title: Time series analysis of the association between ambient temperature and cerebrovascular morbidity in the elderly in Shanghai, China.
abstract: Research on the association between ambient temperature and cerebrovascular morbidity is scarce in China. In this study, we applied mixed generalized additive model (MGAM) to daily counts of cerebrovascular disease of Shanghai residents aged 65 years or older from 2007-2011, stratified by gender. Weighted daily mean temperature up to lags of one week was smoothed by natural cubic spline, and was added into the model to assess both linear and nonlinear effects of temperature. We found that when the mean temperature increased by 1 °C, the male cases of cerebrovascular disease reduced by 0.95% (95% Confidence Interval (CI): 0.80%, 1.10%) or reduced by 0.34% (95% CI: -0.68, 1.36%) in conditions of temperature was below or above 27 °C. However, for every 1 °C increase in temperature, the female cases of cerebrovascular disease increased by 0.34% (95% CI: -0.26%, 0.94%) or decreased by 0.92% (95% CI: 0.72, 1.11%) in conditions of temperature was below or above 8 °C, respectively. Temperature and cerebrovascular morbidity is negatively associated in Shanghai. MGAM is recommended in assessing the association between environmental hazards and health outcomes in time series studies.
authors.affiliation: Shanghai Insurance Medical Center, Shanghai 200032, People's Republic of China.
authors.forename: Xian-Jing
authors.initials: XJ
authors.lastname: Zhang
authors.affiliation: Department of Biostatistics, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai 200032, People's Republic of China.|Department of Genetics and Genomics Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, US.
authors.forename: Wei-Ping
authors.initials: WP
authors.lastname: Ma
authors.affiliation: Department of Biostatistics, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai 200032, People's Republic of China.
authors.forename: Nai-Qing
authors.initials: NQ
authors.lastname: Zhao
authors.affiliation: Department of Biostatistics, School of Public Health and Key Laboratory of Public Health Safety, Fudan University, Shanghai 200032, People's Republic of China.
authors.forename: Xi-Ling
authors.initials: XL
authors.lastname: Wang
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008955:Models, Cardiovascular; D012621:Seasons; D012737:Sex Factors; D013696:Temperature; D013997:Time Factors