Ocular and Health Trajectories: The SEE Study

眼睛与健康轨迹：SEE 研究

• 批准号: 8217220
• 负责人: David J Lee
• 金额: $ 19.4万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-02-01 至 2014-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8217220
• 关键词: Address; Age-Years; Aging; Aging-Related Process; American; Annual Reports; Automobile Driving; Caring; Cataract Extraction; Cessation of life; Child; Chronic Disease; Cognitive; Communities; Contrast Sensitivity; Coupled; Data; Data Set; Diagnosis; Elderly; Enrollment; Epidemiologic Studies; Epidemiology; Equation; Evaluation; Evaluation Studies; Eye; Eye diseases; Goals; Health; Health Status; Health Surveys; Health behavior; Individual; Lead; Life; Life Style; Link; Longitudinal Studies; Malignant Neoplasms; Medical; Methodology; Modeling; Modification; Monitor; Morbidity - disease rate; Names; National Eye Institute; National Health Interview Survey; National Health and Nutrition Examination Survey; Outcome; Participant; Persons; Population; Productivity; Quality of life; Relative (related person); Reporting; Research; Risk; Risk Factors; Role; Sampling; Scientist; Smoking; Social Security Number; Strategic Planning; Symptoms; System; Techniques; Testing; Time; Universities; Vision; Vision Tests; Visit; Visual; Visual Acuity; Visual impairment; cohort; depressive symptoms; disability; disorder risk; experience; flexibility; follow-up; frailty; functional status; grasp; hazard; health care service utilization; improved; indexing; mortality; public health relevance; smoking cessation; vision development

DESCRIPTION (provided by applicant: Vision problems are among the top ten conditions responsible for disability among Americans; these conditions are often associated with an increased risk of death. This study will utilize structural equation modeling (SEM) to study linkages between visual impairment and other ocular conditions with morbidity status and mortality risk to answer the following questions: 1) What is the relative contribution of ocular system declines to changes in overall health and functional status?; 2) Do improvements in ocular health, either via effective medical management of ocular conditions or risk factor modification (e.g., smoking cessation) lead to improvements in functional status and lower mortality risk?; 3) Do ocular system declines directly lead to an increased risk of mortality, or do these changes also indirectly influence mortality risk via adverse impacts on functional status indicators?; and 4) What is the role of visual impairment (VI) in the aging process? That is, is VI simply a symptom of underlying frailty or is it independently associated with worsening health? Data for this study will come from the Salisbury Eye Evaluation (SEE) Project, a study of vision and function in older adults. The study enrolled a random sample of 2520 community residents 65 to 84 years of age. Participants underwent comprehensive vision testing and ocular examinations, and were administered multiple tests of functional status, portions of which were repeated in three subsequent rounds over a 10-year period. Mortality status was obtained thru 2003; full linkage of the entire cohort with the National Death Index (NDI) thru 2009 is proposed as part of this application and will yield a sufficient number of deaths and person-years of follow-up to reliably detect hazard ratio associations smaller than 1.34 with 80% power. This statistical power, in combination with the comprehensive assessment of ocular and functional status indicators assessed over four time periods, will enable us to: 1) examine associations between change in visual acuity levels and change in functional mobility and other morbidity indicators (e.g., grip strength) and depressive symptoms among SEE participants following adjustment for time-varying ocular conditions, and select health conditions and chronic disease risk factors; and 2) examine associations between vision related factors (e.g. changes in visual acuity status, presence of ocular conditions, ocular healthcare utilization) and health-related factors (e.g. health behaviors, health conditions, and mortality risk). Proposed study aims support key goals of the National Eye Institute (NEI) Ocular Epidemiology Strategic Planning Report, including: 1) Determine the burden of eye diseases and their visual outcomes in a changing population, and 2) develop new methodologies to support ophthalmic epidemiological research. PUBLIC HEALTH RELEVANCE: Vision problems are among the top ten conditions responsible for disability among Americans and are also associated with an increased risk of death. This study will examine, in a comprehensive manner, the role of the development of these vision conditions on health, functioning, and risk of death. It will also determine if improvements in visual functioning due to either treatment (e.g., cataract surgery) and/or improvements in lifestyle (e.g., smoking cessation) leads to improved health and a lower risk of death.

描述（由申请人提供：视力问题是导致美国人残疾的十大病症之一；这些病症通常与死亡风险增加相关。本研究将利用结构方程模型 (SEM) 来研究视力障碍与其他疾病之间的联系眼部疾病的发病状况和死亡风险，回答以下问题：1) 眼部系统衰退对整体健康和功能状态变化的相对贡献是什么？ 2）通过对眼部疾病进行有效的医疗管理或改变危险因素（例如戒烟）来改善眼部健康是否会导致功能状态的改善和死亡率风险的降低？ 3）眼系统衰退是否直接导致死亡风险增加，或者这些变化是否也通过对功能状态指标的不利影响间接影响死亡风险？ 4) 视力障碍 (VI) 在衰老过程中起什么作用？也就是说，VI 仅仅是潜在虚弱的症状，还是与健康状况恶化独立相关？这项研究的数据将来自索尔兹伯里眼科评估 (SEE) 项目，该项目是一项针对老年人视力和功能的研究。该研究随机招募了 2520 名 65 至 84 岁的社区居民。参与者接受了全面的视力测试和眼部检查，并接受了多项功能状态测试，其中部分测试在 10 年期间的后续三轮中重复进行。 2003 年之前获得了死亡率状况；作为本申请的一部分，提议将整个队列与 2009 年全国死亡指数 (NDI) 完全联系起来，并将产生足够数量的死亡和人年随访，以可靠地检测小于 1.34 的风险比与 80 ％ 力量。这种统计能力，与四个时间段内对眼睛和功能状态指标的综合评估相结合，将使我们能够：1）检查视力水平变化与功能活动度变化和其他发病指标（例如握力）之间的关联调整随时间变化的眼部状况后，SEE 参与者的抑郁症状，并选择健康状况和慢性病风险因素； 2) 检查视力相关因素（例如视力状态的变化、眼部疾病的存在、眼部医疗保健利用）与健康相关因素（例如健康行为、健康状况和死亡风险）之间的关联。拟议的研究旨在支持国家眼科研究所 (NEI) 眼流行病学战略规划报告的主要目标，包括：1) 确定不断变化的人群中眼部疾病的负担及其视力结果，2) 开发新的方法来支持眼科流行病学研究。 公共卫生相关性：视力问题是导致美国人残疾的十大疾病之一，并且还与死亡风险增加有关。这项研究将以全面的方式研究这些视力状况的发展对健康、功能和死亡风险的作用。它还将确定由于治疗（例如白内障手术）和/或生活方式的改善（例如戒烟）引起的视觉功能的改善是否会改善健康状况并降低死亡风险。

项目成果

Visual acuity and increased mortality: the role of allostatic load and functional status.

视力和死亡率增加：稳态负荷和功能状态的作用。

• DOI: 10.1167/iovs.14-14202
• 发表时间: 2014
• 期刊: Investigative ophthalmology & visual science
• 影响因子: 4.4
• 作者: Zheng,DDiane;Christ,SharonL;Lam,ByronL;Tannenbaum,StaceyL;Bokman,ChristineL;Arheart,KristopherL;McClure,LauraA;Fernandez,CristinaA;Lee,DavidJ
• 通讯作者: Lee,DavidJ

Structural equation modeling: a framework for ocular and other medical sciences research.

• DOI: 10.3109/09286586.2013.867508
• 发表时间: 2014-03
• 期刊: Ophthalmic epidemiology
• 影响因子: 1.8
• 作者: Christ SL;Lee DJ;Lam BL;Zheng DD
• 通讯作者: Zheng DD