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Jie Jin Wang

Publications and source records attributed to Jie Jin Wang.

At least 19 recordsLinked to original sources
PubMed2007

Ten-year incidence and progression of age-related maculopathy: the blue Mountains Eye Study.

PURPOSE: To assess the 10-year incidence of age-related maculopathy (ARM) in an older Australian cohort. DESIGN: Population-based cohort study. PARTICIPANTS: Three thousand six hundred fifty-four Blue Mountains Eye Study participants > or =49 years old were examined during 1992 through 1994; 2335 (75% of survivors) were reexamined after 5 years (1997-1999) and 1952 (76% of survivors) after 10 years (2002-2004). METHODS: The same graders performed retinal photographic grading in all examinations, using the Wisconsin Age-Related Maculopathy Grading System. Photographs of participants with ARM lesions at any of the examinations were subsequently regraded using a side-by-side comparison method. MAIN OUTCOME MEASURES: The diagnosis of incident late ARM was given if neovascular ARM or geographic atrophy was detected at either follow-up examination in persons free of these lesions at baseline. Incident early ARM was diagnosed if early ARM (soft indistinct or reticular drusen or combined soft distinct drusen and retinal pigment abnormality) was present in persons free of early and late ARM at baseline. Age-related maculopathy incidence was calculated using Kaplan-Meier methods to incorporate information from both 5- and 10-year examinations. Discrete logistic models were used to assess the risk of incident late ARM according to various baseline factors, including early ARM lesion characteristics. RESULTS: After excluding 72 late ARM cases present at baseline, 2395 of 3582 subjects at risk of late ARM (67%) were reexamined at either follow-up time point or both follow-up time points. Over the 10-year period, 72 of 2395 subjects (3.7%) developed late ARM and 266 of 2255 subjects (14.1%) developed early ARM. After age standardization to the Beaver Dam Eye Study population, our 10-year incidences of late and early ARM were 2.8% and 10.8%, respectively. Baseline age and early ARM lesion characteristics and severity were strong predictors of late ARM incidence. CONCLUSIONS: Long-term follow-up of this older population confirms that the risk of ARM progression is related strongly to the severity of early-stage lesions. The study provides evidence-based criteria for identifying persons at high risk of developing late ARM.

Aged↗
PubMed2007

Measurement of retinal vascular caliber: issues and alternatives to using the arteriole to venule ratio.

PURPOSE: The arteriole to venule ratio (AVR) is widely used in studies of the associations of retinal microvascular disease with systemic and ocular outcomes. This is a discussion of the limitations of AVR; a comparison of its predictive information with that of its components, arteriolar and venular caliber; and a description of a suggested alternative method of modeling arteriolar and venular calibers directly. METHODS: Data from the population-based Blue Mountains Eye Study were used to compare the predictive information in models using AVR with models using arteriolar and venular calibers directly. Determination was made of how the apparent relationship between vessel caliber and two systemic outcomes (blood pressure [BP] and white blood cell count [WBC]) was influenced by the choice of regression model. These findings were interpreted with reference to the known biological relationship among vessel calibers, BP, and WBC. RESULTS: Models using arteriolar and venular calibers directly had more predictive information than models using AVR. The apparent relationship of vessel caliber to BP and WBC differed substantially, depending on the model chosen. For example, after adjustment for age, sex, and other covariates, decreasing venular caliber was associated with higher systolic BP when modeled separately, but was associated with lower systolic BP when modeled simultaneously with arteriolar caliber. CONCLUSIONS: The findings suggest AVR provides less information with regards to predicting systemic outcomes than its two components. Modeling arteriolar and venular calibers separately could be biased by confounding, while modeling both simultaneously appears to provide unbiased, biologically plausible results. The use of this approach is recommended in future research relating retinal vascular caliber to systemic or ocular outcomes.

Aged↗
PubMed2006

Retinal vein occlusion and vascular mortality: pooled data analysis of 2 population-based cohorts.

PURPOSE: To assess the association of retinal vein occlusion (RVO) with cardiovascular and cerebrovascular mortality. DESIGN: Pooled data from 2 population-based cohort studies. PARTICIPANTS: At baseline, the Beaver Dam Eye Study (BDES) examined 4926 persons aged 43 to 86 years (from 1988-1990) and the Blue Mountains Eye Study (BMES) examined 3654 persons aged 49 to 97 years (from 1992 to 1994). METHODS: Retinal vein occlusion was assessed from retinal photographs. Vascular deaths were determined using either death certificates (BDES) or the Australian National Death Index (BMES). Cox regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). MAIN OUTCOME MEASURE: Vascular (cardiovascular and cerebrovascular) mortality was determined. RESULTS: Of 8384 baseline participants, 96 (1.14%) had RVO at baseline (BDES, n = 38; BMES, n = 58). Over 12 years, 1312 (15.7%) died of cardiovascular-related conditions and 341 (4.1%) died of cerebrovascular-related conditions. Age-standardized vascular mortality rates were 26.0% and 5.3%, respectively, in persons with RVO and 17.1% and 4.5%, respectively, in those without RVO. After adjusting for age, gender, body mass index, hypertension, diabetes, smoking, glaucoma, and study site, RVO was not associated with cardiovascular-related mortality (HR, 1.2; 95% CI, 0.8-1.8) or cerebrovascular-related mortality (HR, 0.9; 95% CI, 0.4-2.1) among participants of all ages. However, in persons aged less than 70 years, baseline RVO was associated with higher cardiovascular mortality (combined BDES and BMES: HR, 2.5; 95% CI, 1.2-5.2; BDES: HR, 2.5; 95% CI, 0.9-6.9; BMES: HR, 2.1; 95% CI, 0.7-6.8). CONCLUSIONS: Retinal vein occlusion in persons aged 43 to 69 years may signal a doubling of the risk of cardiovascular mortality.

Adult↗
PubMed2006

Association between circulating white blood cell count and long-term incidence of age-related macular degeneration: the Blue Mountains Eye Study.

Inflammatory processes are implicated in the development and progression of age-related macular degeneration (AMD). However, there are limited data on longitudinal associations between systemic markers of inflammation and AMD. The authors examined the prospective relation between the circulating white blood cell (WBC) count and early and late AMD in a population-based cohort of 3,654 participants, aged 49-97 years, in the Blue Mountains region, Australia. The main outcome of interest was the 10-year incidence of early and late AMD among individuals free from corresponding disease at the baseline (1992-1994). An elevated baseline WBC count was associated with early AMD incidence, independent of smoking and other major confounders. The multivariable relative risk comparing tertile 3 of WBC count (>6.7 x 10(9) cells/liter) with tertile 1 (</=5.5 x 10(9) cells/liter) was 1.85 (95% confidence interval: 1.33, 2.58). The association between WBC count and early AMD was present consistently in analyses of different early AMD lesions, including incident pigmentary abnormalities and soft indistinct/reticular drusen. Moreover, this association persisted in subgroup analyses by gender and smoking. An elevated WBC count at baseline was not consistently associated with late AMD incidence. This study provides population-based evidence supporting a longitudinal association between the circulating WBC count, a widely available marker of inflammation, and incidence of early AMD.

Aged↗
PubMed2006

Prevalence and associations of enhanced retinal arteriolar light reflex: a new look at an old sign.

PURPOSE: To assess the prevalence, associated risk factors and prognosis (mortality) of the enhanced retinal arteriolar light reflex sign in an older Australian population. DESIGN: Population-based cross-sectional study. PARTICIPANTS: Three thousand six hundred fifty-four participants (82.4% response) ages >/=49 years from Australia's Blue Mountains region. METHODS: Retinal photographs of participants were graded for presence and severity of the enhanced arteriolar light reflex sign by comparison with standard photographs. Associations with systemic factors (subject-specific) and ocular variables (eye-specific) were assessed by logistic regression. Mortality data were obtained using the Australian National Death Index. Hazard ratios were calculated using Cox regression. MAIN OUTCOME MEASURES: Prevalence of enhanced arteriolar light reflex and associations with demographic variables (age, gender), blood pressure, blood parameters, health risk behaviors, cataract, retinal vessel wall signs, retinopathy, and 10-year incident mortality. RESULTS: The enhanced arteriolar light reflex sign was found in 1053 participants (31.7%, including 28.8% graded as mild and 2.9% as marked). Prevalence decreased with age (36.0%, 37.7%, 28.0%, and 18.8% for age groups < 60, 60-69, 70-79 and > or = 80 years, respectively, P(trend)<0.0001); odds ratio (OR) 0.78; and 95% confidence interval (CI) 0.72 to 0.85 per decade. Persons with cataract were less likely to have mildly enhanced light reflex (OR, 0.74; CI 0.64-0.87). After multivariate adjustment, mildly enhanced light reflex was significantly associated with serum glucose (OR 1.11 per SD increase), total cholesterol (OR 1.11), low-density lipoprotein (OR 1.55), triglycerides (OR 1.11), platelets (OR 0.89), and body mass index (OR 1.12). Markedly enhanced light reflex was significantly associated with mean arterial blood pressure (OR 1.24), heavy alcohol consumption (OR 2.66, > or = 40 grams alcohol per day), and serum glucose (OR 1.16). Strong associations were demonstrated between presence of mildly enhanced light reflex and either arteriovenous nicking (OR 3.12) or retinopathy (OR 1.96). There was no association between mildly or markedly enhanced light reflex and either all-cause or vascular mortality. CONCLUSIONS: In this older population, the enhanced retinal arteriolar light reflex sign was a relatively common finding. Although some associations of this sign with vascular risk factors were found, only a marked level of enhanced light reflex was correlated with elevated blood pressure, but not with poor survival.

Aged↗
PubMed2006

Is early age-related macular degeneration related to carotid artery stiffness? The Atherosclerosis Risk in Communities Study.

BACKGROUND/PURPOSE: Atherosclerosis and vascular stiffness have been implicated in the pathogenesis of age-related macular degeneration (AMD). The association of carotid artery stiffness, a measure of arterial elasticity reflecting early atherosclerosis, with early AMD, was examined in this study. METHODS: A population-based, cross-sectional study of 9954 middle-aged people (age range 51-72 years). The presence of AMD signs was determined from fundus photographs according to the Wisconsin grading protocol. Carotid arterial stiffness was measured from high-resolution ultrasonic echo tracking of the left common carotid artery, and was defined as an adjusted arterial diameter change (AADCmu). A smaller AADC reflects greater carotid artery stiffness. The associations of pulse pressure and carotid artery intima-media thickness (IMT) with early AMD signs were also analysed. RESULTS: In the study population, 454 (4.6%) had early AMD. The mean (SD) AADC was 403 (127) mu. After adjusting for age, sex, race/centre, education, cigarette smoking, fasting glucose, lipid profile and inflammatory markers, a smaller AADC was found to be not associated with early AMD (odds ratio 0.94; 95% confidence interval, 0.71 to 1.25) or its component lesions. Other measures of arterial stiffness (pulse pressure) and atherosclerosis (carotid IMT) were also not associated with early AMD. CONCLUSIONS: Carotid artery stiffness was not associated with signs of early AMD in this middle-aged population. These data provide no evidence of a link between age-related elastoid changes and early atherosclerotic processes in the carotid arteries and early AMD.

Aged↗
PubMed2006

Pain and falls in older people.

Pain and falling both affect substantial segments of the older population. Despite the presence of several plausible mechanisms for pain to contribute to falling, very few studies have investigated this relationship in older people. If pain is a falls risk factor, this represents a potentially important point of intervention for falls prevention. Falls are a major cause of disability and loss of independent living status in older people. We examined the relationship between pain, pain-related interference with activities and falls in a cross-sectional analysis of 3509 people aged 49 years or more in two postal code areas in New South Wales, Australia (the Blue Mountains Eye Study). We found that subjects reporting pain with moderate to severe level of pain-related interference with activities were more likely to report any falls or multiple falls in the past 12 months than subjects not reporting pain (adjusted prevalence ratios 1.42, p=0.0001 and 1.62, p=0.0156, respectively). We also found a significant trend in the association indicating an increasing likelihood of self-reported falls associated with increasing level of pain-related interference with activities. The association was stronger for multiple falls than for any falls. Excluding subjects with recent fractures did not alter the findings. Given the high prevalence and public health importance of both conditions, further investigation of this association in prospective studies is recommended.

Accidental Falls↗
PubMed2006

Positive association between plasma fibrinogen level and incident hypertension among men: population-based cohort study.

Elevated plasma fibrinogen is implicated in cardiovascular disease. However, it is not clear whether fibrinogen levels predict the development of hypertension. We examined the relationship between plasma fibrinogen level and hypertension in a population-based cohort study of 3654 participants (mean age: 61.5 years; range: 49 to 84 years) at the baseline examination (1992-1994) in the Blue Mountains region, west of Sydney, Australia, who were examined 5 years (1997-1999) later. Main outcomes of interest were prevalent hypertension (systolic blood pressure >or=140 mm Hg, diastolic blood pressure >or=90 mm Hg, or a combination of self-reported hypertension diagnosis and use of antihypertensive medications) at baseline (n=2212/3180) and 5-year incidence of hypertension among baseline normotensive individuals (n=361/637). Elevated plasma fibrinogen level was positively associated with prevalent hypertension both among men and women and positively associated with 5-year incident hypertension among men, independent of several cardiovascular risk factors. Multivariable odds ratio (95% CI) of 5-year incident hypertension comparing tertile 3 of plasma fibrinogen (>or=3.9 g/L) with tertile 1 (<or=3.2 g/L) was 1.95 (1.03 to 3.68; P trend=0.040). This prospective association, however, was not observed in women (odds ratio; 95% CI) comparing tertile 3 versus tertile 1 of plasma fibrinogen (1.00; 0.54 to 1.86; P trend=0.986). Subgroup analyses stratified by smoking, body mass index, diabetes, and blood pressure categories supported this male gender-specific pattern of association. These data provide prospective epidemiological evidence of an essential link between plasma fibrinogen level and incident hypertension among men but not among women, a finding consistent with that observed in the Atherosclerosis Risk in Communities Study.

Aged↗
PubMed2006

Cataract surgery and the 10-year incidence of age-related maculopathy: the Blue Mountains Eye Study.

PURPOSE: To assess the long-term (10-year) risk of late age-related maculopathy (ARM) in eyes that had previously undergone cataract surgery (before the baseline examination). DESIGN: Population-based cohort study. PARTICIPANTS: In the Blue Mountains Eye Study (BMES) cohort, 2335 of 3654 baseline participants > or =49 years old (75% of survivors) were reexamined after 5 years and 1952 (76% of survivors) were reexamined after 10 years. METHODS: At the baseline examination, nonphakic (aphakic or pseudophakic) eyes were identified at slit-lamp examination and confirmed at lens photographic grading. Side-by-side grading of baseline and follow-up stereoretinal photographs was performed using the Wisconsin ARM grading system. Eye-specific data were analyzed using Kaplan-Meier estimates and generalized estimating equation models, adjusting for correlation between the 2 eyes. MAIN OUTCOME MEASURES: Incident late ARM was defined if either neovascular ARM or geographic atrophy developed in eyes without either lesion at baseline. RESULTS: After excluding eyes with either late ARM lesion at baseline or that had missing photographs at either examination, 4763 eyes were considered at risk of incident late ARM, including 132 eyes that had cataract surgery before the baseline examination. Late ARM developed in 10 of 132 nonphakic eyes (7.6%) compared to 96 of 4631 phakic eyes (2.1%). After adjusting for baseline age, gender, smoking, and presence of early ARM lesions, nonphakic (cataract surgical) eyes had a 3-fold risk of developing late-stage ARM (odds ratio [OR], 3.3; 95% confidence interval [CI], 1.1-9.9) or neovascular ARM (OR, 3.4; 95% CI, 1.1-10.9) compared to phakic eyes. CONCLUSIONS: Our findings support the hypothesis that the long-term risk of developing late ARM is higher in cataract surgical eyes, consistent with findings from the Beaver Dam Eye Study.

Aged↗
PubMed2006

Sensory and cognitive association in older persons: findings from an older Australian population.

BACKGROUND: Explanations for associations found between sensory and cognitive function remain unclear. OBJECTIVE: To assess in an older Australian population: (1) the correlation between sensory and cognitive function across groups with a narrow age range; (2) any independent association between sensory and cognitive impairment. METHODS: We examined 3,509 non-institutionalised residents aged 50+ years in the second cross-sectional survey of the Blue Mountains Eye Study (1997-2000). Visual impairment was defined for best-corrected visual acuity (VA) < 6/12 in the better eye, moderate to severe hearing loss for hearing threshold > 40 dB (better ear), and likely cognitive impairment for Mini-Mental State Examination (MMSE) < 24 points. RESULTS: We found likely cognitive impairment in 3.3%, vision impairment in 2.7% and moderate to severe hearing loss in 10.5% of this population. Correlation between VA or hearing threshold and MMSE score increased with age. After adjusting for age, weak but significant correlation was evident in the normal ageing sample between vision and MMSE (r = 0.12 with vision items included and r = 0.11 with vision items excluded, both p < 0.0001), and between hearing thresholds and MMSE (r = -0.12, p < 0.0001). After adjusting for age, sex, education and history of stroke, persons with vision impairment had a lower mean MMSE score than those with normal vision, regardless of whether vision-related items were included (27.1 vs. 28.6, p < 0.001) or excluded (19.8 vs. 21.0, p < 0.001). Similarly, persons with moderate to severe hearing loss had a lower mean MMSE score than those without hearing loss (28.1 vs. 28.7, p < 0.001). Persons with likely cognitive impairment also had lower mean VA and higher mean hearing threshold than those without, after adjustment. CONCLUSIONS: We have documented an age-related correlation between sensory and cognitive function in a normal ageing sample. The association between sensory impairment and likely cognitive impairment remained significant after excluding vision-related MMSE items and adjusting for confounding factors. Our data suggest that age-related decline and the effect of visual impairment on the measurement of cognition only partly explain the association between sensory and cognitive impairments in older persons.

Age Factors↗
PubMed2006

Relation of age-related macular degeneration and cognitive impairment in an older population.

BACKGROUND: The aetiology of age-related macular degeneration (AMD) and cognitive impairment is poorly understood. A link between cognitive impairment and AMD has been proposed although only a weak association was found in population-based studies. PURPOSE: To assess cross-sectional associations between AMD and cognitive impairment in an older Australian population. METHODS: The Blue Mountains Eye Study examined 3,509 persons aged 49+ years during 1997-2000. AMD lesions were assessed from retinal photographs using the Wisconsin System. Mini-mental state examination (MMSE), demographics, lifestyle factors and medical history were collected at interview. MMSE score was categorised as high-normal (28-30), low-normal (24-27) and impaired (< 24). A modified MMSE excluded five vision related items and was dichotomised as normal (18-22) and impaired (0-17). Logistic regression was used to assess associations after adjusting for age, sex, visual impairment, stroke, current smoking status, hypertension, alcohol consumption and post-high-school qualification. RESULTS: Prevalence rates for late and early AMD were 1.5% (n = 50) and 8.3% (n = 273), respectively. Cognitive impairment was present in 18.0% in persons with late AMD and 8.4% with early AMD, compared to 2.6% in persons without AMD. After multivariate adjustment, late AMD was associated with low normal MMSE (odds ratio (OR): 2.2, 95% confidence interval (CI): 1.1-5.0) and cognitive impairment (OR: 3.7, CI: 1.3-10.6). Using the modified MMSE, the multivariate association between late AMD and cognitive impairment remained (OR: 2.2, CI: 1.0-5.0). No significant association was found between cognitive impairment and early AMD. CONCLUSIONS: We found a significant, cross-sectional association between late AMD and cognitive impairment in a sample of older Australians that appeared to be independent of visual impairment. The association was weaker but remained significant after excluding vision-related items from the MMSE.

Aged↗
PubMed2006

Retinal vessel signs and 10-year incident age-related maculopathy: the Blue Mountains Eye Study.

OBJECTIVE: To examine whether retinal vessel signs are independent predictors of the long-term development of age-related maculopathy (ARM). DESIGN: Prospective population-based cohort study. PARTICIPANTS: Blue Mountains Eye Study participants aged > or =49 years (n = 3654) were examined during 1992 through 1994; 2335 (75% of survivors) were reexamined after 5 years and 1952 (76% of survivors) were reexamined after 10 years. METHODS: Baseline focal arteriolar narrowing and arteriovenous (AV) nicking were assessed and vessel calibers were measured from retinal photographs. A side-by-side grading method was used to assess ARM incidence. Eye-specific data were analyzed using generalized estimating equation models, adjusting for age, gender, smoking, and blood pressure. MAIN OUTCOME MEASURES: Incident early ARM (soft indistinct or reticular drusen or combined soft distinct drusen and retinal pigment abnormality) was defined in eyes free of both early and late ARM at baseline. Incident late ARM (either geographic atrophy or neovascular macular degeneration) was defined in eyes free of these 2 lesions at baseline. RESULTS: Over a 10-year period, incident late ARM developed in 106/4745 eyes at risk of late ARM (2.2%). Eyes with mild (2.7%) or severe (4.6 %) AV nicking were more likely to develop late ARM than eyes without this sign (1.5%). The adjusted odds ratio (OR) was 1.4, 95% confidence interval (CI) 0.8 to 2.4 for mild and OR 2.6, 95% CI 1.2 to 5.5 for severe AV nicking. Eyes with focal narrowing were also more likely to develop late ARM (7.6% vs. 1.8%), adjusted OR 2.2, 95% CI 1.1 to 4.1. Incident early ARM developed in 398/4490 eyes at risk of early ARM (8.9%). Severe AV nicking, but not focal arteriolar narrowing, was associated with an increased long-term risk of early ARM (13.6% vs. 8.2%; OR 1.5; 95% CI 1.0-2.3). Neither arteriolar nor venular caliber was significantly associated with the incidence of either early or late ARM. CONCLUSIONS: These 10-year incidence data confirm our previous observation that structural retinal arteriolar changes may either contribute to ARM progression or share common pathologic pathways with ARM, independent of traditional vascular risk factors.

Aged↗
PubMed2006

Retinal arteriolar emboli and long-term mortality: pooled data analysis from two older populations.

BACKGROUND AND PURPOSE: To assess the relationship between retinal arteriolar emboli and mortality in older people. METHODS: Pooled data from 2 population-based cohort studies. At baseline, the Beaver Dam Eye Study (BDES) examined 4926 persons 43 to 86 years of age (1988 to 1990), and the Blue Mountains Eye Study (BMES) examined 3654 persons 49 to 97 years of age (1992 to 1994). Retinal arteriolar emboli were assessed by grading retinal photographs using standardized methods. Deaths and causes of death were determined from death certificates or Australian National Death Index. Cox regression models were used to estimate mortality hazard ratios (HRs) associated with emboli, adjusting for age, gender, body mass index, hypertension, diabetes, smoking, serum total cholesterol, high-density lipoprotein cholesterol, study site, and past histories of stroke, angina, and acute myocardial infarct. RESULTS: Of 8580 baseline participants, 8384 (98%) had retinal photographs available, and 111 showed retinal arteriolar emboli (BDES n=61; BMES n=50). Over 10 to 12 years, 2506 participants (30%) died, including 344 (4%) from stroke-related and 1315 (16%) from cardiovascular causes. The cumulative mortality rates were higher in participants with than without emboli (all-cause 56% versus 30%; stroke-related 12% versus 4.0%; cardiovascular 30% versus 16%). The increased mortality risk associated with emboli was independent of age, gender, other vascular risk factors, and past histories of stroke or heart disease for all-cause (multivariate-adjusted HR, 1.3; CI, 1.0 to 1.8) and stroke-related mortality (HR, 2.0; CI, 1.1 to 3.8) but not for cardiovascular mortality (HR, 1.2; CI, 0.8 to 1.7). CONCLUSIONS: Our pooled data from 2 older populations suggest that retinal emboli predict a modest increase in all-cause and stroke-related mortality independent of cardiovascular risk factors.

Adult↗
PubMed2006

The association between circulating white blood cell count, triglyceride level and cardiovascular and all-cause mortality: population-based cohort study.

OBJECTIVES: To examine the individual and combined relationship between elevated white blood cell count (WBC), triglyceride level and cardiovascular and all-cause mortality among older Australians. DESIGN: Prospective population-based cohort study. SETTING: Community in Blue Mountains region, Australia. PARTICIPANTS: 2904 individuals, aged 49-84 years, free of cardiovascular disease and cancer at the baseline examination. MAIN OUTCOME MEASURES: Cardiovascular (n=242) and all-cause mortality (n=575). RESULTS: Elevated WBC count and triglyceride level were found to be associated with cardiovascular and all-cause mortality, independent of several important confounders. Multivariable relative risk [RR] (95% confidence interval [CI]) comparing fourth (6.8 x 10(9) cells/L and above) versus first quartile (4.8 x 10(9) cells/L and below) of WBC count was 2.01 (1.40-2.90) for cardiovascular mortality and 1.68 (1.35-2.09) for all-cause mortality. Multivariable RR (95% CI) comparing fourth (1.98 mmol/L and above) versus first quartile (0.95 mmol/L and below) of triglyceride level was 1.58 (1.08-2.30) for cardiovascular mortality and 1.40 (1.11-1.77) for all-cause mortality. Furthermore, a combined exposure to the fourth quartiles of both WBC count and triglyceride level was found to be related to more than three-fold risk of cardiovascular mortality (RR [95% CI]: 3.15 [2.17-4.57], p-interaction=0.01), independent of traditional risk factors. CONCLUSIONS: Elevated WBC count and triglyceride level were associated with cardiovascular and all-cause mortality among older Australians. These data provide new epidemiological evidence regarding cardiovascular risk stratification using simple, inexpensive, and routinely available measures, suggesting that a combined exposure to both high WBC count and triglyceride level is related to more than three-fold risk of cardiovascular mortality, independent of traditional risk factors.

Aged↗
PubMed2006

Temporal trends in the age-specific prevalence of diabetes and diabetic retinopathy in older persons: Population-based survey findings.

PURPOSE: To compare the age-specific prevalence of diabetes and diabetic retinopathy (DR) over 6 years. METHODS: The Blue Mountains Eye Study (BMES) examined 3654 residents (82.4% response) aged >49 years in BMES I (1992-1994). Survivors (n = 2335) and newly eligible residents (n = 1174) were examined in BMES II (1997-2000). Diabetes was defined by history or fasting plasma glucose > or =7.0 mmol/L. DR was graded from 6-field retinal photographs using the Airlie House Classification. Age-specific prevalence in 5-year intervals was compared, as samples of each age group were independent. RESULTS: The overall diabetes prevalence increased from 7.8 to 9.9% (p = 0.002) while the age-specific prevalence increased in age groups 60-74 years, over 6 years. A slightly higher prevalence of mild levels of DR (p = 0.018) but lower prevalence of moderate-severe levels of DR (p = 0.049) was evident in BMES II compared to BMES I. Factors significantly associated with DR prevalence were diabetes duration > or =20 years (BMES I, OR 7.6 [2.9-20.5]; BMES II, OR 6.1 [2.5-15.4]) and blood glucose level (BMES I, OR 1.1 [1.0-1.2]; BMES II, OR 1.2 [1.1-1.3] per mmol/L increase). CONCLUSIONS: An increased prevalence of diabetes, but decreased prevalence of severe levels of DR, was documented in two survey samples from the same region over 6 years.

Aged↗
PubMed2006

Comparison of age-specific cataract prevalence in two population-based surveys 6 years apart.

BACKGROUND: In this study, we aimed to compare age-specific cortical, nuclear and posterior subcapsular (PSC) cataract prevalence in two surveys 6 years apart. METHODS: The Blue Mountains Eye Study examined 3654 participants (82.4% of those eligible) in cross-section I (1992-4) and 3509 participants (75.1% of survivors and 85.2% of newly eligible) in cross-section II (1997-2000, 66.5% overlap with cross-section I). Cataract was assessed from lens photographs following the Wisconsin Cataract Grading System. Cortical cataract was defined if cortical opacity comprised > or = 5% of lens area. Nuclear cataract was defined if nuclear opacity > or = Wisconsin standard 4. PSC was defined if any present. Any cataract was defined to include persons who had previous cataract surgery. Weighted kappa for inter-grader reliability was 0.82, 0.55 and 0.82 for cortical, nuclear and PSC cataract, respectively. We assessed age-specific prevalence using an interval of 5 years, so that participants within each age group were independent between the two surveys. RESULTS: Age and gender distributions were similar between the two populations. The age-specific prevalence of cortical (23.8% in 1st, 23.7% in 2nd) and PSC cataract (6.3%, 6.0%) was similar. The prevalence of nuclear cataract increased slightly from 18.7% to 23.9%. After age standardization, the similar prevalence of cortical (23.8%, 23.5%) and PSC cataract (6.3%, 5.9%), and the increased prevalence of nuclear cataract (18.7%, 24.2%) remained. CONCLUSION: In two surveys of two population-based samples with similar age and gender distributions, we found a relatively stable cortical and PSC cataract prevalence over a 6-year period. The increased prevalence of nuclear cataract deserves further study.

Age Distribution↗