Ocular and Health Trajectories: The SEE Study

眼睛与健康轨迹：SEE 研究

• 批准号: 8032094
• 负责人: David J Lee
• 金额: $ 24.36万
• 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 2013-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8032094
• 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; 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：视力问题是负责美国人残疾的十大条件之一；这些条件通常与死亡风险增加有关。本研究将利用结构方程建模（SEM）来研究视觉障碍与其他人之间的联系具有发病率状况和死亡率风险的眼部条件回答以下问题：1）眼部系统对整体健康和功能状况的变化有何相对贡献？ 2）通过有效的眼部状况医疗管理或风险因素修改（例如，戒烟）可以改善眼部健康，导致功能状况的改善和降低死亡率风险？ 3）眼系统是否会直接导致死亡率的风险增加，还是通过对功能状态指标的不利影响间接影响死亡率风险？ 4）视觉障碍（VI）在老化过程中的作用是什么？也就是说，vi仅仅是潜在脆弱的症状还是与健康状况恶化有关？这项研究的数据将来自索尔兹伯里眼睛评估（SEE）项目，这是一项对老年人的视力和功能的研究。该研究招募了2520名社区居民65至84岁的随机样本。参与者接受了全面的视力测试和眼检查，并接受了多次功能状态测试，其中一部分在10年内在随后的三轮中重复。 2003年通过2003年获得死亡率状态；整个队列与国家死亡指数（NDI）的完整连锁2009年是本申请的一部分，将产生足够数量的死亡和随访年度，以可靠地检测到危害比率关联的危险比率小于80。 ％ 力量。这种统计能力以及对四个时间段评估的眼和功能状态指标的全面评估，将使我们能够：1）检查视力敏锐度的变化与功能迁移率变化与功能性流动性变化与其他发病率指标之间的关联（例如，抓地力（例如，握把）力量）和抑郁症状，请参与参与者调整时期的眼部状况，并选择健康状况和慢性疾病风险因素； 2）检查与视力相关因素之间的关联（例如，视敏度状态的变化，眼睛状况的存在，眼部医疗保健利用）和与健康相关的因素（例如健康行为，健康状况和死亡率风险）。拟议的研究旨在支持国家眼睛研究所（NEI）眼部流行病学战略计划报告，包括：1）确定眼病的负担及其在不断变化的人群中的视觉结果，以及2）开发新方法来支持眼科流行病学研究。 公共卫生相关性：视力问题是负责美国人残疾的十大条件之一，也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条件对健康，功能和死亡风险的发展的作用。它还将确定因治疗（例如白内障手术）和/或生活方式改善（例如，戒烟）的视觉功能改善是否会改善健康和较低的死亡风险。