Guan-Hua Huang

Dry Eye in the Beaver Dam Offspring Study: Prevalence, Risk Factors, and Health-Related Quality of Life

PURPOSE To estimate dry eye prevalence in the Beaver Dam Offspring Study (BOSS), including a young adult population, and investigate associated risk factors and impact on health-related quality of life. DESIGN Cohort study. METHODS The BOSS (2005-2008) is a study of aging in the adult offspring of the population-based Epidemiology of Hearing Loss Study cohort. Questionnaire data on health history, medication use, risk factors, and quality of life were available for 3275 participants. Dry eye was determined by self-report of frequency of symptoms and the intensity of those symptoms. Associations between dry eye and risk factors were analyzed using logistic regression. RESULTS The prevalence of dry eye in the BOSS was 14.5%: 17.9% of women and 10.5% of men. In a multivariate model, statistically significant associations were found with female sex (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.33-2.11), current contact lens use (OR, 2.01; 95% CI, 1.53-2.64), allergies (OR, 1.59; 95% CI, 1.22-2.08), arthritis (OR, 1.44; 95% CI, 1.12-1.85), thyroid disease (OR, 1.43; 95% CI, 1.02-1.99), antihistamine use (OR, 1.54; 95% CI, 1.18-2.02), and steroid use (OR, 1.54; 95% CI, 1.16-2.06). Dry eye was also associated with lower scores on the Medical Outcomes Study Short Form 36 (β = -3.9, P < .0001) as well as on the National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25) (β = -3.4, P < .0001) when controlling for age, sex, and comorbid conditions. CONCLUSIONS The prevalence of dry eye and its associated risk factors in the BOSS were similar to previous studies. In this study, dry eye was associated with lower quality of life on a health-related quality-of-life instrument and the vision-specific NEI VFQ-25.

Generational Differences in the Prevalence of Hearing Impairment in Older Adults

There were significant changes in health and lifestyle throughout the 20th century which may have changed temporal patterns of hearing impairment in adults. In this study, the authors aimed to assess the effect of birth cohort on the prevalence of hearing impairment in an adult population aged 45-94 years, using data collected between 1993 and 2008 from 3 cycles of the Epidemiology of Hearing Loss Study (n = 3,753; ages 48-92 years at baseline) and a sample of participants from the Beaver Dam Offspring Study (n = 2,173; ages > or =45 years). Hearing impairment was defined as a pure-tone average of thresholds at 0.5, 1, 2, and 4 kHz greater than 25-dB HL [hearing level]. Descriptive analysis, generalized additive models, and alternating logistic regression models were used to examine the birth cohort effect. Controlling for age, with every 5-year increase in birth year, the odds of having hearing impairment were 13% lower in men (odds ratio = 0.87, 95% confidence interval: 0.83, 0.92) and 6% lower in women (odds ratio = 0.94, 95% confidence interval: 0.89, 0.98). These results suggest that 1) older adults may be retaining good hearing longer than previous generations and 2) modifiable factors contribute to hearing impairment in adults.

Tinnitus and its risk factors in the Beaver Dam Offspring Study

Abstract Objective: To assess the prevalence of tinnitus along with factors potentially associated with having tinnitus. Design: Data were from the Beaver Dam Offspring Study, an epidemiological cohort study of aging. Study Sample: After a personal interview and audiometric examination, participants (n = 3267, ages 21–84 years) were classified as having tinnitus if in the past year they reported having tinnitus of at least moderate severity or that caused difficulty in falling asleep. Results: The prevalence of tinnitus was 10.6%. In a multivariable logistic regression model adjusting for age and sex, the following factors were associated with having tinnitus: hearing impairment (Odds Ratio (OR) = 3.20), currently having a loud job (OR = 1.90), history of head injury (OR = 1.84), depressive symptoms (OR = 1.82), history of ear infection (men, OR = 1.75), history of target shooting (OR = 1.56), arthritis (OR = 1.46), and use of NSAID medications (OR = 1.33). For women, ever drinking alcohol in the past year was associated with a decreased risk of having tinnitus (OR = 0.56). Conclusions: These results suggest that tinnitus is a common symptom in this cohort and may be associated with some modifiable risk factors. Sumario Objetivo: Evaluar la prevalencia del acúfeno junto con los factores potencialmente asociados para tenerlo. Diseño: Los datos fueron obtenidos del Estudio “Beaver Dam Offspring”, una cohorte epidemiológica para el estudio del envejecimiento. Muestra: Después de una entrevista personal y un examen audiométrico, los participantes (n = 3267, edades 21–84 años) fueron clasificados como portadores de acúfeno si en el pasado año habían reportado tener acúfeno al menos de severidad moderada o si éste les ocasionaba dificultad conciliar el sueño. Resultados: La prevalencia del acúfeno fue de 10.6%. En modelo de regresión logística multivariada ajustada para edad y sexo, los siguientes factores fueron asociados al acúfeno: hipoacusia (tasa de probabilidad (OR) = 3.20), tener un empleo ruidoso (OR = 1.90), historia de traumatismo cefálico (OR = 1.84), síntomas depresivos (OR = 1.82), historia de infección ótica (hombres, OR = 1.75), historia de tiro con arma de fuego (OR = 1.56), artritis (OR = 1.46), y uso de AINES (OR = 1.33). Para las mujeres, el no haber bebido alcohol en el pasado año fue asociado con un decremento en el riesgo de tener acúfeno (OR = 0.56). Conclusiones: Estos resultados sugieren que el acúfeno es un síntoma común en esta cohorte y que puede estar asociado con algunos de los factores de riesgo modificables.

Olfactory Impairment in an Adult Population: The Beaver Dam Offspring Study

The objective of this study was to determine the prevalence of olfactory impairment and associated risk factors and the effects of olfactory impairment on dietary choices and quality of life. Odor identification was measured in 2838 participants aged 21-84 years (mean 49 years) in the Beaver Dam Offspring Study. The overall prevalence of olfactory impairment was 3.8%, increased with age (from 0.6% in those<35 years to 13.9% among those≥65 years) and was more common in men than women. In a multivariate model age (odds ratio [OR]=1.48, 95% confidence interval [CI]=1.33, 1.64 for every 5-year increase), nasal polyps or deviated septum (OR=2.69, 95% CI=1.62, 4.48), ankle-brachial index<0.9 (OR=3.62, 95% CI=1.45, 9.01), and smoking (women only) (OR=2.43, 95% CI=1.19, 4.98 ever smoked vs. never) were associated with an increased odds of olfactory impairment, whereas higher household income, ≥

Measuring Refraction in Adults in Epidemiological Studies

50,000 versus <

Factors Related to Fungiform Papillae Density: The Beaver Dam Offspring Study

50,000 per year, was associated with a decreased odds of olfactory impairment (OR=0.48, 95% CI=0.31, 0.73). Participants with olfactory impairment were less likely to report that food tasted as good as it used to, or that they experienced food flavors the same. There was no association between olfactory impairment and general health-related quality of life, depressive symptoms, or dietary choices. The prevalence of olfactory impairment was low in this largely middle-aged cohort, and some factors associated with olfactory impairment are potentially modifiable.

Test-retest reliability of the San Diego Odor Identification Test and comparison with the brief smell identification test.

OBJECTIVE To compare refraction measured before and after pharmacologic cycloplegia. METHODS This study used preliminary data from the Beaver Dam Offspring Study, which includes adult children of participants in the population-based Epidemiology of Hearing Loss Study of older adults living in Beaver Dam, Wisconsin. Data were available for 5018 eyes of 2529 participants. Refraction was defined by the spherical equivalent (SE), using autorefractor readings. Differences were calculated as the SE after drops were administered minus the SE before drops were administered. Myopia was defined as SE of -1 diopter (D) or less; emmetropia, as SE more than -1 D and less than 1 D; and hyperopia, as SE of 1 D or more. RESULTS The mean age was 48 years (range, 22-84 years). The mean difference in SE between measurements before and after cycloplegia was 0.29 D (95% confidence interval, 0.28-0.31). The difference decreased with age and varied by refractive status for participants younger than 50 years, with the largest differences observed among young persons with hyperopic refractive errors. Across all age groups, agreement on classifications of refraction was high (84%-92%). CONCLUSIONS Overall, clinically inconsequential differences were observed between SEs before and after pharmacologic cycloplegia, suggesting that cycloplegia may not be necessary in epidemiological studies of refraction in adults.

Carotid atherosclerosis and cognitive function in midlife: The beaver dam offspring study

The distribution of fungiform papillae density and associated factors were examined in the Beaver Dam Offspring Study. Data were from 2371 participants (mean age = 48.8 years, range = 21-84 years) with 1108 males and 1263 females. Fungiform papillae were highlighted with blue food coloring and the number of fungiform papillae within a standard 6-mm circle was counted. Whole mouth suprathreshold taste intensity was measured. The mean fungiform papillae density was 103.5 papillae/cm(2) (range = 0-212.2 papillae/cm(2)). For each 5-year increase in age, the mean fungiform papillae density was 2.8 papillae/cm(2) lower and the mean density for males was 10.2 papillae/cm(2) lower than for females. Smokers had significantly lower mean densities (former smokers: -5.1 papillae/cm(2); current smokers: -9.3 papillae/cm(2)) than nonsmokers, and heavy alcohol drinkers had a mean density that was 4.7 papillae/cm(2) lower than nonheavy drinkers. Solvent exposure was related to a significantly higher density (+6.8 papillae/cm(2)). The heritability estimate for fungiform papillae density was 40.2%. Propylthiouracil taster status, TAS2R38 haplotype, and perceived taste intensity were not related to density. In summary, wide variability in fungiform papillae density was observed and a number of related factors were found including the modifiable factors of smoking and alcohol consumption.

Generational Differences in the Reporting of Tinnitus

This study described the San Diego Odor Identification Test (SDOIT) reliability and compared the SDOIT and the Brief Smell Identification Test (B-SIT). Ninety participants aged 50-70 years completed this 2-visit olfaction study. During visit 1, the SDOIT and B-SIT were administered according to standard protocols. Three weeks later, participants returned to retake the SDOIT. The SDOIT score was the total number of odorants correctly identified out of 8 odorants presented, and olfactory impairment was defined as correctly identifying less than 6 odorants. The B-SIT score was the total number of odorants correctly identified out of 12 odorants presented, and participants correctly identifying less than 9 odorants were categorized as abnormal. The SDOIT reliability was high (concordance correlation coefficient = 0.85, 95% confidence interval [CI] = 0.79-0.91). The same score was obtained on retest for 73% of participants, whereas 18% improved, and 9% declined. Test-retest agreement was 96% for the SDOIT; 4% improved from impaired at visit 1 to unimpaired at visit 2. Overall, SDOIT impairment classification and B-SIT abnormal classification agreed in 96% of participants (kappa = 0.81, 95% CI = 0.63-0.99). In conclusion, the SDOIT showed good test-retest reliability. Agreement for impaired/abnormal olfaction was demonstrated for the SDOIT and the B-SIT.

Functional trajectory 6 months posthospitalization: a cohort study of older hospitalized patients in Taiwan.

BACKGROUND Atherosclerosis may be associated with cognitive function; however the studies are few, especially among midlife adults. METHODS Participants in the beaver dam offspring study who had cognitive test data and gradable carotid artery ultrasound scans were included (n=2794, mean age: 49 years). Atherosclerosis was measured by carotid intima-media thickness (IMT) and the presence of plaque. Cognitive function was measured by the trail making test (TMT), grooved pegboard test (GPT) and mini-mental state examination (MMSE). Generalized cognitive function was defined by a summary score calculated from the TMT and GPT. Linear regression was used to evaluate the associations between carotid atherosclerosis and cognitive function tests. RESULTS Larger IMT was associated with lower GPT, MMSE and the summary score adjusting for multiple factors, the coefficients were: 13.8s (p<0.0001), -0.6 (p=0.007), and 0.47 (p=0.01), respectively for 1mm increase in IMT. Plaque scores were significantly associated with TMT-B, GPT, MMSE, and the summary score adjusting for age, sex and education. The associations remained statistically significant after further adjustments except for the association with TMT-B, which was attenuated and no longer significant. CONCLUSIONS Our results show the significant associations between markers of carotid atherosclerosis and cognitive function in a cohort of persons aged 21-84 years. Longitudinal studies are needed to further examine these associations.