Browsing by Author "Huang, Guan-Hua"

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A Bayesian clustering approach for detecting gene-gene interactions in high-dimensional genotype data
(2014-06-01)
Chen, Sui-Pi
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Huang, Guan-Hua
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統計學研究所
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Institute of Statistics
This paper uses a Bayesian formulation of a clustering procedure to identify gene-gene interactions under case-control studies, called the Algorithm via Bayesian Clustering to Detect Epistasis (ABCDE). The ABCDE uses Dirichlet process mixtures to model SNP marker partitions, and uses the Gibbs weighted Chinese restaurant sampling to simulate posterior distributions of these partitions. Unlike the representative Bayesian epistasis detection algorithm BEAM, which partitions markers into three groups, the ABCDE can be evaluated at any given partition, regardless of the number of groups. This study also develops permutation tests to validate the disease association for SNP subsets identified by the ABCDE, which can yield results that are more robust to model specification and prior assumptions. This study examines the performance of the ABCDE and compares it with the BEAM using various simulated data and a schizophrenia SNP dataset.
A Walk-and-Eat Intervention Improves Outcomes for Patients With Esophageal Cancer Undergoing Neoadjuvant Chemoradiotherapy
(2015-10-01)
Xu, Yu-Juan
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Cheng, Jason Chia-Hsien
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Lee, Jang-Ming
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Huang, Pei-Ming
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Huang, Guan-Hua
Background. Preserving functional walking capacity and nutritional status is important for patients with esophageal cancer, but no effective intervention is available, particularly during active treatment. Methods. This pilot randomized controlled trial tested the effects of a walk-and-eat intervention for patients with esophageal cancer undergoing neoadjuvant chemoradiotherapy. Participants with locally advanced esophageal cancer stage IIB or higher (n = 59) were randomly assigned to receive the walk-and-eat intervention (n = 30; nurse-supervised walking three times per week and weekly nutritional advice) or usual care (n = 29; control group) during 4-5-weeks of chemoradiotherapy. Primary endpoints were changes in distance on the 6-minute walk test, hand-grip strength, lean muscle mass, and body weight between initiation and completion of intervention. Results. Participants (mean age: 59.6 years) were mostly male (92.9%) with squamous cell carcinoma (96.4%). During chemoradiotherapy, participants who received the walk-and- eat intervention had 100-m less decline than controls in walk distance (adjusted p = .012), 3-kg less decrease in hand-grip strength (adjusted p = .002), and 2.7-kg less reduction in body weight (adjusted p < .001), regardless of age. The intervention group also had significantly lower rates of need for intravenous nutritional support and wheelchair use. Conclusion. The nurse-led walk-and-eat intervention is feasible and effective to preserve functional walking capacity and nutritional status for patients with esophageal cancer undergoing neoadjuvant chemoradiotherapy.
Allocation Variable-Based Probabilistic Algorithm to Deal with Label Switching Problem in Bayesian Mixture Models
(2015-10-12)
Pan, Jia-Chiun
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Liu, Chih-Min
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Hwu, Hai-Gwo
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Huang, Guan-Hua
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統計學研究所
The label switching problem occurs as a result of the nonidentifiability of posterior distribution over various permutations of component labels when using Bayesian approach to estimate parameters in mixture models. In the cases where the number of components is fixed and known, we propose a relabelling algorithm, an allocation variable-based (denoted by AVP) probabilistic relabelling approach, to deal with label switching problem. We establish a model for the posterior distribution of allocation variables with label switching phenomenon. The AVP algorithm stochastically relabel the posterior samples according to the posterior probabilities of the established model. Some existing deterministic and other probabilistic algorithms are compared with AVP algorithm in simulation studies, and the success of the proposed approach is demonstrated in simulation studies and a real dataset.
Atherosclerosis, Inflammation and Decline in Contrast Sensitivity: The Beaver Dam Offspring Study
(2013-06-01)
Cruickshanks, Karen
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Nondahl, David
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Dalton, Dayna
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Huang, Guan-Hua
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Klein, Barbara
BAYESIAN INFERENCES OF LATENT CLASS MODELS WITH AN UNKNOWN NUMBER OF CLASSES
(2014-10-01)
Pan, Jia-Chiun
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Huang, Guan-Hua
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交大名義發表
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統計學研究所
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National Chiao Tung University
This paper focuses on analyzing data collected in situations where investigators use multiple discrete indicators as surrogates, for example, a set of questionnaires. A very flexible latent class model is used for analysis. We propose a Bayesian framework to perform the joint estimation of the number of latent classes and model parameters. The proposed approach applies the reversible jump Markov chain Monte Carlo to analyze finite mixtures of multivariate multinomial distributions. In the paper, we also develop a procedure for the unique labeling of the classes. We have carried out a detailed sensitivity analysis for various hyperparameter specifications, which leads us to make standard default recommendations for the choice of priors. The usefulness of the proposed method is demonstrated through computer simulations and a study on subtypes of schizophrenia using the Positive and Negative Syndrome Scale (PANSS).
Cadmium, obesity, and education, and the 10-year incidence of hearing impairment: The beaver dam offspring study
(1970-01-01)
Dalton, Dayna S.
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Schubert, Carla R.
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Pinto, Alex
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Fischer, Mary E.
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Huang, Guan-Hua
Objectives/Hypothesis To determine the 10-year incidence of hearing impairment (HI) and associated risk factors in the Beaver Dam Offspring Study (BOSS; 2004-present), a large middle-aged cohort followed for 10 years. Study Design Prospective cohort study. Methods Hearing thresholds were measured at baseline (2005-2008) and 5- (2010-2013) and 10-year (2015-2017) follow-up examinations. HI was defined as a pure-tone average >25 dB HL in either ear. BOSS participants free of HI at baseline with at least one follow-up examination (N = 2,065) were included. Potential risk factors evaluated included cardiovascular measures, health history, lifestyle factors, inflammatory markers, vitamins D and B12, lead, and cadmium. Results Participants were 21 to 79 years (mean age = 47.9 years) at baseline. The 10-year cumulative HI incidence was 17.4% (95% confidence interval [CI]: 15.7-19.2) and was twice as likely in men (24.4%, 95% CI: 21.5-27.7) than in women (12.2%, 95% CI: 10.3-14.3). In a multivariable adjusted model, age (hazard ratio [HR] = 1.48, 95% CI: 1.38-1.59, per 5 years), male sex (HR = 2.47, 95% CI: 1.91-3.18), less than a college education (HR = 1.35, 95% CI: 1.02-1.79), body mass index (HR = 1.03, 95% CI: 1.01-1.05, per kg/m(2)), and higher cadmium levels (HR = 1.42, 95% CI: 1.05-1.92, quintile 5 vs. quintiles 1-4) were associated with the 10-year cumulative incidence of HI. There was no association between high lead levels, vitamins D or B12, and 10-year incidence of HI. Conclusions In addition to age and sex, obesity, education, and blood cadmium levels were associated with increased incidence of HI. These prospective results add to evidence that age-related HI is a multifactorial preventable disorder. Level of Evidence 2b Laryngoscope, 2019
Carotid atherosclerosis and cognitive function in midlife: The beaver dam offspring study
(2011-11-01)
Zhong, Wenjun
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Cruickshanks, Karen J.
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Huang, Guan-Hua
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Klein, Barbara E. K.
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Klein, Ronald
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 1 mm 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. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
Carotid Intima Media Thickness, Atherosclerosis, and 5-Year Decline in Odor Identification: The Beaver Dam Offspring Study
(2015-07-01)
Schubert, Carla R.
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Cruickshanks, Karen J.
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Fischer, Mary E.
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Huang, Guan-Hua
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Klein, Ronald
Background. The purpose of this study was to determine if subclinical markers of atherosclerosis are associated with a decline in olfactory function. Methods. The San Diego Odor Identification Test was administered to 2,302 participants (age 21-84 years) at the baseline (2005-2008) and 5-year follow-up (2010-2013) examinations of the Beaver Dam Offspring Study. A decline in odor identification was defined as a decrease in San Diego Odor Identification Test score of 2 or more (range 0-8) from Beaver Dam Offspring Study 1 to Beaver Dam Offspring Study 2. Carotid intima media thickness and plaque, blood pressure, pulse wave velocity, and body mass index were measured and other risk factor data were obtained by interview. Results. Overall 3.2% of participants had a decline in San Diego Odor Identification Test score at 5 years. In age-and sex-adjusted models, mean intima media thickness (odds ratio = 1.17, 95% CI = 1.01, 1.34, per 0.1 mm) and number of sites (range 0-6) with carotid artery plaque (odds ratio = 1.35, 95% CI = 1.11, 1.65, per site) at baseline were associated with an increased risk for decline. Plaque score (odds ratio = 1.24, 95% CI = 1.01, 1.53) remained a significant independent predictor of olfactory decline in a model that included age, sex, hypertension, body mass index, alcohol, and smoking. Conclusions. Subclinical atherosclerosis was associated with an increased risk for olfactory decline indicating that atherosclerosis may be one of the risk factors for the decline in olfactory function seen with aging. Strategies to improve vascular health may also benefit olfactory health.
Cognitive stimulation during hospitalization improves global cognition of older Taiwanese undergoing elective total knee and hip replacement surgery
(2012-06-01)
Cheng, Chia-Min
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Chiu, Ming-Jang
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Wang, Jyh-Horng
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Liu, Hwa-Chang
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Shyu, Yea-Ing Lotus
cheng c.-m., chiu m.-j., wang j.-h., liu h.-c., shyu y.-i.l., huang g.-h. & chen c.c.-h. (2012) Cognitive stimulation during hospitalization improves global cognition of older Taiwanese undergoing elective total knee and hip replacement surgery. Journal of Advanced Nursing68(6), 1322-1329. Abstract Aim. This article is a report on a pilot study conducted to determine the effects of cognitively stimulating activities in older patients undergoing elective hip and/or knee replacement. Background. Cognitive decline occurs in 16-35.5% of older hospitalized patients. In-hospital interventions, such as cognitively stimulating activities, might combat cognitive decline. However, evidence supporting such interventions is limited. Methods. For this randomized pilot trial, 50 older patients (90% women with a mean age of 72.8 years) were recruited in 2008 from a tertiary medical centre in Taiwan. While hospitalized, participants in the intervention group received a daily nurse-led, individual-based, cognitive-stimulation intervention. The comparison group received usual care. Cognitive function was assessed using Mini-Mental State Examination at admission, discharge and 1 month after discharge. Results. The incidence of cognitive decline (=2-point decline in cognitive score) by hospital discharge was significantly lower for the intervention group (12%) than the usual care group (44%). The intervention group also had better cognitive scores following hospitalization. Upon discharge, participants in the intervention group scored 1.28 points higher than at admission, whereas participants in the usual care declined by 0.76 points. Improvement in cognitive status persisted for the intervention group (+1.33 points) vs. usual care (-0.26 points) at 1 month after discharge. Group differences in changes were statistically significant both at discharge and 1 month afterwards. Conclusion. Our cognitive-stimulation intervention benefited global cognitive function among older patients undergoing elective hip and/or knee replacement. The benefit persisted at 1 month after discharge.
CONY: A Bayesian procedure for detecting copy number variations from sequencing read depths
(2020-06-26)
Wei, Yu-Chung
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Huang, Guan-Hua
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統計學研究所
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Institute of Statistics
Copy number variations (CNVs) are genomic structural mutations consisting of abnormal numbers of fragment copies. Next-generation sequencing of read-depth signals mirrors these variants. Some tools used to predict CNVs by depth have been published, but most of these tools can be applied to only a specific data type due to modeling limitations. We develop a tool for copy number variation detection by a Bayesian procedure, i.e., CONY, that adopts a Bayesian hierarchical model and an efficient reversible-jump Markov chain Monte Carlo inference algorithm for whole genome sequencing of read-depth data. CONY can be applied not only to individual samples for estimating the absolute number of copies but also to case-control pairs for detecting patient-specific variations. We evaluate the performance of CONY and compare CONY with competing approaches through simulations and by using experimental data from the 1000 Genomes Project. CONY outperforms the other methods in terms of accuracy in both single-sample and paired-samples analyses. In addition, CONY performs well regardless of whether the data coverage is high or low. CONY is useful for detecting both absolute and relative CNVs from read-depth data sequences. The package is available at https://github.com/weiyuchung/CONY.
Delirium, Subsyndromal Delirium, and Cognitive Changes in Individuals Undergoing Elective Coronary Artery Bypass Graft Surgery
(2015-07-01)
Li, Hsiu-Ching
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Chen, Yih-Sharng
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Chiu, Ming-Jang
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Fu, Mei-Chiung
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Huang, Guan-Hua
Background: The course of incident delirium and subsyndromal delirium (SSD) after cardiac surgery is not well studied. Objective: The aim of this study was to evaluate the course of incident delirium and SSD, their risk factors, and impact on patients\' cognitive function after elective coronary artery bypass graft (CABG) surgery. Methods: Consecutive patients scheduled for an isolated CABG at a tertiary medical center in Taiwan were enrolled if they had no preoperative delirium symptoms. Delirium was assessed daily for 1 week after surgery using the Confusion Assessment Method. Subsyndromal delirium was defined as presenting with any core symptom below the diagnostic threshold for delirium. Cognitive function was assessed by the Mini-mental State Examination. Results: Of 38 participants, 7 had incident (first-time) delirium (18.4% incidence) and 13 had incident SSD (34.2% incidence). Whereas SSD usually lasted 1 day, delirium changed gradually to SSD to recovery and its symptomatology lasted longer. We identified 6 delirium risk factors: older age, more comorbidities, cardiac pulmonary bypass, blood transfusion, larger transfusion volume, and longer duration of intraoperative blood pressure less than 60 mm Hg. The frequencies of these risk factors for SSD were often intermediate between those of risk factors in groups with and without delirium. By hospital discharge, participants with delirium had the longest hospital stays and lowest cognitive scores, those with SSD had intermediate stays and scores, and those without delirium had the lowest stays and scores. Conclusion: Delirium and SSD after CABG are common. Greater number and severity of risk factors for delirium may predict increasingly poor outcomes, with the dose-response relationship between risk factors and outcomes for SSD intermediate between that for no symptoms and full delirium. Intervention trials are indicated, particularly for patients with a greater number and severity of predisposing and precipitating risk factors.
Development and Evaluation of a Modified Hospital Elder Life Program
(2012-03-01)
Chen, Cheryl Chia-Hui
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Chen, Chiung-Nien
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Lai, I-Rue
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Huang, Guan-Hua
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統計學研究所
Background: Older hospitalized patients often experience geriatric syndromes that may be prevented using complex interventions. For example, the Hospital Elder Life Program (HELP) was shown to be successful, but sites with limited resources might find HELP costly. Thus, modifying HELP to include only key components might prove more cost-effective. Objectives: The aim of this study was to develop and evaluate a modified HELP intervention derived from a conceptual model of shared geriatric risk factors for older hospitalized patients undergoing major abdominal surgery. Method: The modified HELP intervention was developed and evaluated in Taiwan, based on the UK Medical Research Council evaluation framework. According to this 4-phase framework, HELP (Phase 1) was modified based on a theoretical model of shared risk factors, and HELP's feasibility and efficacy (Phases 2 and 3) were evaluated between August 2007 and April 2009 in a preintervention and post-intervention pilot trial. Participants were 179 patients enrolled as the control (n = 77) and intervention (n = 102) groups. Results: The modified HELP intervention targeting 3 shared risk factors (cognitive, functional, and nutritional status) was developed and implemented successfully on a surgical ward. By hospital discharge, patients in the intervention group experienced significantly less risk for five geriatric syndromes: functional dependence, malnutrition, in-hospital weight loss 95%, depression, and sleep disturbance (adjusted odds ratio = 0.01-0.39; p<.05). These results were independent of patients' baseline malnutrition, education, periampullary diagnosis, and duration of surgery. Conclusions: The positive findings of this pilot trial support continued development of modified HELP. The next logical step in testing its effectiveness and long-term benefit is a randomized controlled trial.
Dry Eye in the Beaver Dam Offspring Study: Prevalence, Risk Factors, and Health-Related Quality of Life
(2014-04-01)
Paulsen, Adam J.
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Cruickshanks, Karen J.
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Fischer, Mary E.
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Huang, Guan-Hua
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Klein, Barbara E. K.
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 (beta = -3.9, P < .0001) as well as on the National Eye Institute 25-Item Visual Function Questionnaire (NET VFQ-25) (beta = -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. (C) 2014 by Elsevier Inc. All rights reserved.
Effect of a Modified Hospital Elder Life Program on Delirium and Length of Hospital Stay in Patients Undergoing Abdominal Surgery A Cluster Randomized Clinical Trial
(2017-09-01)
Chen, Cheryl Chia-Hui
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Li, Hsiu-Ching
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Liang, Jin-Tung
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Lai, I-Rue
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Purnomo, Jerry Dwi Trijoyo
IMPORTANCE Older patients undergoing abdominal surgery commonly experience preventable delirium, which extends their hospital length of stay (LOS). OBJECTIVE To examine whether a modified Hospital Elder Life Program (mHELP) reduces incident delirium and LOS in older patients undergoing abdominal surgery. DESIGN, SETTING, AND PARTICIPANTS This cluster randomized clinical trial of 577 eligible patients enrolled 377 older patients (>= 65 years of age) undergoing gastrectomy, pancreaticoduodenectomy, and colectomy at a 2000-bed urban medical center in Taipei, Taiwan, from August 1, 2009, through October 31, 2012. Consecutive older patients scheduled for elective abdominal surgery with expected LOS longer than 6 days were enrolled, with a recruitment rate of 65.3%. Participants were cluster randomized by room to receive the mHELP or usual care. INTERVENTIONS The intervention (implemented by an mHELP nurse) consisted of 3 protocols administered daily: orienting communication, oral and nutritional assistance, and early mobilization. Intervention group participants received all 3 mHELP protocols postoperatively, in addition to usual care, as soon as they arrived in the inpatient ward and until hospital discharge. Adherence to protocols was tracked daily. MAIN OUTCOMES AND MEASURES Presence of delirium was assessed daily by 2 trained nurses who were masked to intervention status by using the Confusion Assessment Method. Data on LOS were abstracted from the medical record. RESULTS Of 577 eligible patients, 377 (65.3%) were enrolled and randomly assigned to the mHELP (n = 197; mean [SD] age, 74.3 [5.8] years; 111 [56.4%] male) or control (n = 180; mean [SD] age, 74.8 [6.0] years; 103 [57.2%] male) group. Postoperative delirium occurred in 13 of 196 (6.6%) mHELP participants vs 27 of 179 (15.1%) control individuals, representing a relative risk of 0.44 in the mHELP group (95% CI, 0.23-0.83; P = .008). Intervention group participants received the mHELP for a median of 7 days (interquartile range, 6-10 days) and had a shorter median LOS (12.0 days) than control participants (14.0 days) (P = .04). CONCLUSIONS AND RELEVANCE For older patients undergoing abdominal surgery who received the mHELP, the odds of delirium were reduced by 56% and LOS was reduced by 2 days. Our findings support using the mHELP to advance postoperative care for older patients undergoing major abdominal surgery.
Effects of a Modified Hospital Elder Life Program on Frailty in Individuals Undergoing Major Elective Abdominal Surgery
(2014-02-01)
Chen, Cheryl Chia-Hui
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Chen, Chiung-Nien
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Lai, I-Rue
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Huang, Guan-Hua
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Saczynski, Jane S.
ObjectivesTo test the effects of a modified Hospital Elder Life Program (mHELP) on frailty. DesignMatched and unmatched analyses of data from a before-and-after study. SettingHospital, inpatient. ParticipantsParticipants aged 65 and older (n=189) undergoing major elective abdominal surgery at a medical center in Taiwan. InterventionThe mHELP included three nursing interventions: early mobilization, oral and nutritional assistance, and orienting communication. MeasurementsFrailty rate and transitions between frailty states from hospital discharge to 3months after discharge using Fried's phenotype criteria categorized as nonfrail (0 or 1 criteria present), prefrail (2 or 3 criteria present), and frail (4 or 5 criteria present). ResultsIn matched pairs, participants who received the mHELP interventions were significantly less likely to be frail at discharge (19.2%) than matched controls (65.4%) (adjusted odds ratio (AOR)=0.10, 95% CI=0.02-0.39). Transitions to states of greater frailty during hospitalization were more common for participants in the control group. Three months after discharge, participants who received the mHELP intervention during hospitalization were less likely to be frail (17.3%) than matched controls (23.1%) (AOR=0.73, 95% CI=0.21-2.56), although this difference did not achieve statistical significance. ConclusionThe mHELP intervention is effective in reducing frailty by hospital discharge, but the benefit is diminished by 3months after discharge. Thus, the mHELP provides a useful approach to manage in-hospital frailty for older adults undergoing major abdominal surgery.
Factors Related to Fungiform Papillae Density: The Beaver Dam Offspring Study
(2013-10-01)
Fischer, Mary E.
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Cruickshanks, Karen J.
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Schubert, Carla R.
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Pinto, Alex
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Klein, Ronald
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 2184 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 0212.2 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.
Familial Aggregation of Age-Related Hearing Loss in an Epidemiological Study of Older Adults
(2009-12-01)
Raynor, Laura A.
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Pankow, James S.
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Miller, Michael B.
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Huang, Guan-Hua
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Dalton, Dayna
Purpose: To estimate the genetic contributions to presbycusis. Method: Presbycusis was assessed by audiometric measurements at 3 waves of the population-based Epidemiology of Hearing Loss Study (EHLS). Measurements from the most recent hearing examination were used, at which time the subjects (3,510 participants from the EHLS study) were between 48 and 100 years of age. Heritability of presbycusis was estimated using maximum likelihood methods in 973 biological relative pairs from 376 families. Familial aggregation was also evaluated by tetrachoric correlations, odds ratios, and lambda statistics in 594 sibling pairs from 373 sibships. Results: The prevalence of presbycusis conformed to previous research, increasing with age and male sex. Heritability estimates for presbycusis adjusted for age, sex, education level, and exposure to work noise exceeded 50%, and siblings of an affected relative were at 30% higher risk. When stratified by sex, estimates of familial aggregation were higher in women than men. Conclusions: There is evidence that genetic factors contribute to age-related hearing loss in this population-based sample. The familial aggregation is stronger in women than in men.
Familial Aggregation of Olfactory Impairment and Odor Identification in Older Adults
(2010-08-01)
Raynor, Laura A.
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Pankow, James S.
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Cruickshanks, Karen J.
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Schubert, Carla R.
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Miller, Michael B.
Objectives/Hypothesis: The objective of this analysis was to estimate the genetic contributions to olfactory impairment. Study Design: Population based. Methods: Olfactory impairment was measured using the San Diego Odor Identification Test at the 5-year follow-up examination for the population-based Epidemiology of Hearing Loss study. Subjects were classified as impaired if they correctly identified fewer than six out of eight odorants. To reduce confounding by age, analysis was restricted to subjects who were 60 to 79 years of age. Familial aggregation was evaluated by heritability estimates, tetrachoric correlations, and odds ratios in 207 sibling pairs from 135 sibships. Results: The prevalence of olfactory impairment was 20.2% overall and was higher in men. After adjustment for sex, age, and smoking, heritability of olfactory impairment was moderate (h(2) = 0.55), although not statistically significantly different from 0 (P = .09). By contrast, the adjusted heritability estimate for bubble gum, one of the individual odorants, was significant (h(2) = 0.51; P = .01). Conclusions: Genetic factors might contribute to general olfactory impairment in older adults, but the strength of familial aggregation differs for individual odorants, a finding consistent with prior research.
Functional trajectory 6 months posthospitalization - A cohort study of older hospitalized patients in Taiwan
(2008-03-01)
Chen, Cheryl Chia-Hui
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Wang, Charlotte
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Huang, Guan-Hua
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統計學研究所
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Institute of Statistics
Background. Although it is well-recognized that hospitalization often precipitates functional decline in older patients, there have been few studies to examine these functional changes carefully over multiple points in time. Objective: To describe functional trajectory during and 6 months posthospitalization and to ascertain the predictors that signal different classes of functional trajectory, using latent class analysis. Methods: A cohort study was conducted on 286 older hospitalized patients who were admitted to five surgical-medical units at a tertiary medical center in Northern Taiwan. Results: are reported of 241 participants who completed all four scheduled assessments during hospitalization (within 48 hr after admission and before discharge) and 3 and 6 months postdischarge. Functional trajectory was measured using the Barthel index over four time points, and decline was defined as a reduction on the Barthel index scores. Demographics, comorbidities, visual impairment, medications taken, cognitive status, nutritional status, oral health, depressive symptoms, social support, surgical diagnosis, and length of stay were assessed as the predictors of functional trajectory classes. Most (74.3%) participants developed functional decline during hospitalization, and 32.0% had persistent functional impairment at 6 months posthospitalization. Three functional trajectory classes (good, moderate, and poor) were identified, and gender, age, comorbidities, cognitive status, nutritional status, oral health status, and length of stay were associated with different trajectory classes. Conclusion: Visualizing different classes of functional trajectory and studying predictors that signal such differences during and posthospitalization help practitioners understand how function changed and the possible ways to intervene.
Generational Differences in the 10-year Incidence of Impaired Contrast Sensitivity
(1970-01-01)
Paulsen, Adam J.
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Pinto, Alex
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Fischer, Mary E.
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Chen, Yanjun
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Huang, Guan-Hua
Purpose To determine if incidence of contrast sensitivity (CS) impairment differs by generation and identify factors to explain these differences. Methods The Beaver Dam Eye Study (BDES) and Beaver Dam Offspring Study (BOSS) are cohort studies of aging adults in Beaver Dam, Wisconsin. Baseline examinations occurred from 1993 to 1995 (BDES) and 2005-2008 (BOSS). Follow-up examinations occurred in five-year intervals. CS testing was conducted with Pelli-Robson letter sensitivity charts; Incident impairment was a log CS score <1.55 in either eye at follow-up. Associations of incidence with generation were investigated using estimated hazard ratios (HR) with 95% confidence intervals (CI). Results Participants (N = 3185) had a mean age of 51.9 years at baseline (standard deviation = 9.9) and 51.9% were female. Ten-year cumulative incidence of CS impairment was 40.1%, was higher among women (41.7%) than men (38.8%), and increased by age group. The risk of incident CS impairment decreased by 39% per generation. In multivariable models, the Baby Boom Generation (HR = 0.42, 95%CI = 0.31, 0.58) and Generation X (HR = 0.56, 95%CI = 0.34, 0.91) had a significantly decreased risk of CS impairment compared to the Greatest Generation. Results were similar in sensitivity analyses excluding those with cataract, age-related macular degeneration, or visual acuity impairment. Conclusion The risk of incident CS impairment decreased by birth cohort, with the greatest reduction in the Baby Boom Generation. The difference in risk suggests that there are unknown modifiable risk factors that may help to further explain the etiology of CS impairment and provide potential pathways for prevention in the future.