2.2b Epidemiology

Question 1

What are the leading causes of morbidity and mortality in Canada?

Answer 1

Chronic diseases, including:

CVD, cancer, respiratory diseases, and diabetes

Question 2

Is CVD the leading cause of mortality in Canada?

Answer 2

No, cancer, then CVD

Question 3

What is encompassed within Cardiovascular diseases?

Answer 3

Coronary artery disease
stroke
congestive heart failure
valvular heart disease
rheumatic heart disease
peripheral arterial disease
congenital heart defects

Question 4

Are mortality rates for heart disease increasing or decreasing since the 1950s?

Answer 4

Mortality rates for CVD have dropped considerably, despite being the leading cause of death in Canada

Question 5

Men aged 65+ are __times more likely than women the same age to have diagnosed ischemic heart disease.

Answer 5

men 1.5x more likely

Question 6

About what % of Canadian seniors (65+) had a stroke in 2016-2017?

Answer 6

~10% of seniors had a stroke

Question 7

What % of Canadian seniors (65+) were living with diagnosed COPD in 2016-2017?

Answer 7

~20%

Question 8

What is the difference between chronic bronchitis and emphysema?

Answer 8

Chronic bronchitis (thickening of the mid-airways, smooth muscle thickens, build-up of mucus, lack of ability to get rid of CO2)

Emphysema (weakening of the alveoli, they lose elasticity, lack of ability to get rid of CO2, use more accessory muscles to get rid of air)

Question 9

What is multimorbidity?

Answer 9

the co-occurrence in the same individual of two or more of 10 common chronic diseases

includes heart disease, stroke, cancer (lifetime), asthma, COPD, diabetes, arthritis, Alzheimer disease or other dimentia, mood and anxiety disorders.

Question 10

What is the relationship between multimorbidity and age

Answer 10

multimorbidity increases with age

Question 11

Multimorbidity affects what % or proportion of Canadians aged 85+?

Answer 11

affects almost half (48%) of Canadians aged 85+

Question 12

What is one of the most major modifiable risk factors?

Answer 12

Smoking – even though percentage of smokers has decreased
This is a HUGE modifiable risk factor

Question 13

What is the leading risk factor for death in Canada?

These deaths are associated with what 3 main groups of diseases?

Answer 13

smoking

associated with diseases: cancer, CVD, and respiratory diseases

Question 14

What are the non-modifiable risk factors for CVD? (4)

Answer 14

Age
Gender (male)
Ethnicity
Family history (genetics)

Question 15

What are the modifiable risk factors for CVD? (7)

Answer 15

Smoking
Physical inactivity / Sedentary behav
Poor diet
Dyslipidemia
Hypertension
Diabetes (type 2 and pre-diabetes)
Obesity
Stress/depression/anger/hostility

Question 16

Are type I and type II diabetes risk factors for CVD?

Answer 16

yes, both are
type II = modifiable

Question 17

Do we accumulate the same benefits from vigorous vs. moderate exercise?

Answer 17

We accumulate more significant benefits from vigorous PA when not taken to extremes.

(can be higher risk when taken to extreme)

Question 18

Is there new, limited or substantial evidence for the following:
MVPA association with cardiovascular risk?
Sedentary behaviour association with cardiovascular risk?
Light PA association with cardiovascular risk?

Answer 18

Substantial evidence: MVPA association with cardiovascular risk

New: Sedentary behaviour association with cardiovascular risk

Limited: Light PA association with cardiovascular risk

Question 19

What is the relationship between sitting and dying?

Answer 19

more sitting = higher risk of dying

sitting more than half the day is associated with big increases in death rates for both people that exercise and those that don’t

Question 20

How many minutes per week of physical activity are the minimum recommended to
accumulate significant health benefits?

Answer 20

150-300 at 3 METS
or 75-150 at 6METS+
(or a combination of these two)

SUM of at least 500 MET minutes per week

Question 21

What is the minimum intensity of physical activity recommended to accumulate significant health benefits?

Answer 21

3 METS

Question 22

What two components of sedentary behaviour contribute to the amount of risk associated with sitting?

Answer 22

• Total sedentary duration >= 750 minutes per day (12.5 hours)
• Mean sedentary bout duration > 10 min

Question 23

Describe the relationship between improved cardiovascular fitness and mortality.

Answer 23

• For every 1 MET improvement in functional capacity, CV and all-cause mortality decrease on average by ~12%.