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Qu Y, Zhang G, Wu Z, Luo H, Chen R, Jia H, Sun X. Associations of Socioeconomic Status Inequity with Incident Age-related Macular Degeneration in Middle-Aged and Elderly Population. HEALTH DATA SCIENCE 2024; 4:0148. [PMID: 38952896 PMCID: PMC11214909 DOI: 10.34133/hds.0148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 05/14/2024] [Indexed: 07/03/2024]
Abstract
Background: The relationship between socioeconomic status (SES) inequity and incident age-related macular degeneration (AMD) remains unclear. We aim to investigate whether low SES increases the risk of AMD and to explore the effect of a healthy lifestyle on this association. Methods: This prospective cohort study included 316,663 UK Biobank individuals. SES inequity was identified via latent class analysis using education, household income, and occupational status. Healthy lifestyle score was calculated based on smoking, alcohol drinking, and physical activity (PA). Incident AMD was defined according to diagnosis records. Cox proportional hazards models were used to evaluate the relationship of low SES and AMD. Interrelationships of healthy lifestyle score on SES-AMD association were explored, including modification, mediation, and joint effects. Results: During the average 12.2 years of follow-up, 6,355 AMD cases were diagnosed. Participants with medium SES (hazard ratio: 1.10 [95% confidence interval (CI) 1.01 to 1.21]) and low SES (hazard ratio: 1.22 [95% CI 1.11 to 1.34]) had an increased risk of incident AMD compared to participants with high SES. PA significantly affected this association. Moreover, the association between low SES and AMD was significantly mediated (11.3%, 95% CI: 6.56 to 23.0) by smoking. Similarly, alcohol drinking suppressed (9.59%, 95% CI: 4.00 to 23.2) the association between high SES and AMD. Besides, a significant joint effect of SES and healthy lifestyle score was found. Conclusions: We provide further evidence for the relationship of socioeconomic inequity, healthy lifestyle, and incident AMD. Future public health strategies should aim to reduce socioeconomic inequity to prevent AMD.
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Affiliation(s)
- Yanlin Qu
- Department of Ophthalmology, Shanghai General Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Guanran Zhang
- Department of Ophthalmology, Shanghai General Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Zhenyu Wu
- School of Public Health,
Fudan University, Shanghai, China
| | - Huihuan Luo
- School of Public Health,
Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health,
Fudan University, Shanghai, China
| | - Huixun Jia
- Department of Ophthalmology, Shanghai General Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- School of Public Health,
Fudan University, Shanghai, China
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
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Huang A, Zhang D, Zhang L, Zhou Z. Predictors and consequences of visual trajectories in Chinese older population: A growth mixture model. J Glob Health 2024; 14:04080. [PMID: 38817127 PMCID: PMC11140284 DOI: 10.7189/jogh.14.04080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024] Open
Abstract
Background Given the relatively high prevalence of vision impairment and the heterogeneity of visual changes among the elderly population, we aimed to identify the visual trajectories and to examine the predictors and consequences associated with each trajectory class. Methods We analysed data from 2235 participants involved in the 5th, 6th, 7th, and 8th waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), where vision impairment was evaluated using an adapted Landolt-C chart during each wave. We employed a growth mixture model (GMM) to identify distinct visual trajectories and logistic regression analysis to examine the predictors associated with each trajectory class. Furthermore, we investigated the effect of visual trajectories on distal consequences, including cognitive function, activities of daily living (ADL), instrumental activities of daily living (IADL), depression, anxiety, and fall risk. Within the CLHLS study, cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (CMMSE), ADL via the Katz index, and IADL through a modified version of Lawton's scale. Lastly, depression was assessed using the 10-item version of the Centre for Epidemiologic Studies (CES-D-10), while anxiety was measured using the Generalized Anxiety Disorder scale (GAD-7). Fall risk was determined by asking the question: 'Have you experienced any falls within the past year?' Results We identified two distinct visual trajectories in our analysis. Most older adults (n = 1830, 81.9%) initially had a good vision level that diminished ('high-baseline decline' group). Conversely, the remaining participants (n = 405, 18.1%) initially had a lower vision level that improved over time ('low-baseline improvement' group). The 'high-baseline decline' group was more likely to include older adults with relatively higher body mass index (BMI) (odds ratio (OR) = 1.086; 95% confidence interval (CI) = 1.046, 1.127), individuals with higher formal educational qualifications (OR = 1.411; 95% CI = 1.068, 1.864), those current engaging in exercise (OR = 1.376; 95% CI = 1.046, 1.811), and individuals reporting more frequent consumption of fruit (OR = 1.357; 95% CI = 1.053, 1.749). Conversely, the 'low-baseline improvement' group had a higher likelihood of including older individuals (OR = 0.947; 95% CI = 0.934, 0.961), residents of nursing homes (OR = 0.340; 95% CI = 0.116, 0.993) and those self-reporting cataracts (OR = 0.268; 95% CI = 0.183, 0.391) and glaucoma (OR = 0.157; 95% CI = 0.079, 0.315). Furthermore, the 'high-baseline decline' group showed a positive impact on distal consequences, adjusting for sex, birthplace, residence, main occupation, education, economic status, and marital status. This impact included cognitive function (correlation coefficient (β) = 2.092; 95% CI = 1.272, 2.912), ADL (β = -0.362; 95% CI = -0.615, -0.108), IADL (β = -1.712; 95% CI = -2.304, -1.121), and reported lower levels of depression (β = 0.649; 95% CI = 0.013, 1.285). We observed no significant influence on fall risk and anxiety within the identified visual trajectories in the adjusted model. Conclusions Vision in older adults with ocular disease could potentially be improved. Having formal education, maintaining an appropriate BMI, engaging in exercise, and consuming fruit more frequently appear to be beneficial for the visual health of the elderly. Considering the negative impact of visual impairment experience on distal cognition, self-care ability, and depression symptoms, stakeholder should prioritise long-term monitoring and management of vision impairment among older adults.
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Affiliation(s)
- Anle Huang
- School of Nursing, Wannan Medical College, Wuhu, China
| | - Dongmei Zhang
- School of Nursing, Wannan Medical College, Wuhu, China
| | - Lin Zhang
- School of Nursing, Wannan Medical College, Wuhu, China
| | - Zhiqing Zhou
- Nursing Department, The First Affiliated Hospital of Wannan Medical College, Wuhu, China
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Wu Y, Curhan S, Rosner B, Curhan G, Wang M. Analytical method for detecting outlier evaluators. BMC Med Res Methodol 2023; 23:177. [PMID: 37528402 PMCID: PMC10391872 DOI: 10.1186/s12874-023-01988-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 07/11/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Epidemiologic and medical studies often rely on evaluators to obtain measurements of exposures or outcomes for study participants, and valid estimates of associations depends on the quality of data. Even though statistical methods have been proposed to adjust for measurement errors, they often rely on unverifiable assumptions and could lead to biased estimates if those assumptions are violated. Therefore, methods for detecting potential 'outlier' evaluators are needed to improve data quality during data collection stage. METHODS In this paper, we propose a two-stage algorithm to detect 'outlier' evaluators whose evaluation results tend to be higher or lower than their counterparts. In the first stage, evaluators' effects are obtained by fitting a regression model. In the second stage, hypothesis tests are performed to detect 'outlier' evaluators, where we consider both the power of each hypothesis test and the false discovery rate (FDR) among all tests. We conduct an extensive simulation study to evaluate the proposed method, and illustrate the method by detecting potential 'outlier' audiologists in the data collection stage for the Audiology Assessment Arm of the Conservation of Hearing Study, an epidemiologic study for examining risk factors of hearing loss in the Nurses' Health Study II. RESULTS Our simulation study shows that our method not only can detect true 'outlier' evaluators, but also is less likely to falsely reject true 'normal' evaluators. CONCLUSIONS Our two-stage 'outlier' detection algorithm is a flexible approach that can effectively detect 'outlier' evaluators, and thus data quality can be improved during data collection stage.
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Affiliation(s)
- Yujie Wu
- Department of Biostatistics, Harvard University, Boston, USA
| | - Sharon Curhan
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, USA
- Harvard Medical School, Boston, USA
| | - Bernard Rosner
- Department of Biostatistics, Harvard University, Boston, USA
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, USA
| | - Gary Curhan
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, USA
- Harvard Medical School, Boston, USA
- Department of Epidemiology, Harvard University, Boston, USA
- Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, USA
| | - Molin Wang
- Department of Biostatistics, Harvard University, Boston, USA.
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, USA.
- Department of Epidemiology, Harvard University, Boston, USA.
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Berry EC, Marshall HN, Mullany S, Torres SD, Schmidt J, Thomson D, Knight LSW, Hollitt GL, Qassim A, Ridge B, Schulz A, Hassall MM, Nguyen TT, Lake S, Mills RA, Agar A, Galanopoulos A, Landers J, Healey PR, Graham SL, Hewitt AW, MacGregor S, Casson RJ, Siggs OM, Craig JE. Physical Activity Is Associated With Macular Thickness: A Multi-Cohort Observational Study. Invest Ophthalmol Vis Sci 2023; 64:11. [PMID: 36867133 PMCID: PMC9988706 DOI: 10.1167/iovs.64.3.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Purpose To assess the association between physical activity and spectral-domain optical coherence tomography (SD-OCT)-measured rates of macular thinning in an adult population with primary open-angle glaucoma. Methods The correlation between accelerometer-measured physical activity and rates of macular ganglion cell-inner plexiform layer (GCIPL) thinning was measured in 735 eyes from 388 participants of the Progression Risk of Glaucoma: RElevant SNPs with Significant Association (PROGRESSA) study. The association between accelerometer-measured physical activity and cross-sectional SD-OCT macular thickness was then assessed in 8862 eyes from 6152 participants available for analysis in the UK Biobank who had SD-OCT, ophthalmic, comorbidity, and demographic data. Results Greater physical activity was associated with slower rates of macular GCIPL thinning in the PROGRESSA study (beta = 0.07 µm/y/SD; 95% confidence interval [CI], 0.03-0.13; P = 0.003) after adjustment for ophthalmic, demographic and systemic predictors of macular thinning. This association persisted in subanalyses of participants characterized as glaucoma suspects (beta = 0.09 µm/y/SD; 95% CI, 0.03-0.15; P = 0.005). Participants in the upper tertile (greater than 10,524 steps/d) exhibited a 0.22-µm/y slower rate of macular GCIPL thinning than participants in the lower tertile (fewer than 6925 steps/d): -0.40 ± 0.46 µm/y versus -0.62 ± 0.55 µm/y (P = 0.003). Both time spent doing moderate/vigorous activity and mean daily active calories were positively correlated with rate of macular GCIPL thinning (moderate/vigorous activity: beta = 0.06 µm/y/SD; 95% CI, 0.01-0.105; P = 0.018; active calories: beta = 0.06 µm/y/SD; 95% CI, 0.006-0.114; P = 0.032). Analysis among 8862 eyes from the UK Biobank revealed a positive association between physical activity and cross-sectional total macular thickness (beta = 0.8 µm/SD; 95% CI, 0.47-1.14; P < 0.001). Conclusions These results highlight the potential neuroprotective benefits of exercise on the human retina.
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Affiliation(s)
- Ella C Berry
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Henry N Marshall
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Sean Mullany
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | | | - Joshua Schmidt
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Daniel Thomson
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Lachlan S W Knight
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Georgina L Hollitt
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Ayub Qassim
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Bronwyn Ridge
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Angela Schulz
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, Australia
| | - Mark M Hassall
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Thi Thi Nguyen
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Stewart Lake
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Richard A Mills
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Ashish Agar
- Department of Ophthalmology, University of New South Wales, Sydney, New South Wales, Australia
| | - Anna Galanopoulos
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - John Landers
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Paul R Healey
- Centre for Vision Research, University of Sydney, Sydney, New South Wales, Australia
| | - Stuart L Graham
- Faculty of Health and Medical Sciences, Macquarie University, Sydney, Australia
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Stuart MacGregor
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Robert J Casson
- Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Owen M Siggs
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia.,Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
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Marbaniang SP, Patel R, Kumar P, Chauhan S, Srivastava S. Hearing and vision difficulty and sequential treatment among older adults in India. Sci Rep 2022; 12:19056. [PMID: 36351946 PMCID: PMC9646738 DOI: 10.1038/s41598-022-21467-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 09/27/2022] [Indexed: 11/11/2022] Open
Abstract
Aging not only affect biomarker-related processes, but it also affects the physiological processes of the human body. Of all the physiological processes, hearing and vision are of utmost importance to a human. Therefore, this study examines the prevalence and factors associated with hearing and vision difficulty and their sequential treatment among older adults in India. Utilizing data from Building a Knowledge Base on Population Aging in India, study used two sets of outcome variables; firstly, self-reported hearing and vision difficulty and secondly, treatment-seeking for hearing and vision difficulty. A total of 9541 older adults aged 60+ years from seven major regionally representative states were selected. Descriptive statistics were used to perform preliminary analysis. Additionally, the study employed the Heckprobit selection model. It is a two-equation model. This model is used in order to accommodate the heterogeneity (i.e., shared unobserved factors) among older adults and then address the endogeneity (between hearing and vision loss problems and their treatment-seeking behaviour) for older adults in India, the model offers a two-step analysis and deals with the zero-sample issue. Around 59% and 21% of older adults reported vision and hearing difficulty, respectively. Only 5% of older adults suffering from hearing difficulty reported utilizing hearing aids. Lifestyle factors (smoking tobacco and chewing tobacco) significantly affect hearing and vision difficulty; various chronic diseases were also found to be associated with high levels of hearing and vision difficulty among older adults. Results from Heckprobit model shows that older adults with 11+ years of education had higher probability to use visual [β = 0.54, 95% confidence interval (CI): 0.37, 0.70] and hearing aids [β = 0.6, 95% CI: 0.18, 1.02]. The use of hearing and vision aids was lower among poor older adults, older adults from Scheduled Caste, and older adults in rural areas. The study indicates that more than half of older adults face vision difficulty and almost one-fourth face hearing difficulty in rural India, education and lifestyle appear to be the main driver of health-seeking behaviour. Additional attention shall be given to understand the strategies that may advocate a higher use for hearing aids among older adults.
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Affiliation(s)
| | - Ratna Patel
- grid.419349.20000 0001 0613 2600Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Pradeep Kumar
- grid.419349.20000 0001 0613 2600Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, India
| | - Shekhar Chauhan
- grid.419349.20000 0001 0613 2600Department of Family and Generations, International Institute for Population Sciences, Mumbai, India
| | - Shobhit Srivastava
- grid.419349.20000 0001 0613 2600Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, India
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Lee OE, Park D, Park J. Association of vision impairment with suicide ideation, plans, and attempts among adults in the United States. J Clin Psychol 2022; 78:2197-2213. [PMID: 36017683 PMCID: PMC9804446 DOI: 10.1002/jclp.23437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 06/16/2022] [Accepted: 08/08/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVE This study aims to investigate the relative strength of association between vision impairment (VI) and suicidal ideation, plans, and attempts among adults in the United States. METHOD The study sample consisted of 214,505 adults, aged 18 years and older. Researchers used data from the 2015-2019 National Survey on Drug Use and Health, in which respondents were asked whether they had any suicidal thoughts, plans, and attempts, in the past 12 months. RESULTS Approximately, 4.4% of respondents reported experiencing VI, being blind, or having serious difficulty seeing. Compared to their sighted peers, a relatively high proportion of adults with VI had serious thoughts about suicide (9.0%), suicidal plans (3.0%), or suicidal attempts (1.6%) in the past year. The findings showed that individuals with VI may disproportionately experience suicidal ideation, plans, and attempts, after controlling potentially confounding variables (adjusted odds ratio [AOR] = 1.36; AOR = 1.27; AOR = 1.40, respectively). CONCLUSION With findings demonstrating such a strong association between VI and suicide, this study suggests the importance of screening for suicidal ideation, plans, and attempts among adults with VI, and the strong need for developing behavioral health services which keep this correlation in mind.
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Affiliation(s)
- Othelia E.‐K. Lee
- School of Social WorkUniversity of North Carolina at CharlotteCharlotteNorth CarolinaUSA
| | - Daejun Park
- Department of Social WorkOhio UniversityAthensOhioUSA
| | - Junghyun Park
- Silver School of Social WorkNew York UniversityNew York CityNew YorkUSA
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Mendez I, Kim M, Lundeen EA, Loustalot F, Fang J, Saaddine J. Cardiovascular Disease Risk Factors in US Adults With Vision Impairment. Prev Chronic Dis 2022; 19:E43. [PMID: 35862513 PMCID: PMC9336192 DOI: 10.5888/pcd19.220027] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Adults with vision impairment (VI) have a higher prevalence of cardiovascular disease (CVD) compared with those without VI. We estimated the prevalence of CVD and CVD risk factors by VI status in US adults. METHODS We used nationally representative data from the 2018 National Health Interview Survey (N = 22,890 adults aged ≥18 years). We estimated the prevalence of self-reported diagnosis of CVD (coronary heart disease [including angina and myocardial infarction], stroke, or other heart disease) by VI status. We used separate logistic regression models to generate adjusted prevalence ratios (aPRs), controlling for sociodemographic covariates, for those with VI (reference group, no VI) for CVD and CVD risk factors: current smoking, physical inactivity, excessive alcohol intake, obesity, hypertension, high cholesterol, and diabetes. RESULTS Overall, 12.9% (95% CI, 12.3-13.5) of the sample had VI. The prevalence of CVD was 26.6% (95% CI, 24.7-28.6) in people with VI versus 12.2% (95% CI, 11.7-12.8) in those without VI (aPR = 1.65 [95% CI, 1.51-1.80]). Compared with adults without VI, those with VI had a higher prevalence of all risk factors examined: current smoking (aPR = 1.40 [95% CI, 1.27-1.53]), physical inactivity (aPR = 1.14 [95% CI, 1.06-1.22]), excessive alcohol intake (aPR = 1.29 [95% CI, 1.08-1.53]), obesity (aPR = 1.28 [95% CI, 1.21-1.36]), hypertension (aPR = 1.29 [95% CI, 1.22-1.36]), high cholesterol (aPR = 1.21 [95% CI, 1.14-1.29]), and diabetes (aPR = 1.54 [95% CI, 1.38-1.72]). CONCLUSION Adults with VI had a higher prevalence of CVD and CVD risk factors compared with those without VI. Effective clinical and lifestyle interventions, adapted to accommodate VI-related challenges, may help reduce CVD risk in adults with VI.
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Affiliation(s)
- Isabel Mendez
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.,Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Mail Stop S107-3, Atlanta, GA 30341.
| | - Minchul Kim
- University of Illinois College of Medicine, Peoria, Illinois
| | - Elizabeth A Lundeen
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Fleetwood Loustalot
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jing Fang
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jinan Saaddine
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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A Dose–Response Relationship of Alcohol Consumption with Risk of Visual Impairment in Korean Adults: The Kangbuk Samsung Health Study. Nutrients 2022; 14:nu14040791. [PMID: 35215441 PMCID: PMC8875794 DOI: 10.3390/nu14040791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/09/2022] [Accepted: 02/09/2022] [Indexed: 01/08/2023] Open
Abstract
Visual impairment is a global health problem that leads to poor quality of life. The aim of the study was to examine the dose–response relationship between alcohol consumption and incident visual impairment (VI). This longitudinal cohort study consisted of 287,352 Korean adults who attended health screenings between March 2011 and December 2017 and were followed for up to 8.8 years (median, 4.9 years). Participants were categorized based on their average alcohol consumption. VI was defined as bilateral visual acuity (VA) worse than 0.3 logMAR. We identified 8320 cases of new-onset bilateral VI (incidence rate, 6.0/1000 person-years). Increased alcohol intake was positively and dose-dependently associated with elevated incidence of VI (ptrend < 0.001). With lifetime abstinence (reference), the multivariable-adjusted hazard ratios (HRs) (95% confidence intervals (CIs)) for incident VI with alcohol intake of <10, 10 to <20, 20–39.9, and ≥40 g/day were 1.07 (0.96–1.19), 1.15 (1.03–1.30), 1.15 (1.01–1.30), and 1.23 (1.08–1.40), respectively. Frequent binge drinking (≥once/per week) was associated with elevated risk of VI (HRs, 1.22; 95% CIs: 1.13–1.32). Former drinkers, particularly men, were at a higher risk for incident VI than lifetime abstainers. Similar associations were observed on evaluating changes in alcohol consumption and other confounders as time-varying covariates. Alcohol consumption, both in moderation and excess, was associated with increased VI incidence.
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de Almeida Torres R, de Almeida Torres R, Luchini A, Anjos Ferreira A. The oxidative and inflammatory nature of age-related macular degeneration. JOURNAL OF CLINICAL OPHTHALMOLOGY AND RESEARCH 2022. [DOI: 10.4103/jcor.jcor_268_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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10
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Guo X, Arsiwala LT, Dong Y, Mihailovic A, Ramulu PY, Sharrett AR, Mosley T, Abraham AG. Visual Function, Physical Function, and Activities of Daily Living in Two Aging Communities. Transl Vis Sci Technol 2021; 10:15. [PMID: 34913953 PMCID: PMC8684303 DOI: 10.1167/tvst.10.14.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/20/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose We report the distribution of visual acuity impairment (VAI), contrast sensitivity impairment (CSI) and their associations with physical health in an aging population. Methods In this cross-sectional analysis, VAI was categorized as mild (20/40-20/60) and moderate or greater (<20/60) in the better eye for distance and near vision. CSI was categorized as moderate (1.04-1.50 logCS) and severe or profound (<1.04 logCS). Physical outcomes included the short physical performance battery (SPPB) scores, self-reported quality of life (QoL) scores, physical limitations, difficulty with activity of daily living (ADL) and instrumental ADL (IADL). The associations between VAI and CSI with physical outcomes were explored overall and by community. Results There were 494 Black Jackson and 558 White Washington County participants. The mean age was 80 years, 63% were female, and 15% had VAIdistance presenting. Moderate or greater VAInear presenting was associated with higher prevalence of greater physical limitations (prevalence ratio, 1.25; 95% confidence interval, 1.09-1.44) and IADL difficulties (prevalence ratio, 1.77; 95% confidence interval, 1.32-2.38), but not ADL difficulties. Associations of VAIdistance presenting with physical limitations and lower SPPB scores, and CSI with physical limitations, IADL difficulties, lower QoL, and lower SPPB scores were found. A stratified analysis showed stronger associations in Jackson. Conclusions VAI and CSI were associated with poor physical health. These associations should be understood in the context of community differences. Translational Relevance Community-based factors may mitigate the impact of vision loss on physical outcomes. Public health endeavors are needed to address VAI and CSI to optimize physical health in the older adults with poor vision.
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Affiliation(s)
- Xinxing Guo
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lubaina T. Arsiwala
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yanan Dong
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Aleksandra Mihailovic
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Pradeep Y. Ramulu
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A. Richey Sharrett
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thomas Mosley
- The MIND Center, University of Mississippi Medical Center, Jackson, MS, USA
| | - Alison G. Abraham
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Colorado School of Public Health, University of Colorado, CO, USA
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11
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Mehta P, Petersen CA, Wen JC, Banitt MR, Chen PP, Bojikian KD, Egan C, Lee SI, Balazinska M, Lee AY, Rokem A. Automated Detection of Glaucoma With Interpretable Machine Learning Using Clinical Data and Multimodal Retinal Images. Am J Ophthalmol 2021; 231:154-169. [PMID: 33945818 DOI: 10.1016/j.ajo.2021.04.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 01/17/2023]
Abstract
PURPOSE To develop a multimodal model to automate glaucoma detection DESIGN: Development of a machine-learning glaucoma detection model METHODS: We selected a study cohort from the UK Biobank data set with 1193 eyes of 863 healthy subjects and 1283 eyes of 771 subjects with glaucoma. We trained a multimodal model that combines multiple deep neural nets, trained on macular optical coherence tomography volumes and color fundus photographs, with demographic and clinical data. We performed an interpretability analysis to identify features the model relied on to detect glaucoma. We determined the importance of different features in detecting glaucoma using interpretable machine learning methods. We also evaluated the model on subjects who did not have a diagnosis of glaucoma on the day of imaging but were later diagnosed (progress-to-glaucoma [PTG]). RESULTS Results show that a multimodal model that combines imaging with demographic and clinical features is highly accurate (area under the curve 0.97). Interpretation of this model highlights biological features known to be related to the disease, such as age, intraocular pressure, and optic disc morphology. Our model also points to previously unknown or disputed features, such as pulmonary function and retinal outer layers. Accurate prediction in PTG highlights variables that change with progression to glaucoma-age and pulmonary function. CONCLUSIONS The accuracy of our model suggests distinct sources of information in each imaging modality and in the different clinical and demographic variables. Interpretable machine learning methods elucidate subject-level prediction and help uncover the factors that lead to accurate predictions, pointing to potential disease mechanisms or variables related to the disease.
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Affiliation(s)
- Parmita Mehta
- From the Paul G. Allen School of Computer Science and Engineering, Seattle, Washington, USA (PM, S-IL, MB)
| | - Christine A Petersen
- Department of Ophthalmology, Seattle, Washington, USA (CAP, JCW, MRB, PPC, KDB, AYL)
| | - Joanne C Wen
- Department of Ophthalmology, Seattle, Washington, USA (CAP, JCW, MRB, PPC, KDB, AYL)
| | - Michael R Banitt
- Department of Ophthalmology, Seattle, Washington, USA (CAP, JCW, MRB, PPC, KDB, AYL)
| | - Philip P Chen
- Department of Ophthalmology, Seattle, Washington, USA (CAP, JCW, MRB, PPC, KDB, AYL)
| | - Karine D Bojikian
- Department of Ophthalmology, Seattle, Washington, USA (CAP, JCW, MRB, PPC, KDB, AYL)
| | | | - Su-In Lee
- From the Paul G. Allen School of Computer Science and Engineering, Seattle, Washington, USA (PM, S-IL, MB)
| | - Magdalena Balazinska
- From the Paul G. Allen School of Computer Science and Engineering, Seattle, Washington, USA (PM, S-IL, MB); eScience Institute, Seattle, Washington, USA (MB, AR)
| | - Aaron Y Lee
- Department of Ophthalmology, Seattle, Washington, USA (CAP, JCW, MRB, PPC, KDB, AYL)
| | - Ariel Rokem
- eScience Institute, Seattle, Washington, USA (MB, AR); Department of Psychology, Seattle, Washington, USA (AR).
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12
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Gbessemehlan A, Guerchet M, Helmer C, Delcourt C, Houinato D, Preux PM. Association between visual impairment and cognitive disorders in low-and-middle income countries: a systematic review. Aging Ment Health 2021; 25:1786-1795. [PMID: 32896159 DOI: 10.1080/13607863.2020.1808878] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Visual impairment and cognitive disorders are common among older people in Low-and Middle-Income Countries (LMIC). Several recent studies performed in High-Income Countries suggested that visual impairment is associated with cognitive disorders. However, no synthesis of current knowledge exists for LMIC. METHODS We have conducted an extensive literature search combining six databases and two grey literature databases. We searched for studies assessing the link between visual and cognitive impairments carried out in LMIC. The systematic search was performed up to 14th February 2019. RESULTS Overall, eight studies were included in this review. Among them, five studies were performed in Asia and seven studies had a cross-sectional design. Mean age of the participants varied from 64.2 to 76.2 years. Participants were most often females. Only three studies were specifically focused on the association between visual impairment and cognitive disorders. Out of the eight studies included, four reported a significant association; two showed a possible association and two did not retrieve any statistically significant effect. Heterogeneity in assessments of visual and cognitive impairments was high. CONCLUSION In LMIC, very few studies explored the association between visual and cognitive impairments among older people. The current review seems to suggest that visual impairment is associated with cognitive disorders in LMIC. However, further studies are required to improve the knowledge on this relationship. Improving vision, in particular through optical correction and cataract surgery, could potentially be easy pathways to reduce cognitive disorders incidence and to improve quality of life of people affected by this disorder.
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Affiliation(s)
- Antoine Gbessemehlan
- INSERM U 1094 Institute of Epidemiology and Tropical Neurology, University of Limoges, Limoges, France.,IRD Associated Unit Tropical Neuroepidemiology, University of Limoges, Limoges, France
| | - Maëlenn Guerchet
- INSERM U 1094 Institute of Epidemiology and Tropical Neurology, University of Limoges, Limoges, France.,IRD Associated Unit Tropical Neuroepidemiology, University of Limoges, Limoges, France
| | - Catherine Helmer
- INSERM U1219 Bordeaux Population Health Research Center Team LEHA, University of Bordeaux, Bordeaux, France
| | - Cecile Delcourt
- INSERM U1219 Bordeaux Population Health Research Center Team LEHA, University of Bordeaux, Bordeaux, France
| | - Dismand Houinato
- INSERM U 1094 Institute of Epidemiology and Tropical Neurology, University of Limoges, Limoges, France.,IRD Associated Unit Tropical Neuroepidemiology, University of Limoges, Limoges, France
| | - Pierre-Marie Preux
- INSERM U 1094 Institute of Epidemiology and Tropical Neurology, University of Limoges, Limoges, France.,IRD Associated Unit Tropical Neuroepidemiology, University of Limoges, Limoges, France
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13
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Torres RJDA, Ferreira ALDA. Age-related macular degeneration: an overview. REVISTA BRASILEIRA DE OFTALMOLOGIA 2021. [DOI: 10.37039/1982.8551.20210038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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14
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Gbessemehlan A, Helmer C, Delcourt C, Boumediene F, Ndamba-Bandzouzi B, Mbelesso P, Samba H, Kehoua G, Désormais I, Lacroix P, Aboyans V, Dartigues JF, Houinato D, Preux PM, Guerchet M. Cardiovascular Health and Near Visual Impairment Among Older Adults in the Republic of Congo: A Population-Based Study. J Gerontol A Biol Sci Med Sci 2021; 76:842-850. [PMID: 33438029 DOI: 10.1093/gerona/glaa304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Visual impairment (VI) and determinants of poor cardiovascular health are very common in Sub-Saharan Africa. However, we do not know whether these determinants are associated with VI among older adults in this region. This study aimed at investigating the association between the determinants of poor cardiovascular health and near VI among older adults living in Congo. METHODS Participants were Congolese adults aged 65 or older included in Epidemiology of Dementia in Central Africa-Follow-up population-based cohort. Near VI was defined as visual acuity less than 20/40 measured at 30 cm. Associations between determinants of poor cardiovascular health collected at baseline and near visual acuity measured at first follow-up were investigated using multivariable logistic regression models. RESULTS Among the 549 participants included, 378 (68.8%; 95% confidence interval [CI]: 64.9%-72.7%]) had near VI. Of the determinants of poor cardiovascular health explored, we found that having high body mass index of at least 25 kg/m2 (odds ratio [OR] = 2.15; 95% CI: 1.25-3.68), diabetes (OR = 2.12; 95% CI: 1.06-4.25) and hypertension (OR = 1.65; 95% CI: 1.02-2.64) were independently associated with near VI. CONCLUSIONS Several determinants of poor cardiovascular health were associated with near VI in this population. This study suggests that promoting good cardiovascular health could represent a target for VI prevention among older adults.
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Affiliation(s)
- Antoine Gbessemehlan
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Faculty of Health Sciences, Laboratory of Chronic and Neurologic Diseases Epidemiology, LEMACEN, University of Abomey-Calavi, Cotonou, Benin
| | - Catherine Helmer
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, France
| | - Cécile Delcourt
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, France
| | - Farid Boumediene
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | | | - Pascal Mbelesso
- Department of Neurology, Amitié Hospital, Bangui, Central African Republic
| | - Harielle Samba
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Gilles Kehoua
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Ileana Désormais
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Department of Thoracic and Cardiovascular Surgery and Angiology, Dupuytren University Hospital, Limoges, France
| | - Philippe Lacroix
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Department of Thoracic and Cardiovascular Surgery and Angiology, Dupuytren University Hospital, Limoges, France
| | - Victor Aboyans
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | | | - Dismand Houinato
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France.,Faculty of Health Sciences, Laboratory of Chronic and Neurologic Diseases Epidemiology, LEMACEN, University of Abomey-Calavi, Cotonou, Benin
| | - Pierre-Marie Preux
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | - Maëlenn Guerchet
- INSERM, Univ. Limoges, IRD, U1094 Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
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15
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Di Carlo E, Augustin AJ. Prevention of the Onset of Age-Related Macular Degeneration. J Clin Med 2021; 10:jcm10153297. [PMID: 34362080 PMCID: PMC8348883 DOI: 10.3390/jcm10153297] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/12/2022] Open
Abstract
Age-related macular degeneration (AMD) represents the leading cause of irreversible blindness in elderly people, mostly after the age of 65. The progressive deterioration of visual function in patients affected by AMD has a significant impact on quality of life and has also high social costs. The current therapeutic options are only partially able to slow down the natural course of the disease, without being capable of stopping its progression. Therefore, better understanding of the possibilities to prevent the onset of the disease is needed. In this regard, a central role is played by the identification of risk factors, which might participate to the development of the disease. Among these, the most researched are dietary risk factors, lifestyle, and light exposure. Many studies showed that a higher dietary intake of nutrients, such as lutein, zeaxanthin, beta carotene, omega-3 fatty acids and zinc, reduced the risk of early AMD. Regarding lifestyle habits, the association between smoking and AMD is currently accepted. Finally, retinal damage caused by ultraviolet rays and blue light is also worthy of attention. The scope of this review is to summarize the present knowledge focusing on the measures to adopt in order to prevent the onset of AMD.
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16
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Han SY, Chang Y, Shin H, Choi CY, Ryu S. Smoking, urinary cotinine levels and incidence of visual impairment. Sci Rep 2021; 11:398. [PMID: 33432008 PMCID: PMC7801542 DOI: 10.1038/s41598-020-79865-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 12/08/2020] [Indexed: 12/12/2022] Open
Abstract
The longitudinal relationship between smoking status and risk of developing visual impairment (VI) remains unclear. We examined the relationship of smoking status and urinary cotinine level, an objective measure of smoking, with incidence of VI. This cohort study included 279,069 individuals free of VI who were followed for up to 8.8 years (median 4.8 years). VI was defined as when bilateral visual acuity was worse than 0.5 (cutoffs of 0.3 Logarithm of the Minimum Angle of Resolution). During 1,324,429.8 person-years of follow-up, 7852 participants developed new-onset bilateral VI. Self-reported current smoking status was associated with increased risk of developing VI in both men and women, with a stronger association in women (P for interaction = 0.01). Multivariable adjusted hazard ratios (95% confidence intervals) for incident VI comparing current smokers to never-smokers were 1.14 (1.04–1.25) in men and 1.52 (1.28–1.80) in women. Urinary cotinine levels of ≥ 100 ng/ml were significantly associated with increased risk of incident VI, and these associations remained when introducing changes in urinary cotinine and other confounders during follow-up as time-varying covariates. Cigarette smoking assessed based on self-report and urinary cotinine level was associated with increased incidence of VI. Our findings identify smoking as an independent risk factor for VI.
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Affiliation(s)
- So Young Han
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250, Taepyung-ro 2ga, Jung-gu, Seoul, 04514, Republic of Korea.,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hocheol Shin
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chul Young Choi
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea.
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. .,Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Samsung Main Building B2, 250, Taepyung-ro 2ga, Jung-gu, Seoul, 04514, Republic of Korea. .,Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.
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17
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Park J, Lee OE. Association between vision impairment and suicidal ideation among older adults: Results from National Survey on Drug Use and Health. Disabil Health J 2020; 13:100939. [DOI: 10.1016/j.dhjo.2020.100939] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/16/2020] [Accepted: 04/28/2020] [Indexed: 10/24/2022]
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18
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Jabbehdari S, Handa JT. Oxidative stress as a therapeutic target for the prevention and treatment of early age-related macular degeneration. Surv Ophthalmol 2020; 66:423-440. [PMID: 32961209 DOI: 10.1016/j.survophthal.2020.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/10/2020] [Accepted: 09/14/2020] [Indexed: 12/13/2022]
Abstract
Age-related macular degeneration, the leading cause of irreversible visual loss among older adults in developed countries, is a chronic, multifactorial, and progressive disease with the development of painless, central vision loss. Retinal pigment epithelial cell dysfunction is a core change in age-related macular degeneration that results from aging and the accumulated effects of genetic and environmental factors that, in part, is both caused by and leads to oxidative stress. In this review, we describe the role of oxidative stress, the cytoprotective oxidative stress pathways, and the impact of oxidative stress on critical cellular processes involved in age-related macular degeneration pathobiology. We also offer targeted therapy that may define how antioxidant therapy can either prevent or improve specific stages of age-related macular degeneration.
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Affiliation(s)
- Sayena Jabbehdari
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - James T Handa
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
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19
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McDaniel JT, Jenkins WD, Albright DL, Null D, McIntosh S, McDaniel MR. Illicit drug use and self-reported vision loss among military service members or veterans. BMJ Mil Health 2020; 168:377-381. [PMID: 32796013 DOI: 10.1136/bmjmilitary-2020-001518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Little is known about differences in vision loss prevalence among service members or veterans (SMVs) and civilians; further, no study has compared vision loss risk factors in these two populations. As such, we seek to fill this gap in the literature. METHODS In this cross sectional study, we obtained data on 106 SMVs and 1572 civilians from the 2013-2018 National Health and Nutrition Examination Surveys. We compared the prevalence of or mean values of vision loss risk factors between SMVs and civilians using the Wald χ2 statistic or Kruskal-Wallis test. Further, we examined the relative strength of 17 vision loss risk factors in predicting self-reported vision loss via Firth's logistic regression. RESULTS SMVs had a significantly higher prevalence of illicit drug use (20.75% vs 13.62%) and HIV (1.89% vs 0.41%), while civilians had a higher prevalence of poor dietary habits (7.61% vs 13.21%). SMVs also had higher mean values of systolic blood pressure (125.85 vs 122.53 mmHg), pack years of cigarette smoking (8.29 vs 4.25), and sedentary minutes per day (379.15 vs 337.07 min). More SMVs (8.49%) self-reported vision loss than civilians (4.48%). After adjustment for covariates, illicit drug use (adjusted β coefficient=0.72, p=0.02) was associated with self-reported vision loss. CONCLUSIONS This study indicates that self-reported vision loss among SMVs is more prevalent than among civilians, and vision loss in SMVs is associated with severe or prolonged illicit drug use.
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Affiliation(s)
- Justin Tyler McDaniel
- School of Human Sciences, Southern Illinois University Carbondale, Carbondale, Illinois, USA
| | - W D Jenkins
- Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - D L Albright
- School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA
| | - D Null
- School of Human Sciences, Southern Illinois University Carbondale, Carbondale, Illinois, USA
| | - S McIntosh
- School of Social Work, The University of Alabama, Tuscaloosa, Alabama, USA
| | - M R McDaniel
- College of Adult and Graduate Studies, Colorado Christian University, Lakewood, Colorado, USA
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20
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Makrynioti D, Zagoriti Z, Koutsojannis C, Morgan PB, Lagoumintzis G. Ocular conditions and dry eye due to traditional and new forms of smoking: A review. Cont Lens Anterior Eye 2020; 43:277-284. [PMID: 32111452 DOI: 10.1016/j.clae.2020.02.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 01/24/2020] [Accepted: 02/16/2020] [Indexed: 12/26/2022]
Abstract
Addiction to cigarette smoking has high prevalence rates recorded worldwide. Smoking has been linked to several life-threatening systemic conditions such as cancer, heart attack and stroke, in addition to a range of ocular pathologies. In recent years, electronic cigarettes (EC) have emerged as alternatives to smoking. ECs are nicotine delivery devices which produce an aerosol by heating, rather than combusting, a liquid which contains nicotine, flavours and preservatives. This review focuses on the association of traditional and new forms of smoking with dry eye disease, contact lens wear and four other common ocular diseases: cataract, age-related macular degeneration, glaucoma and Graves' ophthalmopathy. It is concluded that smoking and vaping appear as a risk factor for the aforementioned ocular conditions. An evidence-based, clear link between cigarette smoking, or EC vaping and ocular problems is yet to be discovered.
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Affiliation(s)
- Dimitra Makrynioti
- School of Health Rehabilitation Sciences, University of Patras, Psaron 6, GR 25100, Aιgio, Greece.
| | - Zoi Zagoriti
- Department of Pharmacy, Laboratory of Molecular Biology and Immunology, University of Patras, University Campus, GR26504, Patras, Greece.
| | - Constantinos Koutsojannis
- Department of Physiotherapy, Laboratory of Health Physics and Computational Intelligence, School of Health Rehabilitation Sciences, University of Patras, Psaron 6, GR 25100, Aιgio, Greece.
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, Carys Bannister Building, Dover Street, Manchester, M13 9PL, United Kingdom.
| | - George Lagoumintzis
- School of Health Rehabilitation Sciences, University of Patras, Psaron 6, GR 25100, Aιgio, Greece; Department of Pharmacy, Laboratory of Molecular Biology and Immunology, University of Patras, University Campus, GR26504, Patras, Greece.
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Crews JE, Chou CF, Naavaal S, Griffin SO, Saaddine JB. Self-Reported Oral Health Status Among Adults Aged 40+ Years With and Without Vision Impairment: National Health Interview Study, 2008. Am J Ophthalmol 2020; 210:184-191. [PMID: 31604065 DOI: 10.1016/j.ajo.2019.08.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/25/2019] [Accepted: 08/27/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE To examine self-reported oral health among adults aged 40 years and older with and without vision impairment. DESIGN Cross-sectional, with a nationally representative sample. METHODS We used publicly available data from the Oral Health Module, last administered in 2008, of the National Health Interview Survey. Outcome variables included fair/poor oral health status, mouth condition compared to others the same age, mouth problems (mouth sores, difficulty eating, dry mouth, bad breath, and/or jaw pain), teeth problems (toothache; broken/missing fillings or teeth; loose, crooked, or stained teeth; and/or bleeding gums), and lack of social participation. Using descriptive statistics and multivariate logistic regression, we examined the association (P < .05) between vision impairment and oral health outcomes by age group, sociodemographics, and other explanatory variables. RESULTS Our study sample included 12,090 adults; 12.8% of adults aged 40-64 years reported vision impairment, and among them, 44.5% reported fair/poor oral health status and 47.2% reported any mouth problems. Among adults aged ≥65 years, 17.3% reported vision impairment, of whom 36.3% reported fair/poor oral health status and 57.3% reported any mouth problems. There is a strong association between vision impairment and poorer oral health of adults; adults aged 40-64 years with vision impairment reported 90%-150% greater odds of oral health problems, including fair/poor oral health status, mouth problems, and teeth problems, compared to people without vision impairment. CONCLUSIONS Oral health disparities exist between adults with and without vision impairment. Targeted interventions are required to improve oral health in this vulnerable population.
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Affiliation(s)
| | - Chiu-Fang Chou
- National Center for Health Workforce Analysis, Bureau of Health Workforce, Health Resources and Services Administration, Rockville, Maryland, USA
| | - Shillpa Naavaal
- Department of Dental Public Health and Policy, School of Dentistry, and Oral Health in Childhood and Adolescence, Institute for Inclusion, Inquiry, and Innovation, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Susan O Griffin
- Divisions of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jinan B Saaddine
- Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Long-term outcome of cataract surgery: 20-year results from a population-based prospective study. J Cataract Refract Surg 2019; 45:1732-1737. [PMID: 31856983 DOI: 10.1016/j.jcrs.2019.07.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/18/2019] [Accepted: 07/25/2019] [Indexed: 11/23/2022]
Abstract
PURPOSE To report the longitudinal visual functional outcome after cataract surgery over 20 years. SETTING Eye clinic, Norrlands University Hospital, Sweden. DESIGN Prospective population-based cohort study. METHODS One hundred fourteen patients (86% of survivors) who had cataract surgery during a 1-year period (1997 to 1998) answered the same Visual Function Index-14 questionnaire (VF-14) preoperatively, 2 to 4 months postoperatively, and at 5, 10, 15, and 20 years after surgery. Most patients (100 [88%] of 114; 75% of survivors) also had a routine ocular examination, including corrected distance visual acuity (CDVA). RESULTS The mean age of the114 patients in the study was 60.6 years (range 36 to 80 years) at the time of surgery. Twenty years after surgery, the median CDVA in the operated eye had deteriorated from Snellen acuity 20/20 (logarithm of the minimum angle of resolution [logMAR] 0.0) postoperatively to 20/23 (logMAR 0.07) (P = .001). Patients aged 70 years or older at surgery had the largest loss of CDVA at 20 years compared with younger patients. At 20 years, 63 (55%) of the 114 patients had no deterioration in subjective visual function and most patients (82 [72%]) had 10 points decline or less. Patients who were older at surgery had a more pronounced decline in VF-14 total score over 20 years (P = .002). Fifty-six (58%) of 96 patients had never been treated for posterior capsule opacification. CONCLUSIONS This prospective 20-year follow-up study provided estimates of longitudinal visual results. Cataract surgery also offered excellent long-term visual rehabilitation for the majority, especially younger patients, after 20 years, with a low requirement for Nd:YAG laser capsulotomy. The results in this study are of value for counseling younger patients with cataract and patients considering refractive lens surgery.
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Mathieu ME, Reid RER, King NA. Sensory Profile of Adults with Reduced Food Intake and the Potential Roles of Nutrition and Physical Activity Interventions. Adv Nutr 2019; 10:1120-1125. [PMID: 31121014 PMCID: PMC6855938 DOI: 10.1093/advances/nmz044] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/20/2018] [Accepted: 03/29/2019] [Indexed: 12/12/2022] Open
Abstract
The sensory profile, referring to sight, smell, taste, hearing, and touch, plays an essential role in optimizing the habitual intake of energy and macronutrients. However, specific populations, such as older adults, are known to have impaired energy intake. In this paper, the relevance of sensory impairments in this older population is described, and the extent to which nutritional and physical activity interventions can modulate these sensory responses when food intake is insufficient is explored. With aging, all senses deteriorate, and in most cases, such deteriorations diminish the nutritional response. The only exception is sight, for which both positive and negative impacts on nutritional response have been reported. From a prevention perspective, nutritional interventions have been understudied, and to date, only hearing is known to be positively affected by a good nutritional profile. In comparison, physical activity has been more frequently studied in this context, and is linked to an improved preservation of 4 senses. Regarding treatment, very few studies have directly targeted sensory training, and the focus of research has tended to be on nutrition and physical activity intervention. Sensory training, and nutritional and physical activity treatments all have beneficial effects on the senses. In the future, researchers should focus on exploring gaps in the literature specifically concerning prevention, treatment, and sensory response to understand how to improve the efficacy of current approaches. In order to maintain sensory acuity and recover from sensory impairment, the current state of knowledge supports the importance of improving nutritional habits as well as physical activity early on in life. A combined approach, linking a detailed lifestyle profile with the assessment of numerous senses and one or more interventional approaches (nutrition, physical activity, sensory training, etc.), would be required to identify effective strategies to improve the nutritional state of older individuals.
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Affiliation(s)
- Marie-Eve Mathieu
- École de kinésiologie et des sciences de l'activité physique, Université de Montréal, Montréal, Canada,Sainte-Justine University Hospital Center, Montréal, Canada,Address correspondence to M-EM (E-mail: )
| | - Ryan E R Reid
- École de kinésiologie et des sciences de l'activité physique, Université de Montréal, Montréal, Canada,Sainte-Justine University Hospital Center, Montréal, Canada
| | - Neil A King
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Australia
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Impact of visual impairment on physical activity in early and late age-related macular degeneration. PLoS One 2019; 14:e0222045. [PMID: 31634374 PMCID: PMC6802830 DOI: 10.1371/journal.pone.0222045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 08/20/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Modifiable risk factors for age-related macular degeneration (AMD) include smoking, nutrition and likely physical activity (PA). Levels of PA, however, are impacted by any visual impairment which makes the assessment of any association with AMD difficult. PURPOSE To assess the impact of visual impairment under both high and low luminance conditions on levels of PA in early and late AMD. METHODS Ninety participants with early to late AMD underwent a clinical assessment including conventional best-corrected visual acuity, low luminance visual acuity, contrast sensitivity and the Moorfields acuity test. PA was recorded using a wrist-worn accelerometer (GENEActiv, Activeinsights) on seven consecutive days. Patient characteristics were compared with the Wilcoxon rank-sum test and determinants of moderate-to-vigorous-PA (MVPA) were assessed using linear regression models. RESULTS Mean age was 73.9 ± 8.5 years (range 50-89) and 47 subjects (52.2%) were women. Average MVPA time was longer in the early (355.1 ± 252.0 minutes/week) compared to the late AMD group (162.2 ± 134.6 minutes/week; p<0.001). Using linear regression, age [β = -0.25; 95% confidence interval (CI): -12.9; -0.8, p = 0.028] and AMD stage (β = -0.28; 95% CI: -230.9, -25.0; p = 0.015) but not visual impairment on any of the employed tests were associated with MVPA (minutes/week). CONCLUSIONS We found late AMD to be associated with reduced PA. As performance on any of the visual tests was not associated with PA, this association cannot entirely be explained by functional impairment. More research is needed to further explore the association of PA and AMD as PA may be a potentially modifiable risk factor.
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25
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Narayanan SP, Shosha E, D Palani C. Spermine oxidase: A promising therapeutic target for neurodegeneration in diabetic retinopathy. Pharmacol Res 2019; 147:104299. [PMID: 31207342 PMCID: PMC7011157 DOI: 10.1016/j.phrs.2019.104299] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 04/23/2019] [Accepted: 06/05/2019] [Indexed: 12/20/2022]
Abstract
Diabetic Retinopathy (DR), is a significant public health issue and the leading cause of blindness in working-aged adults worldwide. The vision loss associated with DR affects patients' quality of life and has negative social and psychological effects. In the past, diabetic retinopathy was considered as a vascular disease; however, it is now recognized to be a neuro-vascular disease of the retina. Current therapies for DR, such as laser photocoagulation and anti-VEGF therapy, treat advanced stages of the disease, particularly the vasculopathy and have adverse side effects. Unavailability of effective treatments to prevent the incidence or progression of DR is a major clinical problem. There is a great need for therapeutic interventions capable of preventing retinal damage in DR patients. A growing body of evidence shows that neurodegeneration is an early event in DR pathogenesis. Therefore, studies of the underlying mechanisms that lead to neurodegeneration are essential for identifying new therapeutic targets in the early stages of DR. Deregulation of the polyamine metabolism is implicated in various neurodegenerative diseases, cancer, renal failure, and diabetes. Spermine Oxidase (SMOX) is a highly inducible enzyme, and its dysregulation can alter polyamine homeostasis. The oxidative products of polyamine metabolism are capable of inducing cell damage and death. The current review provides insight into the SMOX-regulated molecular mechanisms of cellular damage and dysfunction, and its potential as a therapeutic target for diabetic retinopathy. Structural and functional changes in the diabetic retina and the mechanisms leading to neuronal damage (excitotoxicity, loss of neurotrophic factors, oxidative stress, mitochondrial dysfunction etc.) are also summarized in this review. Furthermore, existing therapies and new approaches to neuroprotection are discussed.
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Affiliation(s)
- S Priya Narayanan
- Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia, Augusta, GA, United States; Augusta University Culver Vision Discovery Institute, Augusta, GA, United States; Vascular Biology Center, Augusta University, Augusta, GA, United States; VA Medical Center, Augusta, GA, United States.
| | - Esraa Shosha
- Augusta University Culver Vision Discovery Institute, Augusta, GA, United States; Vascular Biology Center, Augusta University, Augusta, GA, United States; Clinical Pharmacy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Chithra D Palani
- Clinical and Experimental Therapeutics, College of Pharmacy, University of Georgia, Augusta, GA, United States; Augusta University Culver Vision Discovery Institute, Augusta, GA, United States; Vascular Biology Center, Augusta University, Augusta, GA, United States
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26
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Lüdtke L, Jürgens C, Ittermann T, Völzke H, Tost F. Age-Related Macular Degeneration and Associated Risk Factors in the Population-Based Study of Health in Pomerania (SHIP-Trend). Med Sci Monit 2019; 25:6383-6390. [PMID: 31446436 PMCID: PMC6724561 DOI: 10.12659/msm.915493] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Age-related macular degeneration (AMD) is the leading cause of visual impairment in developed countries, especially in the older population. The Study of Health in Pomerania (SHIP) is a population-based study designed to investigate risk factors and clinical disorders in the general population. In the present study, we analysed the AMD prevalence and risk factors in the north-eastern German population. Material/Methods From 2008 to 2012, we collected data among participants ages 29–79 years. The study population consisted of 4420 individuals. Non-mydriatic retinal photographs were taken of 3934 participants. AMD stages were graded according to the Rotterdam Classification System and the International Classification System. Results Photographs from 1854 participants were available for grading. The baseline examinations showed small hard drusen (<63 μm, stage 0b and 0c) were present in 10.7% of the participants (stage 0b in 7.5% and stage 0c in 3.2%). Earliest signs of AMD were detected in 28.68% (stage 0b in 7.5% and stage 1b in 21.18%). Late AMD (geographic atrophy and neovascular AMD, stages 4a and 4b) were identified in 0.43% (stage 4a in 0.16% and stage 4b 0.27%). Risk of AMD increased significantly with age and higher body mass index, waist circumference, hip circumference, and weight-waist-ratio. Smoking, sex, systolic and diastolic blood pressure, HbA1c, cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride were not associated with AMD in this study. Conclusions The prevalence of AMD increases with age and obesity-associated factors. These results must be verified in the follow-up. Data concerning the incidence of AMD will be available after the 5- and 10-year follow-ups.
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Affiliation(s)
- Lisa Lüdtke
- Department of Ophthalmology, University of Medicine, Greifswald, Germany
| | - Clemens Jürgens
- Institute of Community Medicine, University of Medicine, Greifswald, Germany
| | - Till Ittermann
- Institute of Community Medicine, University of Medicine, Greifswald, Germany
| | - Henry Völzke
- Institute of Community Medicine, University of Medicine, Greifswald, Germany.,German Center of Cardiovascular Research, University of Medicine, Greifswald, Germany
| | - Frank Tost
- Department of Ophthalmology, University of Medicine, Greifswald, Germany
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Schubert CR, Fischer ME, Pinto AA, Chen Y, Klein BE, Klein R, Tsai MY, Tweed TS, Cruickshanks KJ. Brain Aging in Midlife: The Beaver Dam Offspring Study. J Am Geriatr Soc 2019; 67:1610-1616. [PMID: 30934109 PMCID: PMC6684355 DOI: 10.1111/jgs.15886] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/22/2019] [Accepted: 02/21/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Middle age has been identified as a critical time period for health later in life. Identifying factors associated with worse brain function in middle-aged adults may help identify ways to preserve brain function with aging. Our objective was to evaluate factors associated with a novel measure of brain aging in middle-aged and older adults. DESIGN Longitudinal cohort study. SETTING Beaver Dam Offspring Study (BOSS) baseline (2005-2008), 5-year (2010-2013), and 10-year examinations (2015-2017). PARTICIPANTS A total of 2285 adults, 22 to 84 years of age, with complete sensorineural and neurocognitive data at the 5-year examination. MEASUREMENTS Principal component analysis (PCA) was performed combining 5-year sensorineural (hearing, vision, olfaction) and cognitive (Trail Making Test A and B, Digit Symbol Substitution Test, Verbal Fluency Test, Auditory Verbal Learning Test) test data. Participants with a standardized PCA score less than -1 were classified as having brain aging. Incident brain aging was defined as a PCA score less than -1 at 10 years among participants who had a PCA score of -1 or higher at 5 years. Logistic regression and Poisson models were used to estimate associations between baseline factors and prevalent or incident brain aging, respectively. RESULTS Older age, being male, current smoking, larger waist circumference, not consuming alcohol, cardiovascular disease, and interleukin-6 were associated with greater odds of prevalent brain aging, whereas more education and exercise were associated with decreased odds. In addition to age and sex, less than a college education, higher levels of soluble intercellular adhesion molecule-1, diabetes, depressive symptoms, and history of head injury were associated with an increased 5-year risk of incident brain aging. CONCLUSION In the current study, vascular and inflammatory factors were associated with a new brain aging marker in middle-aged and older adults. Many of these factors are modifiable, highlighting the importance of addressing health and lifestyle factors in midlife to potentially preserve function for better brain health later in life. J Am Geriatr Soc 67:1610-1616, 2019.
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Affiliation(s)
- Carla R. Schubert
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
| | - Mary E. Fischer
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
| | - A. Alex Pinto
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
| | - Yanjun Chen
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
| | - Barbara E.K. Klein
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
| | - Michael Y. Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, 420 Delaware Street S.E., Minneapolis, MN 55455
| | - Ted S. Tweed
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
| | - Karen J. Cruickshanks
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
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Liao H, Zhu Z, Wang H, Rong X, Young CA, Peng Y. Cognitive Performance Concomitant With Vision Acuity Predicts 13-Year Risk for Mortality. Front Aging Neurosci 2019; 11:65. [PMID: 30967772 PMCID: PMC6439522 DOI: 10.3389/fnagi.2019.00065] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 03/06/2019] [Indexed: 01/04/2023] Open
Abstract
Objective: To assess the joint impact of cognitive performance and visual acuity on mortality over 13-year follow-up in a representative US sample. Methods: Data from National Health and Nutrition Examination Survey (NHANES) participants (≥18 years old) were linked with the death record data of the National Death Index (NDI) with mortality follow-up through December 31, 2011. Cognitive performance was evaluated by the Digit Symbol Substitution Test (DSST) and cognitive performance impairment was defined as the DSST score equal to or less than the median value in the study population. Visual impairment (VI) was defined as presenting visual acuity worse than 20/40 in the better-seeing eye. Risks of all-cause and specific-cause mortality were estimated with Cox proportional hazards models after adjusting for confounders. Results: A total of 2,550 participants 60 years and older from two waves of (NHANES, 1999–2000, 2001–2002) were included in the current analysis. Over a median follow-up period of 9.92 years, 952 (35.2%) died of all causes, of whom 239 (23.1%), 224 (24.0%), and 489 (52.9%) died from cardiovascular disease (CVD), cancer, and non-CVD/non-cancer mortality, respectively. Cognitive performance impairment and VI increased the odds for mortality. Co-presence of VI among cognitive impaired elderly persons predicted nearly a threefold increased risk of all-cause mortality [hazard ratios (HRs), 2.74; 95% confidence interval (CI), 2.02–3.70; P < 0.001) and almost a fourfold higher risk of non-CVD/non-cancer mortality (HR, 3.72; 95% CI, 2.30–6.00; P < 0.001) compared to having neither impairment. Conclusion: People aged 60 years and over with poorer cognitive performance were at higher risk of long-term mortality, and were especially vulnerable to further mortality when concomitant with VI. It is informative for clinical implication in terms of early preventive interventions.
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Affiliation(s)
- Huan Liao
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhuoting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Hongxuan Wang
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoming Rong
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Charlotte Aimee Young
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
| | - Ying Peng
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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29
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Paulsen AJ, Schubert CR, Johnson LJ, Chen Y, Dalton DS, Klein BEK, Klein R, Pinto A, Cruickshanks KJ. Association of Cadmium and Lead Exposure With the Incidence of Contrast Sensitivity Impairment Among Middle-aged Adults. JAMA Ophthalmol 2018; 136:1342-1350. [PMID: 30242333 PMCID: PMC6292732 DOI: 10.1001/jamaophthalmol.2018.3931] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Contrast sensitivity (CS) is an important indicator of visual function that affects daily life, including mobility, visually intensive tasks, safety, and autonomy. Understanding the risk factors for CS impairment could prevent decreases in visual function. Objective To determine the incidence of and factors associated with CS impairment in a large cohort. Design, Setting, and Participants The Beaver Dam Offspring Study is an ongoing longitudinal cohort study of aging involving adults in Beaver Dam, Wisconsin. Participants who were free of CS impairment in both eyes at baseline were included (N = 1983). Baseline data collection occurred from June 8, 2005, through August 4, 2008, when the participants ranged from 21 to 84 years of age. Two follow-up examinations occurred at 5-year intervals: one was conducted between July 12, 2010, and March 21, 2013, and the other between July 1, 2015, and November 13, 2017. Data analysis was performed from November 27, 2017, to February 27, 2018. Main Outcomes and Measures Contrast sensitivity testing was conducted with Pelli-Robson letter sensitivity charts, and incident impairment was defined as a log CS score less than 1.55 in either eye at any follow-up examination. Cadmium and lead levels were measured in whole blood with inductively coupled plasma mass spectrometry. Associations between baseline characteristics and CS impairment incidence were examined using Cox proportional hazard models and quantified as hazard ratios (HRs) with 95% CI. Results Of the 1983 participants included, 1028 (51.8%) were female and 955 (48.2%) were male, with a mean (SD) age of 48 (9.3) years. The 10-year cumulative incidence of CS impairment was 24.8% (95% CI, 22.9-26.8), similar in women (24.9%) and men (24.6%), and highest in the oldest age group (65-84 years) at 66.3%. In multivariable models, cadmium level in the highest quintile (HR, 1.35; 95% CI, 1.02-1.78), older age (HR, 1.36; 95% CI, 1.25-1.47), larger waist circumference (HR, 1.06; 95% CI, 1.01-1.11), and more plaque sites (1-3 sites: HR, 1.43; 95% CI, 1.07-1.92; 4-6 sites: HR, 2.75; 95% CI, 1.26-6.05) were among the factors associated with increased risk, while male sex (HR, 0.77; 95% CI, 0.60-0.98) and any alcohol consumption (HR, 0.61; 95% CI, 0.43-0.88) were associated with decreased risk. Results were similar when smoking status replaced cadmium exposure in the models. Lead level was not associated with increased risk. Conclusions and Relevance This study's findings suggest that incident CS impairment was common in the 10-year follow-up, with cadmium, but not lead, exposure associated with increased risk. The associations of diminished CS with other modifiable risk factors found appear to imply that changes in behavior may reduce future incidence of CS impairment.
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Affiliation(s)
- Adam J. Paulsen
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin - Madison
| | - Carla R. Schubert
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin - Madison
| | - Lauren J. Johnson
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin – Madison
| | - Yanjun Chen
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin - Madison
| | - Dayna S. Dalton
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin - Madison
| | - Barbara E. K. Klein
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin - Madison
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin - Madison
| | - Alex Pinto
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin - Madison
| | - Karen J. Cruickshanks
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin - Madison
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin – Madison
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Unhealthy behaviours and risk of visual impairment: The CONSTANCES population-based cohort. Sci Rep 2018; 8:6569. [PMID: 29700371 PMCID: PMC5920045 DOI: 10.1038/s41598-018-24822-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 03/29/2018] [Indexed: 01/19/2023] Open
Abstract
Unhealthy behaviours are linked to a higher risk of eye diseases, but their combined effect on visual function is unknown. We aimed to examine the individual and combined associations of diet, physical activity, smoking and alcohol consumption with visual impairment among French adults. 38 903 participants aged 18–73 years from the CONSTANCES nationwide cohort (2012–2016) with visual acuity measured and who completed, lifestyle, medical and food frequency questionnaires were included. Visual impairment was defined as a presenting visual acuity <20/40 in the better eye. After full multivariate adjustment, the odds for visual impairment increased with decreasing diet quality (p for trend = 0.04), decreasing physical activity (p for trend = 0.02) and increasing smoking pack-years (p for trend = 0.03), whereas no statistically significant association with alcohol consumption was found. Combination of several unhealthy behaviours was associated with increasing odds for visual impairment (p for trend = 0.0002), with a fully-adjusted odds ratio of 1.81 (95% CI 1.18 to 2.79) for participants reporting 2 unhealthy behaviours and 2.92 (95% CI 1.60 to 5.32) for those reporting 3 unhealthy behaviours. An unhealthy lifestyle including low/intermediate diet quality, low physical activity and heavy smoking was associated with visual impairment in this large population-based study.
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31
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Kivinen N. The role of autophagy in age-related macular degeneration. Acta Ophthalmol 2018; 96 Suppl A110:1-50. [PMID: 29633521 DOI: 10.1111/aos.13753] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Niko Kivinen
- Department of Ophthalmology; University of Eastern Finland; Kuopio Finland
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32
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Heinemann M, Welker SG, Holz FG, Finger RP. [Physical activity in older persons with eye diseases : Applicability of wrist-worn accelerometer]. Ophthalmologe 2018; 116:351-356. [PMID: 29564538 DOI: 10.1007/s00347-018-0688-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND OBJECTIVES Physical activity (PA) impacts age-related diseases but its measurement is difficult. The acceptance of wrist-worn accelerometers (ACC) in older patients with eye diseases was evaluated and the results were compared with a validated activity questionnaire. MATERIALS AND METHODS In this study 50 patients underwent a clinical examination and were interviewed with the International Physical Activity Questionnaire (IPAQ). They then wore an ACC for 7 days and then for 30 days. After descriptive analysis of the data, influencing factors on the PA were assessed using multiple, linear models. RESULTS A total of 94% of participants wore the ACC for 7 days and 74% for 30 days. For 36 patients complete data were available. In comparison, IPAQ (e. g. moderate PA: 1183.4 ± 864.3 min/week) vs. ACC across 7 and 30 days (248.5 ± 266.0 min/week and 248.8 ± 190.6 min/week, respectively) showed substantially higher results (p < 0.05 for both intervals). The ACC data across 7 and 30 days were comparable (e. g. high PA: 25.4 ± 33.7 min/week and 22.5 ± 29.0 min/week). In multiple, linear models body mass index (BMI) was associated with 7 days moderate activity (β = -0.22 [95% confidence intervals CI: -21.7; -1.9]; p = 0.021) and vigorous activity (β = -0.35 [95% CI: -4.3; -0.5]; p = 0.033) as well as 30 days vigorous activity (β = -0.45 [95% CI: -5.9; -0.1]; p = 0.044). Other factors such as better visual acuity, age and gender were not associated. CONCLUSION The use of ACCs are acceptable to the majority of older patients with eye diseases. The results of ACC are more precise with lower variation, and much lower PA than those of a comparable activity questionnaire. Measurement over 7 days is sufficient for capturing the average PA in older patients and can be easily applied in clinical trials.
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Affiliation(s)
- M Heinemann
- Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland
| | - S G Welker
- Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland
| | - F G Holz
- Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland
| | - R P Finger
- Universitäts-Augenklinik Bonn, Ernst-Abbe-Str. 2, 53127, Bonn, Deutschland.
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33
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Vottonen P. Anti-vascular endothelial growth factors treatment of wet age-related macular degeneration: from neurophysiology to cost-effectiveness. Acta Ophthalmol 2018; 96 Suppl A109:1-46. [PMID: 29468838 DOI: 10.1111/aos.13706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Pasi Vottonen
- Department of Ophthalmology; Kuopio University Hospital; University of Eastern Finland; Kuopio Finland
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34
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Li Y, Wang D. Association between PEDF gene polymorphisms and the risk of age-related macular degeneration. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2017; 10:11814-11818. [PMID: 31966545 PMCID: PMC6966057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 03/17/2016] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Pigment epithelium-derived factor (PEDF) strongly inhibits angiogenesis, and plays an important role in retinoblastoma cells. In this study we detect the association of PEDF gene polymorphisms (rs1136287 and rs12150053) and age-related macular degeneration (AMD) risk. METHODS This is a case-control study including 118 AMD patients and 121 healthy controls. PEDF gene polymorphisms were genotyped by TaqMan method. Hardy-Weinberg equilibrium (HWE) was used to detect the representativeness of the cases and controls. Differences of genotype and allele distributions of PEDF polymorphisms were calculated by Chi-square test. Odds ratios (ORs) and corresponding 95% confidence intervals (95% CIs) were used to present the relative risk of AMD. RESULTS Genotype and allele distributions in controls were in accordance with HWE. Genotype and allele distributions of rs1136287 had no significant association with the susceptibility of AMD under five contrast models (P<0.05). CC genotype and C allele of rs12150053 were higher in cases than that in controls, and rs12150053 was obviously related to the risk of AMD under T vs. C model (P=0.044, OR=1.499, 95% CI=1.009-2.226). CONCLUSION In this study, there was no obvious association between PEDF gene rs1136287 polymorphism and AMD susceptibility, and rs12150053T might act as a susceptible allele in the occurrence of AMD.
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Affiliation(s)
- Yuanyuan Li
- Department of Ophthalmology, Shangluo Second People's Hospital Shangluo, Shanxi, China
| | - Deliang Wang
- Department of Ophthalmology, Shangluo Second People's Hospital Shangluo, Shanxi, China
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McGuinness MB, Le J, Mitchell P, Gopinath B, Cerin E, Saksens NTM, Schick T, Hoyng CB, Guymer RH, Finger RP. Physical Activity and Age-related Macular Degeneration: A Systematic Literature Review and Meta-analysis. Am J Ophthalmol 2017; 180:29-38. [PMID: 28549846 DOI: 10.1016/j.ajo.2017.05.016] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 05/13/2017] [Accepted: 05/15/2017] [Indexed: 11/28/2022]
Abstract
PURPOSE To better understand the association, in a white population, of physical activity and age-related macular degeneration (AMD)-the main cause of irreversible severe vision loss in developed countries-given the suggestion that a healthy lifestyle may assist in delaying the onset and progression of AMD. DESIGN Systematic review and meta-analysis. METHODS Medline, EMBASE, and Google Scholar were systematically searched for studies up to May 2015. Reference lists of published articles were hand searched and study authors were contacted to provide additional data. Those in the lowest category of activity in each study were compared with all other participants to assess the association between physical activity and both early and late AMD using random-effects meta-analysis. RESULTS Nine studies (subject age range 30-97 years) were included in the meta-analysis. Physical activity was found to have a protective association with both early AMD (8 studies, n = 38 112, odds ratio (OR) 0.92, 95% confidence interval [CI] 0.86-0.98) and late AMD (7 studies, n = 28 854, OR 0.59, 95% CI 0.49-0.72). CONCLUSIONS Physical activity is associated with lower odds of early and late AMD in white populations. These findings have important implications, reinforcing the public health message of staying active throughout life. However, further longitudinal studies are required to confirm and further characterize a protective effect of physical activity on the onset and/or progression of AMD.
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Affiliation(s)
- Myra B McGuinness
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital & Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Jerome Le
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital & Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Bamini Gopinath
- Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Ester Cerin
- Australian Catholic University, Melbourne, Australia
| | | | - Tina Schick
- Department of Ophthalmology, University Hospital of Cologne, Cologne, Germany
| | - Carel B Hoyng
- Ophthalmology, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Robyn H Guymer
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital & Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Robert P Finger
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital & Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia; Department of Ophthalmology, University of Bonn, Bonn, Germany.
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Tuuminen R, Uusitalo-Järvinen H, Aaltonen V, Hautala N, Kaipiainen S, Laitamäki N, Ollila M, Rantanen J, Välimäki S, Sipilä R, Laukkala T, Komulainen J, Tommila P, Immonen I, Tuulonen A, Kaarniranta K. The Finnish national guideline for diagnosis, treatment and follow-up of patients with wet age-related macular degeneration. Acta Ophthalmol 2017; 95:1-9. [PMID: 28686003 DOI: 10.1111/aos.13501] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Age-related macular degeneration (AMD) is the main cause of visual impairment in developed countries. Several improvements in the visualization of posterior segment of the eye together with the introduction of intravitreal anti-VEGF treatment have revolutionized the prognosis of the wet form of AMD (wAMD). Increasing incidence of wAMD together with the limited resources of society and of the healthcare system poses challenges for the provision and development of care. In context of these current aspects, we aimed to set evidence-based medical guidelines for diagnosis, treatment and follow-up of patients with wAMD.
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Affiliation(s)
- Raimo Tuuminen
- Department of Ophthalmology; Kymenlaakso Central Hospital; Kotka Finland
- Helsinki Retina Research Group; University of Helsinki; Helsinki Finland
- Patient Insurance Centre; Helsinki Finland
| | | | - Vesa Aaltonen
- Department of Ophthalmology; Turku University Hospital; Turku Finland
| | - Nina Hautala
- Department of Ophthalmology; Oulu University Hospital; Oulu Finland
- Medical Research Center; University of Oulu; Oulu Finland
| | - Sulevi Kaipiainen
- Department of Ophthalmology; North Karelian Central Hospital; Joensuu Finland
| | - Nina Laitamäki
- Department of Ophthalmology; Kanta-Häme Central Hospital; Hämeenlinna Finland
| | - Marko Ollila
- Department of Ophthalmology; Lapland Central Hospital; Rovaniemi Finland
| | - Jari Rantanen
- Department of Ophthalmology; Satakunta Central Hospital; Pori Finland
| | - Satu Välimäki
- Department of Ophthalmology; Päijät-Häme Central Hospital; Lahti Finland
| | - Raija Sipilä
- The Finnish Medical Society Duodecim; Helsinki Finland
| | | | | | - Petri Tommila
- Department of Ophthalmology; Helsinki University Hospital; Helsinki Finland
| | - Ilkka Immonen
- Department of Ophthalmology; Helsinki University Hospital; Helsinki Finland
| | - Anja Tuulonen
- Tays Eye Centre; Tampere University Hospital; Tampere Finland
| | - Kai Kaarniranta
- Department of Ophthalmology; Kuopio University Hospital; Kuopio Finland
- Department of Ophthalmology; Institute of Clinical Medicine; University of Eastern Finland; Kuopio Finland
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Schubert CR, Fischer ME, Pinto AA, Klein BEK, Klein R, Tweed TS, Cruickshanks KJ. Sensory Impairments and Risk of Mortality in Older Adults. J Gerontol A Biol Sci Med Sci 2017; 72:710-715. [PMID: 26946102 DOI: 10.1093/gerona/glw036] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 02/11/2016] [Indexed: 11/13/2022] Open
Abstract
Background Sensory impairments increase with age and the majority of older people will experience a sensory impairment if they live long enough. However, the relationships of hearing, visual, and olfactory impairments with mortality are not well understood. Methods Epidemiology of Hearing Loss Study participants (n = 2,418) aged 53-97 years (mean = 69 years) were examined in 1998-2000 and hearing, visual acuity, and olfaction were measured. Participants were followed for mortality for up to 17 years (mean = 12.8 years). Cox proportional hazards models were used to assess the association between prevalent sensory impairments and the 15-year cumulative incidence of death. Results A total of 1,099 (45.4%) of participants died during the follow-up period. In age- and sex-adjusted Cox models, the risk of mortality was higher among participants with one (hazard ratio [HR] = 1.40, 95% confidence interval [CI] = 1.19, 1.64) or two or more (HR = 2.12, 95% CI = 1.74, 2.58) sensory impairments than among participants with no sensory impairments. Olfactory impairment at baseline was significantly associated with mortality (HR = 1.28, 95% CI = 1.07, 1.52) after adjusting for age, sex, sensory comorbidities, cardiovascular risk factors and disease, cognitive impairment, frailty, subclinical atherosclerosis, and inflammatory marker levels (n = 1,745). Hearing and visual impairment were not associated with mortality after adjusting for subclinical atherosclerosis and inflammation. Conclusion Olfactory impairment, but not hearing or visual impairment, was associated with an increased risk of mortality. These results suggest that olfactory impairment may be a marker of underlying physiologic processes or pathology that is associated with aging and reduced survival in older adults.
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Affiliation(s)
| | | | - A Alex Pinto
- Department of Ophthalmology and Visual Sciences and
| | | | - Ronald Klein
- Department of Ophthalmology and Visual Sciences and
| | - Ted S Tweed
- Department of Ophthalmology and Visual Sciences and
| | - Karen J Cruickshanks
- Department of Ophthalmology and Visual Sciences and.,Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison
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Association of alcohol intake with risk of diabetic retinopathy: a meta-analysis of observational studies. Sci Rep 2017; 7:4. [PMID: 28127054 PMCID: PMC5428369 DOI: 10.1038/s41598-017-00034-w] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 12/20/2016] [Indexed: 01/10/2023] Open
Abstract
Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus (DM). The associations of alcohol intake with DR risk have demonstrated contradictory results. Relevant studies were identified by searching electronic databases (Medline, EMBASE and Web of Science) until May 2016. We identified a total of 12,875 DR cases among 37,285 participants in 15 observational studies. The pooled estimation of all the included observational studies was 0.91 (95% CI, 0.79 to 1.06) in a random-effect model. Analyses stratified by study design showed no significant association between alcohol intake and DR incidence in cohort, case control or cross-sectional studies. In the subgroup analyses, neither beer nor spirits intake were associated with DR risk. Furthermore, it was interesting to find that protective effects were detected in the wine (OR = 0.77, 95% CI = 0.64 to 0.92) and sherry (OR = 0.22, 95% CI = 0.05 to 0.95) groups. In conclusion, this current meta-analysis demonstrated that alcohol intake was not associated with risk of DR. Subgroup analysis by alcoholic beverage types showed that wine consumption would reduce the incidence of DR. In the future, more large-scale prospective studies with detailed alcohol subtypes and contents are still warranted to clarify the association.
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Hu JY, Yan L, Chen YD, Du XH, Li TT, Liu DA, Xu DH, Huang YM, Wu Q. Population-based survey of prevalence, causes, and risk factors for blindness and visual impairment in an aging Chinese metropolitan population. Int J Ophthalmol 2017; 10:140-147. [PMID: 28149791 DOI: 10.18240/ijo.2017.01.23] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 07/23/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To assess the prevalence, causes, and risk factors for blindness and visual impairment among elderly (≥60 years of age) Chinese people in a metropolitan area of Shanghai, China. METHODS Random cluster sampling was conducted to identify participants among residents ≥60 years of age living in the Xietu Block, Xuhui District, Shanghai, China. Presenting visual acuity (PVA) and best-corrected visual acuity (BCVA) were checked by the Early Treatment Diabetic Retinopathy Study (ETDRS) visual chart. All eligible participants underwent a comprehensive eye examination. Blindness and visual impairment were defined according to World Health Organization (WHO) criteria. RESULTS A total of 4190 persons (1688 men and 2502 women) participated in the study, and the response rate was 91.1%. Based on PVA, the prevalence of blindness was 1.1% and that of visual impairment was 7.6%. Based on BCVA, the prevalence of blindness and visual impairment decreased to 0.9% and 3.9%, respectively. Older (≥80 years of age) women, with low educational levels and smoking habits, exhibited a significantly greater chance for blindness and visual impairment than did those with high educational levels and no smoking habits (P<0.05). Based on PVA and BCVA, the main causes of blindness were cataract, myopic maculopathy, and age-related macular degeneration (AMD). CONCLUSION Our findings help to identify the population in need of intervention, to highlight the need for additional eye healthcare services in urban China.
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Affiliation(s)
- Jian-Yan Hu
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Liang Yan
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Yong-Dong Chen
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Xin-Hua Du
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Ting-Ting Li
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - De-An Liu
- Community Health Center, Xietu Street, Xuhui District, Shanghai 200233, China
| | - Dong-Hong Xu
- Community Health Center, Xietu Street, Xuhui District, Shanghai 200233, China
| | - Yi-Min Huang
- Community Health Center, Xietu Street, Xuhui District, Shanghai 200233, China
| | - Qiang Wu
- Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
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Siegel M. Self-perceived vision in farming, forestry, and fishing occupations. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2017; 72:20-25. [PMID: 26894930 DOI: 10.1080/19338244.2016.1148005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 01/15/2016] [Indexed: 06/05/2023]
Abstract
Using data from the 2005-2006 and 2007-2008 NHANES questionnaires, we evaluated self-perceived vision difficulty in individuals with a history of farming, forestry, and fishing (FFF) occupations. A self-perceived vision difficulty indicator was derived from responses to 3 separate measures. Those indicating farming, forestry, or fishing as longest job worked were classified as having an FFF history and compared to those reporting any other occupation. Logistic regression analyses utilizing NHANES sampling weights were conducted. After controlling for age, gender, race/ethnicity, education, and income-to-poverty ratio, those with an FFF history were 76% more likely to report vision difficulty than those having an alternate occupational history. Personal protective equipment and routine optometric examination may be particularly prudent for this occupational group.
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Affiliation(s)
- Miriam Siegel
- a Department of Epidemiology , College of Public Health, University of Kentucky , Lexington , Kentucky , USA
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Fischer ME, Cruickshanks KJ, Schubert CR, Pinto AA, Carlsson CM, Klein BEK, Klein R, Tweed TS. Age-Related Sensory Impairments and Risk of Cognitive Impairment. J Am Geriatr Soc 2016; 64:1981-1987. [PMID: 27611845 PMCID: PMC5073029 DOI: 10.1111/jgs.14308] [Citation(s) in RCA: 157] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the associations between sensory impairments and 10-year risk of cognitive impairment. DESIGN The Epidemiology of Hearing Loss Study (EHLS), a longitudinal, population-based study of aging in the Beaver Dam, Wisconsin community. Baseline examinations were conducted in 1993 and follow-up examinations have been conducted every 5 years. SETTING General community. PARTICIPANTS EHLS members without cognitive impairment at EHLS-2 (1998-2000). There were 1,884 participants (mean age 66.7) with complete EHLS-2 sensory data and follow-up information. MEASUREMENTS Cognitive impairment was defined as a Mini-Mental State Examination score of <24 or history of dementia or Alzheimer's disease. Hearing impairment was a pure-tone average of hearing thresholds (0.5, 1, 2, 4 kHz) of >25 dB hearing level in either ear, visual impairment was a Pelli-Robson contrast sensitivity of <1.55 log units in the better eye, and olfactory impairment was a San Diego Odor Identification Test score of <6. RESULTS Hearing, visual, and olfactory impairment were independently associated with cognitive impairment risk (hearing: hazard ratio (HR) = 1.90, 95% confidence interval (CI) = 1.11-3.26; vision: HR = 2.05, 95% CI = 1.24-3.38; olfaction: HR = 3.92, 95% CI = 2.45-6.26)). Nevertheless, 85% of participants with hearing impairment, 81% with visual impairment, and 76% with olfactory impairment did not develop cognitive impairment during follow-up. CONCLUSION The relationship between sensory impairment and cognitive impairment was not unique to one sensory system, suggesting that sensorineural health may be a marker of brain aging. The development of a combined sensorineurocognitive measure may be useful in uncovering mechanisms of healthy brain aging.
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Affiliation(s)
- Mary E Fischer
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.
| | - Karen J Cruickshanks
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Carla R Schubert
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Alex A Pinto
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Cynthia M Carlsson
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
- Division of Geriatrics and Gerontology, Department of Medicine, Geriatric Research, Education and Clinical Center, Department of Veterans Affairs, Madison, Wisconsin
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
| | - Ted S Tweed
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin
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Meyers KJ, Liu Z, Millen AE, Iyengar SK, Blodi BA, Johnson E, Snodderly DM, Klein ML, Gehrs KM, Tinker L, Sarto GE, Robinson J, Wallace RB, Mares JA. Joint Associations of Diet, Lifestyle, and Genes with Age-Related Macular Degeneration. Ophthalmology 2015; 122:2286-94. [PMID: 26354764 PMCID: PMC4714866 DOI: 10.1016/j.ophtha.2015.07.029] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 07/23/2015] [Accepted: 07/27/2015] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Unhealthy lifestyles have been associated with increased odds for age-related macular degeneration (AMD). Whether this association is modified by genetic risk for AMD is unknown and was investigated. DESIGN Interactions between healthy lifestyles AMD risk genotypes were studied in relation to the prevalence of AMD, assessed 6 years later. PARTICIPANTS Women 50 to 79 years of age in the Carotenoids in Age-Related Eye Disease Study with exposure and AMD data (n=1663). METHODS Healthy lifestyle scores (0-6 points) were assigned based on Healthy Eating Index scores, physical activity (metabolic equivalent of task hours/week), and smoking pack years assessed in 1994 and 1998. Genetic risk was based on Y402H in complement factor H (CFH) and A69S in age-related maculopathy susceptibility locus 2 (ARMS2). Additive and multiplicative interactions in odds ratios were assessed using the synergy index and a multiplicative interaction term, respectively. MAIN OUTCOME MEASURES AMD presence and severity were assessed from grading of stereoscopic fundus photographs taken in 2001-2004. AMD was present in 337 women, 91% of whom had early AMD. RESULTS The odds of AMD were 3.3 times greater (95% confidence interval [CI], 1.8-6.1) in women with both low healthy lifestyle score (0-2) and high-risk CFH genotype (CC), relative to those who had low genetic risk (TT) and high healthy lifestyle scores (4-6). There were no significant additive (synergy index [SI], 1.08; 95% CI, 0.70-1.67) or multiplicative (Pinteraction=0.94) interactions in the full sample. However, when limiting the sample to women with stable diets before AMD assessment (n=728) the odds for AMD associated with low healthy lifestyle scores and high-risk CFH genotype were strengthened (odds ratio, 4.6; 95% CI, 1.8-11.6) and the synergy index was significant (SI, 1.34; 95% CI, 1.05-1.70). Adjusting for dietary lutein and zeaxanthin attenuated, and therefore partially explained, the joint association. There were no significant additive or multiplicative interactions for ARMS2 and lifestyle score. CONCLUSIONS Having unhealthy lifestyles and 2 CFH risk alleles increased AMD risk (primarily in the early stages), in an or additive or greater (synergistic) manner. However, unhealthy lifestyles increased AMD risk regardless of AMD risk genotype.
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Affiliation(s)
- Kristin J Meyers
- Department of Ophthalmology and Visual Sciences, McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Zhe Liu
- Department of Ophthalmology and Visual Sciences, McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Amy E Millen
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York
| | - Sudha K Iyengar
- Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio
| | - Barbara A Blodi
- Department of Ophthalmology and Visual Sciences, McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Elizabeth Johnson
- Jean Mayer USDA Human Nutrition, Research Center on Aging, Tufts University, Boston, Massachusetts
| | - D Max Snodderly
- Department of Neuroscience, University of Texas, Austin, Texas
| | - Michael L Klein
- Casey Eye Institute, Department of Ophthalmology, Oregon Health & Science University, Portland, Oregon
| | - Karen M Gehrs
- Department of Ophthalmology & Visual Sciences, University of Iowa Hospital & Clinics, Iowa City, Iowa
| | - Lesley Tinker
- Department of Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Gloria E Sarto
- Department of Obstetrics & Gynecology, School of Medicine & Public Health, University of Wisconsin, Madison, Wisconsin
| | - Jennifer Robinson
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| | - Robert B Wallace
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa
| | - Julie A Mares
- Department of Ophthalmology and Visual Sciences, McPherson Eye Research Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
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Kang HM, Woo YJ, Koh HJ, Lee CS, Lee SC. The effect of consumption of ethanol on subfoveal choroidal thickness in acute phase. Br J Ophthalmol 2015. [PMID: 26206787 DOI: 10.1136/bjophthalmol-2015-306969] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS To investigate the acute effect of ethanol consumption on subfoveal choroidal thickness. METHODS This prospective interventional study included the right eyes of 30 healthy subjects (30 eyes). Ethanol (1.0 g/kg) was administered orally on the first visit. A matching volume of water was administered orally on the second visit. Oral administration of ethanol and water was performed at 14:00, and choroidal thickness was measured every 30 min until 16:00. Change of choroidal thickness after oral administration of ethanol and water was the main outcome measure. RESULTS At baseline, choroidal mean subfoveal thickness was 299.0±73.4 µm (range, 186.5-472.5 µm) before ethanol consumption and 297.1±71.1 µm (range, 187.0-470.5 µm) before water consumption. After consumption of ethanol, mean subfoveal choroidal thickness increased during the first 60 min and then decreased during the next 60 min, which was a significant change over time (p<0.001). After consumption of water, there was no significant change in mean subfoveal choroidal thickness over time (p=0.310). Comparison of changes in the mean subfoveal choroidal thickness during 120 min showed significant difference between ethanol and water consumption (p<0.001). CONCLUSIONS The results of current study show that consumption of ethanol significantly affected the choroidal thickness. Mean subfoveal choroidal thickness increased during the first 60 min and then decreased during the next 120 min after ethanol consumption.
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Affiliation(s)
- Hae Min Kang
- Department of Ophthalmology, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Republic of Korea Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young Jae Woo
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyoung Jun Koh
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Christopher Seungkyu Lee
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Chul Lee
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
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Liljas AEM, Wannamethee SG, Whincup PH, Papacosta O, Walters K, Iliffe S, Lennon LT, Carvalho LA, Ramsay SE. Socio-demographic characteristics, lifestyle factors and burden of morbidity associated with self-reported hearing and vision impairments in older British community-dwelling men: a cross-sectional study. J Public Health (Oxf) 2015; 38:e21-8. [PMID: 26177816 DOI: 10.1093/pubmed/fdv095] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hearing and vision problems are common in older adults. We investigated the association of self-reported sensory impairment with lifestyle factors, chronic conditions, physical functioning, quality of life and social interaction. METHODS A population-based cross-sectional study of participants of the British Regional Heart Study aged 63-85 years. RESULTS A total of 3981 men (82% response rate) provided data. Twenty-seven per cent (n = 1074) reported hearing impairment including being able to hear with aid (n = 482), being unable to hear (no aid) (n = 424) and being unable to hear despite aid (n = 168). Three per cent (n = 124) reported vision impairment. Not being able to hear, irrespective of use of hearing aid, was associated with poor quality of life, poor social interaction and poor physical functioning. Men who could not hear despite hearing aid were more likely to report coronary heart disease (CHD) [age-adjusted odds ratios (ORs) 1.89 (95% confidence interval 1.36-2.63)]. Vision impairment was associated with symptoms of CHD including breathlessness [OR 2.06 (1.38-3.06)] and chest pain [OR 1.58 (1.07-2.35)]. Vision impairment was also associated with poor quality of life, poor social interaction and poor physical functioning. CONCLUSIONS Sensory impairment is associated with poor physical functioning, poor health and poor social interaction in older men. Further research is warranted on pathways underlying these associations.
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Affiliation(s)
- A E M Liljas
- Department of Primary Care and Population Health, University College London, London, UK
| | - S G Wannamethee
- Department of Primary Care and Population Health, University College London, London, UK
| | - P H Whincup
- Population Health Research Centre, Division of Population Health Sciences and Education, St George's, University of London, London, UK
| | - O Papacosta
- Department of Primary Care and Population Health, University College London, London, UK
| | - K Walters
- Department of Primary Care and Population Health, University College London, London, UK
| | - S Iliffe
- Department of Primary Care and Population Health, University College London, London, UK
| | - L T Lennon
- Department of Primary Care and Population Health, University College London, London, UK
| | - L A Carvalho
- Research Department of Epidemiology and Public Health, University College London, London, UK
| | - S E Ramsay
- Department of Primary Care and Population Health, University College London, London, UK
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Ozgonul C, Sertoglu E, Mumcuoglu T. Determination of visual impairment associated with alcohol consumption. Ophthalmic Epidemiol 2015; 22:142-3. [PMID: 25777315 DOI: 10.3109/09286586.2015.1010690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Cem Ozgonul
- Van Military Hospital, Department of Ophthalmology , Van , Turkey
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Shih YH, Chang HY, Lu MI, Hurng BS. Time trend of prevalence of self-reported cataract and its association with prolonged sitting in Taiwan from 2001 and 2013. BMC Ophthalmol 2014; 14:128. [PMID: 25370503 PMCID: PMC4232657 DOI: 10.1186/1471-2415-14-128] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 10/22/2014] [Indexed: 01/09/2023] Open
Abstract
Background Prolong sitting has been found associated with metabolic disorders. Little is known about the self-reported cataract status in general population of Taiwan, not to mention its relation to prolong sitting. We aimed to examine the prevalence of cataract between 2001 and 2013 in Taiwan and to the association between prolonged sitting and cataract. Methods We used three data sets with those aged 40 years and older from the National Health Interview Survey (NHIS) from 2001 (n = 8334), 2009 (n = 11207), and 2013 (n = 10940). Subsequent statistical analyses involved chi-square test, t test, and logistic regression modeling. SUDAAN was used to account for sampling scheme. Results The prevalence of cataract ranged from 10.7% in 2001, 13.13% in 2009, to 11.84% in 2013. Participants who sat for more than 7 hours per day had a significantly higher risk of cataract (OR = 1.20, CI = (1.04-1.39)) compared with those who sat for fewer than 3 hours per day after controlling for age and other risk factors like being older or female, lower education level, not being currently employed, living in a highly urbanized area, having hypertension, diabetes, myopia, and being an former smoker (compared to a never smoker). Conclusion Increased daily sitting time was associated with cataract, especially for people who sat more than 7 hours per day.
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Affiliation(s)
| | - Hsing-Yi Chang
- Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan Town, Miaoli County 350, Taiwan.
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