Suicide in frontotemporal dementia and Huntington disease: analysis of family-reported pedigree data and implications for genetic healthcare for asymptomatic relatives.

OBJECTIVE: Genomic testing for early-onset dementia is becoming more accessible, along with predictive testing for at-risk relatives; however, complex counselling issues are important to address. The topic of suicide often has stigma associated, and thoughts or experiences may not be volunteered without prompting. Little has been published with consideration to suicide rates in the context of family experiences and their significance in genetic counselling for relatives of people with Huntington disease and frontotemporal dementia. DESIGN: This study included pedigree information for 267 symptomatic individuals with frontotemporal dementia or Huntington disease, provided via genetic counselling clinics. MAIN OUTCOME MEASURES: Descriptive statistics and suicide rate calculations based on family reported pedigree data. RESULTS: The suicide rate was 2996 per 100,000 compared with the population rate of 10 per 100,000. Approximately one in 15 families reported suicide of an affected family member, and file notes indicated that one in five families had experienced suicide, suicidal thoughts or suicide attempts in one or more affected, unaffected or pre-symptomatic relative. CONCLUSION: Health professional awareness of family experiences, including suicide of a relative, is vital in facilitating client decisions about genetic testing, and in providing adequate psychosocial support during the process of genetic testing and adaption to results.

Associations of health behaviours with return to work outcomes after colorectal cancer.

PURPOSE: Engaging in positive health behaviours can improve quality of life amongst cancer survivors, whether this facilitates return to work is unknown. We examined associations of health behaviours with return to work outcomes following a diagnosis of colorectal cancer in middle-aged men and women (45-64 years). METHODS: We recruited 239 participants through the Queensland Cancer Registry between January 2010 and September 2011. Data were collected through telephone-administered interviews and postal questionnaires at 6 and 12 months post-diagnosis. Logistic regression examined likelihood of ceasing or reducing work, and Cox regression examined factors associated with time to return to work. RESULTS: No significant associations were observed between health behaviours (fruit and vegetables consumption, alcohol consumption, smoking status, physical activity or sitting time) at 6 months and ceasing or reducing work at 12 months post-diagnosis. Participants who reported excessive sleep (≥9 h/day) were 2.69 times more likely to reduce work time or retire (relative to those sleeping the recommended 7 to <9 h/day; 95 % CI 1.06, 6.87, adjusted for cancer treatment). In Cox regression analysis, excessive sleep was associated with a longer work re-entry time (relative to sleeping 7 to <9 h/day; HR = 0.47; 95 % CI 0.22, 1.00, adjusted for education and cancer treatment). CONCLUSIONS: Further research into how excessive sleep might be related to return to work amongst colorectal cancer survivors is warranted. Interventions focused on achieving optimal sleep patterns may assist colorectal cancer survivors to return to work and should be tested in future studies.

Associations of change in television viewing time with biomarkers of postmenopausal breast cancer risk: the Australian Diabetes, Obesity and Lifestyle Study.

PURPOSE: Sedentary behavior has been previously shown, in a cross-sectional study, to have deleterious associations with biomarkers of postmenopausal breast cancer risk. We examined the associations of change in sedentary behavior [daily television (TV) viewing time, h/day] over a 5-year period with putative markers of postmenopausal breast cancer risk. METHODS: The analytic cohort consisted of 1,001 postmenopausal women from the Australian Diabetes, Obesity and Lifestyle (AusDiab) study (1999-2005). Multivariate linear regression models were used to examine associations of change in TV viewing time with biomarkers of the following risk mechanisms: adiposity (body mass index [BMI], waist circumference); metabolic dysfunction (fasting plasma glucose, 2-h plasma glucose, fasting insulin, insulin resistance [homeostasis model assessment of insulin resistance (HOMA-IR)]); and inflammation (high-sensitivity C-reactive protein (hs-CRP)). All analyses were adjusted for age, baseline TV viewing, and potential confounders. RESULTS: Hourly increments of change in TV viewing time were positively associated with BMI (ß = 0.50, 95% CI 0.20, 0.81; p = 0.001), waist circumference (ß = 1.18, 95% CI 0.49, 1.87; p = 0.001), fasting insulin (ß = 38.13%, 95% CI 37.08, 39.20; p = 0.01) and HOMA-IR (ß = 37.93%, 95% CI 36.92, 38.98; p = 0.03) in fully adjusted models. Significant associations with BMI, waist circumference, fasting insulin and HOMA-IR were also present in analyses using categories of change in TV viewing time (reduced, same, increased). CONCLUSIONS: The findings suggest that increasing habitual sedentary behavior over time could increase breast cancer risk among postmenopausal women. Further investigation into the role of sedentary behavior in breast cancer etiology is warranted.