi.nlm.nih.gov/pubmed/24755478},
year = {2014},
date = {2014-06-01},
journal = {Journal of the American Medical Directors Association},
volume = {15},
number = {6},
pages = {448},
abstract = {BACKGROUND:
Low fat-free mass (FFM) is a risk factor for morbidity and mortality in elderly and patient populations. Therefore, measurement of FFM is important in nutritional assessment. Bioelectrical impedance analysis (BIA) is a convenient method to assess FFM and FFM index (FFMI; FFM/height(2)). Although reference values have been established for individuals with normal body weight, no specific cutoff values are available for overweight and obese populations. Also, limited studies accounted for the age-related decline in FFM.
OBJECTIVE:
To determine BMI- and age-specific reference values for abnormal low FFM(I) in white-ethnic men and women free of self-reported disease from the general population.
DESIGN:
The UK Biobank is a prospective epidemiological study of the general population from the United Kingdom. Individuals in the age category 45 to 69 years were analyzed. In addition to body weight, FFM and FFMI were measured using a Tanita BC-418MA. Also, self-reported chronic conditions and ethnic background were registered, and lung function was assessed using spirometry.
RESULTS:
After exclusion of all individuals with missing data, nonwhite ethnicity, self-reported disease, body mass index (BMI) less than 14 or 36 kg/m(2) or higher, and/or an obstructive lung function, reference values for FFM and FFMI were derived from 186,975 individuals (45.9% men; age: 56.9 ± 6.8 years; BMI: 26.5 ± 3.6 kg/m(2); FFMI 18.3 ± 2.4 kg/m(2)). FFM and FFMI were significantly associated with BMI and decreased with age. Percentiles 5, 10, 25, 50, 75, 90, and 95 were calculated for FFM, FFMI, and fat mass (index), after stratification for gender, age, and BMI.
CONCLUSIONS:
Using the UK Biobank dataset, new reference values for body composition assessed with BIA were determined in white-ethnic men and women aged 45 to 69 years. Because these reference values are BMI specific, they are of broad interest for overweight and obese populations},
keywords = {},
pubstate = {published},
tppubtype = {article}
}

Using the UK Biobank study to estimate occupational causes of chronic disease: comparability with the UK national population and adjustment for bias. Conference

Hutchings, S; Ayres, J; Cullinan, P; Fishwick, D; Jarvis, D; Matteis, De S; Sadhra, S; Wheatley, M; Rushton, L

71 (1), 2014.

@conference{Hutchings2014,
title = {Using the UK Biobank study to estimate occupational causes of chronic disease: comparability with the UK national population and adjustment for bias.},
author = {S Hutchings and J Ayres and P Cullinan and D Fishwick and D Jarvis and S De Matteis and S Sadhra and M Wheatley and L Rushton},
url = {http://www.ncbi.nlm.nih.gov/pubmed/25018481},
year = {2014},
date = {2014-06-01},
journal = {Occupational and Environmental Medicine },
volume = {71},
number = {1},
pages = {A79},
abstract = {OBJECTIVES:
The UK Biobank study is a sample of 502,682 people aged 40-70, clustered around 22 assessment centres. As part of a project to investigate the causes of COPD and estimate the UK occupational burden, we have assessed the sample's representativeness with respect to the UK national population, with a view to accounting for potential biases.
METHOD:
We have compared characteristics of the Biobank population (age, education, employment, smoking etc) to that of the UK population as estimated from national data sources.
RESULTS:
Deprivation index scores indicate that Biobank respondents in more affluent wards are over-represented (52% of Biobank respondents versus 28% nationally have scores of less than -2). The Biobank respondents are also better-educated (33% to degree level, 17% nationally), with similar qualification levels in men and women, whereas more men than women nationally in this age range had higher level qualifications. Fewer were currently employed than nationally (58% vs. 65%), particularly men over 60, with more retired (45% vs. 33%), and fewer disabled or unemployed. There are more in managerial and professional (54% vs. 46%), and fewer in routine and manual occupations (22%, 33% nationally), and fewer smokers (33% vs. 49%). Fewer in the already under-represented unskilled occupations (47% vs. 70% for other occupations), or with reported respiratory ill-health (50% vs. 59%) have a usable email address.
CONCLUSIONS:
As Biobank respondents are on average less deprived, better educated and under-represented in unskilled occupations than the national population, estimating national occupational COPD burden, and collecting further data without bias will require data adjustments},
keywords = {},
pubstate = {published},
tppubtype = {conference}
}

A new, efficient web-based tool to collect and code lifetime job histories in large population-based studies: the COPD project in the UK Biobank cohort Journal Article

Matteis, De S; Rushton, L; Jarvis, D; Wheatley, M; Azhar, H; Cullinan, P

Occupational and Environmental Medicine , 71 (1), pp. A19, 2014.

@article{Matteis2014,
title = {A new, efficient web-based tool to collect and code lifetime job histories in large population-based studies: the COPD project in the UK Biobank cohort},
author = {S De Matteis and L Rushton and D Jarvis and M Wheatley and H Azhar and P Cullinan},
url = {http://www.ncbi.nlm.nih.gov/pubmed/25018275},
year = {2014},
date = {2014-06-01},
journal = {Occupational and Environmental Medicine },
volume = {71},
number = {1},
pages = {A19},
abstract = {OBJECTIVES:
The manual collection and coding of job histories is the standard method for assessing occupational exposure, but may be infeasible for large population-based studies such as the UK Biobank cohort. We aimed to develop a new web-based tool to automatically collect and code individual lifetime job histories in the UK Biobank cohort for investigating the causes and burden of work-related COPD in the UK.
METHOD:
UK Biobank is a population-based cohort of 502 682 subjects, aged 40-69 years, recruited in 2006-2010. Baseline spirometry data, current employment and smoking histories were collected. We developed a job questionnaire based on the hierarchical structure of the standard occupational classification (SOC) 2000 to allow participants to automatically self-collect and code their lifetime job histories. The web-based prototype (www.imperial.ac.uk/biobank/questionnaire) was pre-piloted in May-August 2013 among key job sectors using snowball sampling together with a feedback survey.
RESULTS:
171 subjects participated in both the pre-piloting and feedback survey. 91% completed the questionnaire in <20 min, 85% considered the instructions clear, and 80% found their job categories/titles easily. Overall, 96% judged the questionnaire to be clear and easy. A revised questionnaire has now been designed and will be accessible from different media including PCs/laptops, tablets and smart phones to encourage high response. A demonstration version will be made available to conference participants.
CONCLUSIONS:
Our web-based job questionnaire is an efficient new standard tool for collecting and automatically coding lifetime job histories in large population-based studies and is adaptable for use in many occupational health research projects},
keywords = {},
pubstate = {published},
tppubtype = {article}
}

Dawes, P; Dickinson, C; Emsley, R; Bishop, PN; Cruickshanks, KJ; Edmondson-Jones, M; McCormack, A; Fortnum, H; Moore, DR; Norman, P; Munro, K

Vision impairment and dual sensory problems in middle age. Journal Article

Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)., 34 (4), pp. 479-88, 2014.

@article{Dawes2014b,
title = {Vision impairment and dual sensory problems in middle age.},
author = {P Dawes and C Dickinson and R Emsley and PN Bishop and KJ Cruickshanks and M Edmondson-Jones and A McCormack and H Fortnum and DR Moore and P Norman and K Munro},
url = {http://www.ncbi.nlm.nih.gov/pubmed/24888710},
year = {2014},
date = {2014-05-29},
journal = {Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists).},
volume = {34},
number = {4},
pages = {479-88},
abstract = {PURPOSE:
Vision and hearing impairments are known to increase in middle age. In this study we describe the prevalence of vision impairment and dual sensory impairment in UK adults aged 40-69 years in a very large and recently ascertained data set. The associations between vision impairment, age, sex, socioeconomic status, and ethnicity are reported.
METHODS:
This research was conducted using the UK Biobank Resource, with subsets of UK Biobank data analysed with respect to self-report of eye problems and glasses use. Better-eye visual acuity with habitually worn refractive correction was assessed with a logMAR chart (n = 116,682). Better-ear speech reception threshold was measured with an adaptive speech in noise test, the Digit Triplet Test (n = 164,770). Prevalence estimates were weighted with respect to UK 2001 Census data.
RESULTS:
Prevalence of mild visual impairment (VA >0.1 logMAR (6/7.5, 20/25) and ≥0.48 (6/18, 20/60)) and low vision (VA >0.48 (6/18, 20/60) and ≥1.3 (6/120, 20/400)) was estimated at 13.1% (95% CI 12.9-13.4) and 0.8% (95% CI 0.7-0.9), respectively. Use of glasses was 88.0% (95% CI 87.9-88.1). The prevalence of dual sensory impairment was 3.1% (95% CI 3.0-3.2) and there was a nine-fold increase in the prevalence of dual sensory problems between the youngest and oldest age groups. Older adults, those from low socioeconomic and ethnic minority backgrounds were most at risk for vision problems.
CONCLUSIONS:
Mild vision impairment is common in middle aged UK adults, despite widespread use of spectacles. Increased likelihood of vision impairment with older age and with ethnic minorities is of concern given ageing and more ethnically diverse populations. Possible barriers to optometric care for those from low socioeconomic and ethnic minority backgrounds may require attention. A higher than expected prevalence of dual impairment suggests that hearing and vision problems share common causes. Optometrists should consider screening for hearing problems, particularly among older adults.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}

PURPOSE:
Vision and hearing impairments are known to increase in middle age. In this study we describe the prevalence of vision impairment and dual sensory impairment in UK adults aged 40-69 years in a very large and recently ascertained data set. The associations between vision impairment, age, sex, socioeconomic status, and ethnicity are reported.
METHODS:
This research was conducted using the UK Biobank Resource, with subsets of UK Biobank data analysed with respect to self-report of eye problems and glasses use. Better-eye visual acuity with habitually worn refractive correction was assessed with a logMAR chart (n = 116,682). Better-ear speech reception threshold was measured with an adaptive speech in noise test, the Digit Triplet Test (n = 164,770). Prevalence estimates were weighted with respect to UK 2001 Census data.
RESULTS:
Prevalence of mild visual impairment (VA >0.1 logMAR (6/7.5, 20/25) and ≥0.48 (6/18, 20/60)) and low vision (VA >0.48 (6/18, 20/60) and ≥1.3 (6/120, 20/400)) was estimated at 13.1% (95% CI 12.9-13.4) and 0.8% (95% CI 0.7-0.9), respectively. Use of glasses was 88.0% (95% CI 87.9-88.1). The prevalence of dual sensory impairment was 3.1% (95% CI 3.0-3.2) and there was a nine-fold increase in the prevalence of dual sensory problems between the youngest and oldest age groups. Older adults, those from low socioeconomic and ethnic minority backgrounds were most at risk for vision problems.
CONCLUSIONS:
Mild vision impairment is common in middle aged UK adults, despite widespread use of spectacles. Increased likelihood of vision impairment with older age and with ethnic minorities is of concern given ageing and more ethnically diverse populations. Possible barriers to optometric care for those from low socioeconomic and ethnic minority backgrounds may require attention. A higher than expected prevalence of dual impairment suggests that hearing and vision problems share common causes. Optometrists should consider screening for hearing problems, particularly among older adults.

Dawes, Piers; Cruickshanks, Karen J; Moore, David R; Edmondson-Jones, Mark; McCormack, Abby; Fortnum, Heather; Munro, Kevin J

Cigarette Smoking, Passive Smoking, Alcohol Consumption, and Hearing Loss Journal Article

Journal of the Association for Research in Otolaryngology, 15 (4), pp. 663-674, 2014.

@article{Dawes2014b,
title = {Cigarette Smoking, Passive Smoking, Alcohol Consumption, and Hearing Loss},
author = {Piers Dawes and Karen J. Cruickshanks and David R. Moore and Mark Edmondson-Jones and Abby McCormack and Heather Fortnum and Kevin J. Munro},
url = {http://link.springer.com/article/10.1007/s10162-014-0461-0},
year = {2014},
date = {2014-05-28},
journal = {Journal of the Association for Research in Otolaryngology},
volume = {15},
number = {4},
pages = {663-674},
abstract = {The objective of this large population-based cross-sectional study was to evaluate the association between smoking, passive smoking, alcohol consumption, and hearing loss. The study sample was a subset of the UK Biobank Resource, 164,770 adults aged between 40 and 69 years who completed a speech-in-noise hearing test (the Digit Triplet Test). Hearing loss was defined as speech recognition in noise in the better ear poorer than 2 standard deviations below the mean with reference to young normally hearing listeners. In multiple logistic regression controlling for potential confounders, current smokers were more likely to have a hearing loss than non-smokers (odds ratio (OR) 1.15, 95 % confidence interval (CI) 1.09–1.21). Among non-smokers, those who reported passive exposure to tobacco smoke were more likely to have a hearing loss (OR 1.28, 95 %CI 1.21–1.35). For both smoking and passive smoking, there was evidence of a dose-response effect. Those who consume alcohol were less likely to have a hearing loss than lifetime teetotalers. The association was similar across three levels of consumption by volume of alcohol (lightest 25 %, OR 0.61, 95 %CI 0.57–0.65; middle 50 % OR 0.62, 95 %CI 0.58–0.66; heaviest 25 % OR 0.65, 95 %CI 0.61–0.70). The results suggest that lifestyle factors may moderate the risk of hearing loss. Alcohol consumption was associated with a protective effect. Quitting or reducing smoking and avoiding passive exposure to tobacco smoke may also help prevent or moderate age-related hearing loss},
keywords = {},
pubstate = {published},
tppubtype = {article}
}

Gender differences in the association between adiposity and probable major depression: a cross-sectional study of 140,564 UK Biobank participants Journal Article

Ul-Haq, Zia; Smith, Daniel J; Nicholl, Barbara I; Cullen, Breda; Martin, Daniel; Gill, Jason MR; Evans, Jonathan; Roberts, Beverly; Deary, Ian J; Gallacher, John; Hotopf, Matthew; Craddock, Nick; Mackay, Daniel F; and Pell, Jill P

BMC Psychiatry, 14 (153), 2014.

@article{Ul-Haq2014,
title = {Gender differences in the association between adiposity and probable major depression: a cross-sectional study of 140,564 UK Biobank participants},
author = {Zia Ul-Haq and Daniel J Smith and Barbara I Nicholl and Breda Cullen and Daniel Martin and Jason MR Gill and Jonathan Evans and Beverly Roberts and Ian J Deary and John Gallacher and Matthew Hotopf and Nick Craddock and Daniel F Mackay and and Jill P Pell},
url = {http://www.biomedcentral.com/1471-244X/14/153/abstract},
year = {2014},
date = {2014-05-26},
journal = {BMC Psychiatry},
volume = {14},
number = {153},
abstract = {Background
Previous studies on the association between adiposity and mood disorder have produced contradictory results, and few have used measurements other than body mass index (BMI). We examined the association between probable major depression and several measurements of adiposity: BMI, waist circumference (WC), waist-hip-ratio (WHR), and body fat percentage (BF%).

Methods
We conducted a cross-sectional study using baseline data on the sub-group of UK Biobank participants who were assessed for mood disorder. Multivariate logistic regression models were used, adjusting for potential confounders including: demographic and life-style factors, comorbidity and psychotropic medication.

Results
Of the 140,564 eligible participants, evidence of probable major depression was reported by 30,145 (21.5%). The fully adjusted odds ratios (OR) for obese participants were 1.16 (95% confidence interval (CI) 1.12, 1.20) using BMI, 1.15 (95% CI 1.11, 1.19) using WC, 1.09 (95% CI 1.05, 1.13) using WHR and 1.18 (95% CI 1.12, 1.25) using BF% (all p < 0.001). There was a significant interaction between adiposity and gender (p = 0.001). Overweight women were at increased risk of depression with a dose response relationship across the overweight (25.0-29.9 kg/m2), obese I (30.0-34.9 kg/m2), II (35.0-39.9 kg/m2) and III (≥40.0 kg/m2) categories; fully adjusted ORs 1.14, 1.20, 1.29 and 1.48, respectively (all p < 0.001). In contrast, only obese III men had significantly increased risk of depression (OR 1.29, 95% CI 1.08, 1.54, p = 0.006).

Conclusion
Adiposity was associated with probable major depression, irrespective of the measurement used. The association was stronger in women than men. Physicians managing overweight and obese women should be alert to this increased risk.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}

Dawes, P; Fortnum, H; Moore, DR; Emsley, R; Norman, P; Cruickshanks, K; Davis, A; Edmondson-Jones, M; McCormack, A; Lutman, M; Munro., K

Hearing in middle age: a population snapshot of 40- to 69-year olds in the United Kingdom Journal Article

Ear Hear, 35 (3), pp. e44-51, 2014.

Biobank, UK

UK BIOBANK DATA: COME AND GET IT Journal Article

Science Translational Medicine, 6 (224), pp. 224, 2014, ISSN: 1946-6234.

Cleutjens, Fiona A H M; Spruit, Martijn A; Ponds, Rudolf W H M; Dijkstra, Jeanette B; Franssen, Frits M E; Wouters, Emiel F M; Janssen, Daisy J A

Cognitive Functioning in Obstructive Lung Disease: Results from the United Kingdom Biobank Journal Article

The Journal of Post Acute and Long Term Care Medicine, 2014.

McCormack, Abby; Edmondson-Jones, Mark; Fortnum, Heather; Dawes, Piers; Middleton, Hugh; Munro, Kevin J; Moore, David R

The prevalence of tinnitus and the relationship with neuroticism in a middle-aged UK population Journal Article

Journal of Psychosomatic Research, 76 (1), pp. 56–60, 2014.

@article{McCormack2014,
title = {The prevalence of tinnitus and the relationship with neuroticism in a middle-aged UK population},
author = {Abby McCormack and Mark Edmondson-Jones and Heather Fortnum and Piers Dawes and Hugh Middleton and Kevin J. Munro and David R. Moore },
url = {http://www.sciencedirect.com/science/article/pii/S0022399913003358},
year = {2014},
date = {2014-01-01},
journal = {Journal of Psychosomatic Research},
volume = {76},
number = {1},
pages = { 56–60},
abstract = {Background
Previous research has suggested that a substantial proportion of the population are severely affected by tinnitus, however recent population data are lacking. Furthermore, there is growing evidence that the perception of severity is closely related to personality factors such as neuroticism.

Objective
In a subset (N = 172,621) of a large population sample of > 500,000 adults aged 40 to 69 years, (from the UK Biobank dataset) we calculated the prevalence of tinnitus and that which is perceived as bothersome, and examined the association between tinnitus and a putative predisposing personality factor, neuroticism.

Method
Participants were recruited through National Health Service registers and aimed to be inclusive and as representative of the UK population as possible. The assessment included subjective questions concerning hearing and tinnitus. Neuroticism was self-rated on 13 questions from the Eysenck Personality Inventory. Associations between neuroticism and tinnitus were tested with logistic regression analyses.

Results
Prevalence of tinnitus was significantly higher for males, and increased with age, doubling between the youngest and oldest age groups (males 13% and 26%; females 9% and 19% respectively). Of those with tinnitus, females were more likely to report bothersome tinnitus. Neuroticism was associated with current tinnitus and bothersome tinnitus, with the items: ‘loneliness’, ‘mood swings’, ‘worrier/anxious’ and ‘miserableness’, as the strongest associations of bothersome tinnitus.

Conclusions
Neuroticism was identified as a novel association with tinnitus. Individuals with tinnitus and higher levels of neuroticism are more likely to experience bothersome tinnitus, possibly as a reflection of greater sensitivity to intrusive experiences.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}