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Biomedical subjects

G Davey-Smith

Publications and source records attributed to G Davey-Smith.

8 recordsLinked to original sources

Prevalence of cataract in the Speedwell Cardiovascular Study: a cross-sectional survey of men aged 65-83.

AIMS: To ascertain the prevalence of cataract in a representative group of men who have been followed since 1979 for cardiovascular disease. METHODS: Of 2348 men aged 45-63 recruited in 1979 to the Speedwell Cardiovascular Study, 1420 were alive and willing to take part in further studies in 1997. They were sent a questionnaire about their eye health and invited to an ophthalmological examination at Bristol Eye Hospital. Cataract was graded using the Lens Opacities Classification System III (LOCS III) method. RESULTS: Of the 1420 men, 26 died before they could be examined. Out of the remaining 1394 men, 949 presented for examination and full information was available for 936. Some information about eye health was obtainable for 394 men and 51 were not contactable. The prevalence of cataract increased with age and 36 men (3.8%) had had previous cataract surgery in either or both eyes. Of the remaining 903 men with no previous history of cataract surgery, cortical cataract was present in the right eye of 75 men (8.3%), nuclear (opalescence) in 128 (14.2%) and posterior subcapsular in 15 (1.7%). Five men (0.6%) had visual acuity of 6/60 or worse attributable to cataract in the right eye and 232 (25%) had visual acuity in one or both eyes of 6/24 or less at least partially attributable to cataract. There was no association between social class and the presence of cataract. CONCLUSIONS: The prevalence of cataract in a representative cohort of men followed since 1979 for cardiovascular disease was comparable to that previously reported in the UK and is consistent with studies from around the world. It appears that substantial amounts of visual loss, attributable to cataract, are present in men. Further studies establishing the reasons for this should be undertaken.

Age Factors↗

Vision-related quality of life impairment in an elderly UK population: associations with age, sex, social class and material deprivation.

PURPOSE: To describe the prevalence of vision-related quality of life (VR-QOL) impairment in an elderly UK population sample. METHOD: The survey, using the VCM1 questionnaire, was based on an age- and sex-stratified random population sample of 2783 individuals aged 55 years or over. RESULTS: One thousand eight hundred and forty-six (69.7%) of 2647 eligible subjects responded. One thousand six hundred and eighty-three individuals completed all 10 VCM1 items. Overall the prevalence of a VCM1 score >2.0 ('more than a little' concern about vision) was 4.6% (95% CI = 3.7% to 5.7%), leading to an estimate of more than 550,000 individuals in England with substantial VR-QOL impairment. The prevalence increased with age from 2.1% in the 55-64 year age group to 17.9% in the group aged 85 years and older. The prevalence also increased as social class became lower, from 0 in social class I to 10.2% in social class V, and increased with increasing material deprivation, from 1.2% in the most affluent quintile to 6.8% in the most deprived quintile. Multivariable logistic regression analysis showed that age (p = 0.0001), decreasing social class (p = 0.03) and increasing material deprivation (p = 0.008) were independently associated with VR-QOL impairment (VCM1 score >2.0), whilst gender and means of questionnaire administration were not associated with VR-QOL impairment at the 5% level. CONCLUSIONS: The findings suggest a substantial national prevalence of VR-QOL impairment, and are consistent with earlier studies linking ocular disease with social deprivation. Consideration should be given to directing resources more carefully towards groups at higher risk of VR-QOL impairment, in particular the very elderly and socially deprived.

Age Factors↗

Impaired lung function and mortality risk in men and women: findings from the Renfrew and Paisley prospective population study.

OBJECTIVE: To assess the relation between forced expiratory volume in one second (FEV1) and subsequent mortality. DESIGN: Prospective general population study. SETTING: Renfrew and Paisley, Scotland. SUBJECTS: 7058 men and 8353 women aged 45-64 years at baseline screening in 1972-6. MAIN OUTCOME MEASURE: Mortality from all causes, ischaemic heart disease, cancer, hung and other cancers, stroke, respiratory disease, and other causes of death after 15 years of follow up. RESULTS: 2545 men and 1894 women died during the follow up period. Significant trends of increasing risk with diminishing FEV1 are apparent for both sexes for all the causes of death examined after adjustment for age, cigarette smoking, diastolic blood pressure, cholesterol concentration, body mass index, and social class. The relative hazard ratios for all cause mortality for subjects in the lowest fifth of the FEV1 distribution were 1.92 (95% confidence interval 1.68 to 2.20) for men and 1.89 (1.63 to 2.20) for women. Corresponding relative hazard ratios were 1.56 (1.26 to 1.92) and 1.88 (1.44 to 2.47) for ischaemic heart disease, 2.53 (1.69 to 3.79) and 4.37 (1.84 to 10.42) for lung cancer, and 1.66 (1.07 to 2.59) and 1.65 (1.09 to 2.49) for stroke. Reduced FEV1 was also associated with an increased risk for each cause of death examined except cancer for lifelong nonsmokers. CONCLUSIONS: Impaired lung function is a major clinical indicator of mortality risk in men and women for a wide range of diseases. The use of FEV1 as part of any health assessment of middle aged patients should be considered. Smokers with reduced FEV1 should form a priority group for targeted advice to stop smoking.

Cardiovascular Diseases↗

Blood pressure and blood lead in surveys in Wales.

The association between blood pressure and blood lead level was examined in two population surveys in Wales. In a survey of 1,721 male and female subjects throughout the principality, there was evidence of a marked relation of blood pressure with age, but when this was removed no residual association with blood lead remained. In a survey of 1,164 older men in Caerphilly, there was no evidence of an association between blood lead and either resting blood pressure or the rise in blood pressure during a cold pressor test.

Adult↗

Two Welsh surveys of blood lead and blood pressure.

The relationship between blood pressure and blood lead was examined in two population samples. One of these consisted of 1137 men aged 49 to 65 years, the other of 865 men and 856 women aged 18 to 64 years. Neither population had any known important exposure to lead, and the 95% ranges of blood lead levels were 6 to 26 micrograms/100 mL and 6 to 23 micrograms/mL in the men and 5 to 18 micrograms/100 mL in the women. No significant relationship between blood pressure and blood lead was detected in either of the population samples, and the regression coefficients suggest that if there were a real effect, then the mean difference in blood pressure per 10 micrograms difference in blood lead is likely to be 0.7 mm Hg in both systolic and diastolic pressures. In the survey of 1137 men, the rise in blood pressure was measured during the cold pressor test. This test is likely to be affected if lead were to affect neurogenic mediators of blood pressure. The mean change in systolic pressure was 24 mm Hg and the 95% range was -6 to 60 mm Hg, but there was no evidence of any association with blood lead level.

Aged↗