N.A.Wright
Guest
- Messages
- 106
A potential confounder in the gender ratio is that age of onset may be gender related, and we have no consistent data on age matched to prevalence. What actually happens to ME/CFS patients as we age ? Unless ME/CFS suddenly abates when we hit 60 or we all die well before we hit 70, the age profile, as with any chronic disease that is not quickly fatal, should be balloon shaped as incidence builds prevalence year on year - there ought to be many 60 year olds with ME - perhaps several orders of magnitude more than 30 year olds and twice the number of 50 year olds, but this seems an almost invisible population.I have seen a gender bias in ME of 1:2 to 1:4 in different places. Yet I have also seen a suggestion that men are more likely to get other diagnoses. In teens I think its much close to 1:1, does anyone have any more specific information? Yet the trend across all studies in adults is clear: lots more women than men. So we can debate the exact ratio but not much more than that. Its interesting that funding for serious epidemiological studies has been requested since the 1980s, by Komoroff at least, and yet there were never funded. Instead we got the CDC surveillance studies.
Historically men have had more 'useful' alternative comorbid diagnoses - industrial injuries and diseases, or lifestyle diseases, although changes to work and lifestyle are tending to equalise by lowest common denominator these differences between men and women. But we really have no idea what the actual comparitive rates of ME/CFS incidence or prevalence are for men and women at any age after adolescence.
I'm not clear that current health reporting in either the US or the UK could support good large population level epidemiology of ME/CFS - the collected data just doesn't seem fined grained enough http://www.cdc.gov/nchs/data/nhsr/nhsr029.pdf In the UK, with a strong research bias toward ME/CFS being a pyschological/women's disease, the research data is heavily skewed by intentionally gender biased study cohorts and hospital based services are likely heavily influenced by that research when it comes to diagnosis. In any case hospital services don't have long term data. At present, the collection of valuable long term fine grained data from primary care is stalled because of concerns over medical file security;there is one potential very valuable source of data for the UK, although it is limited to older age groups it should be capable of yielding very significant epidemiology - UK Biobank