Browsing by Author "Klein, Barbara E. K."
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Item type:Item, Cadmium, obesity, and education, and the 10-year incidence of hearing impairment: The beaver dam offspring study(1970-01-01) ;Dalton, Dayna S. ;Schubert, Carla R. ;Pinto, Alex ;Fischer, Mary E.Huang, Guan-HuaObjectives/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, 2019Item type:Item, Carotid atherosclerosis and cognitive function in midlife: The beaver dam offspring study(2011-11-01) ;Zhong, Wenjun ;Cruickshanks, Karen J. ;Huang, Guan-Hua ;Klein, Barbara E. K.Klein, RonaldBackground: 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.Item type:Item, Dry Eye in the Beaver Dam Offspring Study: Prevalence, Risk Factors, and Health-Related Quality of Life(2014-04-01) ;Paulsen, Adam J. ;Cruickshanks, Karen J. ;Fischer, Mary E. ;Huang, Guan-HuaKlein, 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.Item type:Item, Familial Aggregation of Age-Related Hearing Loss in an Epidemiological Study of Older Adults(2009-12-01) ;Raynor, Laura A. ;Pankow, James S. ;Miller, Michael B. ;Huang, Guan-HuaDalton, DaynaPurpose: 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.Item type:Item, Generational Differences in the 10-year Incidence of Impaired Contrast Sensitivity(1970-01-01) ;Paulsen, Adam J. ;Pinto, Alex ;Fischer, Mary E. ;Chen, YanjunHuang, Guan-HuaPurpose 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.Item type:Item, Generational Differences in the Prevalence of Hearing Impairment in Older Adults(2010-01-15) ;Zhan, Weihai ;Cruickshanks, Karen J. ;Klein, Barbara E. K. ;Klein, RonaldHuang, Guan-HuaThere 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 >= 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.Item type:Item, Generational Differences in the Reporting of Tinnitus(2012-09-01) ;Nondahl, David M. ;Cruickshanks, Karen J. ;Huang, Guan-Hua ;Klein, Barbara E. K.Klein, RonaldObjectives: Recent research suggests that hearing impairment is declining among older adults compared with earlier generations of the same age. Tinnitus is often associated with hearing impairment, so one might hypothesize that the prevalence of tinnitus is declining in a similar manner. The purpose of this study was to use multigenerational data with repeated measures to determine whether the prevalence of tinnitus is declining among more recent generations. Design: Using data from the Epidemiology of Hearing Loss Study (1993-1995, 1998-2000, 2003-2005, and 2009-2010) and the Beaver Dam Offspring Study (2005-2008), the authors examined birth cohort patterns in the report of tinnitus for adults aged 45 years and older (n = 12,689 observations from 5764 participants). Participants were classified as having tinnitus if they reported tinnitus in the past year of at least moderate severity or that caused difficulty falling asleep. A low-frequency (500, 1000, and 2000 Hz) and high-frequency (3000, 4000, 6000, and 8000 Hz) pure tone average from the worse ear was used to summarize hearing status. Other potential risk factors for tinnitus were also explored to determine if changes in the prevalence of these factors over time could explain any observed birth cohort differences in the prevalence of tinnitus. These included the following: education, history of head injury, history of doctor-diagnosed ear infections, history of cardiovascular disease (myocardial infarction, stroke, or angina), current noisy job, longest-held job, target shooting in the past year, number of concerts ever attended, alcohol use in the past year, doctor diagnosis of arthritis, current aspirin use, regular exercise, and consulting with a physician in the past year about any hearing/ear problem. Birth cohort effects were modeled with alternating logistic regression models which use generalized estimating equations to adjust for correlation among repeated measurements over time that are nested within families. Results: The report of tinnitus tended to increase with more recent birth cohorts compared with earlier birth cohorts. For example, at ages 55 to 59 years, 7.6% of participants born between 1935 and 1939 reported tinnitus, compared with 11.0% of those born in 1940 to 1944, 13.6% of those born between 1945 and 1949, and 17.5% of those born between 1950 and 1954. Similarly, at ages 65 to 69 years, 7.9% of participants born between 1925 and 1929 reported tinnitus, compared with 10.0% of those born between 1930 and 1934, 11.9% of those born between 1935 and 1939, and 13.7% of those born between 1940 and 1944. Final alternating logistic regression model results indicated that, on average, after adjusting for age and other factors, participants in a given generation were significantly more likely to report tinnitus than participants from a generation 20 years earlier (odds ratio = 1.78, 95% confidence interval = 1.44, 2.21). Conclusions: Increased reports of tinnitus may reflect increased prevalence of symptoms, increased awareness of symptoms, or higher health expectations among more recent generations of adults. Regardless of the reasons, the increasing prevalence of tinnitus suggests that health care providers may see an increased number of patients bothered by this common but little understood symptom.Item type:Item, Intensity of 6-n-Propylthiouracil (PROP) Taste, Food Preferences, and Obesity: The Beaver Dam Offspring Study(2009-09-01) ;Cruickshanks, Karen J. ;Schubert, Carla R. ;Snyder, Derek J. ;Bartoshuk, Linda M.Huang, Guan-HuaItem type:Item, Measuring Refraction in Adults in Epidemiological Studies(2010-01-01) ;Krantz, Elizabeth M. ;Cruickshanks, Karen J. ;Klein, Barbara E. K. ;Klein, RonaldHuang, Guan-HuaObjective: 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 beforeandafter pharmacologic cycloplegia, suggesting that cycloplegia may not be necessary in epidemiological studies of refraction in adults.Item type:Item, Measuring Taste Impairment in Epidemiologic Studies The Beaver Dam Offspring Study(2008-10-01) ;Cruickshanks, Karen J. ;Schubert, Carla R. ;Snyder, Derek J. ;Bartoshuk, Linda M.Acher, Charles W.Item type:Item, Meta-analysis of Dense Genecentric Association Studies Reveals Common and Uncommon Variants Associated with Height(2011-01-07) ;Lanktree, Matthew B. ;Guo, Yiran ;Murtaza, Muhammed ;Glessner, Joseph T.Bailey, Swneke D.Height is a classic complex trait with common variants in a growing list of genes known to contribute to the phenotype. Using a genecentric genotyping array targeted toward cardiovascular-related loci, comprising 49,320 SNPs across approximately 2000 loci, we evaluated the association of common and uncommon SNPs with adult height in 114,223 individuals from 47 studies and six ethnicities. A total of 64 loci contained a SNP associated with height at array-wide significance (p < 2.4 x 10(-6)), with 42 loci surpassing the conventional genome-wide significance threshold (p < 5 x 10(-8)). Common variants with minor allele frequencies greater than 5% were observed to be associated with height in 37 previously reported loci. In individuals of European ancestry, uncommon SNPs in IL11 and SMAD3, which would not be genotyped with the use of standard genome-wide genotyping arrays, were strongly associated with height (p < 3 x 10(-11)). Conditional analysis within associated regions revealed five additional variants associated with height independent of lead SNPs within the locus, suggesting allelic heterogeneity. Although underpowered to replicate findings from individuals of European ancestry, the direction of effect of associated variants was largely consistent in African American, South Asian, and Hispanic populations. Overall, we show that dense coverage of genes for uncommon SNPs, coupled with large-scale meta-analysis, can successfully identify additional variants associated with a common complex trait.Item type:Item, Modifiable determinants of hearing impairment in adults(2011-10-01) ;Zhan, Weihai ;Cruickshanks, Karen J. ;Klein, Barbara E. K. ;Klein, RonaldHuang, Guan-HuaObjective. To identify factors contributing to the declining prevalence of hearing impairment in more recent generations. Methods. We used data on hearing thresholds and potential risk factors of hearing impairment collected from studies in Beaver Dam, Wisconsin, the Epidemiology of Hearing Loss Study (1993-1995, n=3753; 1998-2000, n = 2800 and 2003-2005, n=2395), the concurrent Beaver Dam Eye Study on the same cohort, and a subgroup (n = 2173) of the Beaver Dam Offspring Study (2005-2008). Results. Educational attainment significantly reduced the odds ratio (OR) of the birth cohort effect on hearing impairment from 0.90 to 0.93, while a history of ear infection had a reverse effect on the decreasing trend (significantly changing the OR from 0.93 to 0.94). Occupational noise exposure, smoking, and a history of cardiovascular disease, while associated with hearing impairment, did not attenuate the cohort effect. The cohort effect remained significant after known risk factors were adjusted (OR = 0.93; 95% confidence interval, 0.89-0.97). Conclusion. These data provide strong evidence that environmental, lifestyle, or other modifiable factors contribute to the etiology of hearing impairment and add support to the idea that hearing impairment in adults may be prevented or delayed. (C) 2011 Elsevier Inc. All rights reserved.Item type:Item, OBESITY AND DEPRESSION SYMPTOMS IN THE BEAVER DAM OFFSPRING STUDY POPULATION(2010-09-01) ;Zhong, Wenjun ;Cruickshanks, Karen J. ;Schubert, Carla R. ;Nieto, F. JavierHuang, Guan-HuaBackground: Depression and obesity are both important public health problems. However, it is not clear whether obesity contributes to depression. Our study aims to evaluate the association between obesity and possible depression. Methods: During the Beaver Dam Offspring Study examination, participants' body weight and height were measured with a Detecto 758C digital scale with height bar, and depression symptoms were measured with the Center for Epidemiological Studies-Depression (CES-D) Scale. Other relevant information, such as demographic factors, lifestyle factors, comorbidities, and use of antidepressants, was also collected during the examination. There were 2,641 participants included in the analyses. Results: Obesity was associated with possible depression measured by CES-D Scale (OR= 1.6, 95% CI: 1.3-2.0) after controlling for age and gender. The association remained similar after further adjustments. Obesity was significantly associated with all four domains measured by CES-D Scale after controlling for age and sex, with the largest effect on "Somatic Complaints" domain (beta .15, 95% CI: 0.0836-0.223). The association with "Interpersonal Difficulties" was not significant after further adjustments. Conclusions: Obesity was associated with a higher risk of possible depression and had different influences on specific domains of depression symptoms measured by CES-D Scale. These findings suggest the need for longitudinal studies on the effects of obesity on specific depression symptoms. Depression and Anxiety 27:846-851, 2010. (C) 2010 Wiley-Liss, Inc.Item type:Item, Olfactory Impairment in Adults The Beaver Dam Experience(2009) ;Schubert, Carla R. ;Cruickshanks, Karen J. ;Murphy, Claire ;Huang, Guan-HuaKlein, Barbara E. K.Olfactory function maybe important for environmental and nutritional safety and enjoyment. Population-based epidemiological studies of olfaction are needed to understand the magnitude of the health burden, identify modifiable risk factors, and develop and test prevention and treatment strategies for olfactory impairment. However, measuring olfaction in large studies is challenging, requiring repeatable, efficient methods that can measure change over time. Two large cohort studies, the Epidemiology of Hearing Loss Study (EHLS) and the Beaver Dam Offspring Study (BOSS), included olfactory testing. In both studies, the San Diego Odor Identification Test (SDOIT) was used to measure olfaction. Subjects were asked to identify eight common household odors (such as coffee and chocolate). Olfactory impairment was defined as correctly identifying fewer than six out of eight odorants after two trials. The EHLS participants were age 53-95 years at the time of the first measurement (1998-2000), and participants in the BOSS were age 21-84 years. The prevalence of olfactory impairment in the EHLS was 25% overall, more common in men than women, and increased with age. Five years later olfaction was measured a second time and the majority (84%) of the EHLS participants were classified the same. Among those with impairment at the base line nearly one-third (31%) improved to unimpaired. This heterogeneity in olfactory impairment has unique implications for data analyses and predicting outcomes and associations. Preliminary data from the BOSS suggest the prevalence of olfactory impairment may be lower in younger generations. All these factors point to a continuing need for epidemiological studies of olfaction.Item type:Item, Olfactory Impairment in Adults: The Epidemiology of Hearing Loss Study and the Beaver Dam Offspring Study(2008-10-01) ;Schubert, Carla R. ;Cruickshanks, Karen J. ;Murphy, Claire ;Acher, Charles W.Huang, Guan-HuaItem type:Item, Olfactory Impairment in an Adult Population: The Beaver Dam Offspring Study(2012-05-01) ;Schubert, Carla R. ;Cruickshanks, Karen J. ;Fischer, Mary E. ;Huang, Guan-HuaKlein, Barbara E. K.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, >=$50 000 versus <$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.Item type:Item, Prevalence of Olfactory Impairment in Adults Across the Life Span: The Beaver Dam Offspring Study(2009-09-01) ;Schubert, Carla R. ;Cruickshanks, Karen J. ;Krantz, Elizabeth M. ;Huang, Guan-HuaKlein, Barbara E. K.Item type:Item, Relationships of Retinal Arteriolar and Venular Diameters with Carotid Intima-Media Thickness: The Beaver Dam Offspring Study(2009-03-17) ;Godreau, Ayleen ;Klein, Ronald ;Lee, Kristine ;Klein, Barbara E. K.Schubert, CarlaItem type:Item, Sensorineural Impairments, Cardiovascular Risk Factors, and 10-Year Incidence of Cognitive Impairment and Decline in Midlife: The Beaver Dam Offspring Study(2019-11-01) ;Schubert, Carla R. ;Cruickshanks, Karen J. ;Fischer, Mary E. ;Pinto, A. AlexChen, YanjunBackground: Sensorineural impairments and cardiovascular risk factors (CVRF) and disease (CVD) in midlife may be important predictors of future cognitive health, but longitudinal studies that include multiple sensorineural measures in middle-aged adults are lacking. Methods: Hearing, vision, and olfaction, and CVRF and CVD were measured at the Beaver Dam Offspring Study baseline (2005-2008) examination. The Mini-Mental State Examination and Trail Making Tests A and B were administered at all phases and additional cognitive function measures were obtained at 5 (2010-2013) and 10 years (2015-2017). Cox proportional hazards models were used to evaluate associations between baseline sensorineural impairments, CVRF, CVD, and 10-year cumulative incidence of cognitive impairment and decline. Results: There were 2,556 participants (22-84 years) without cognitive impairment at baseline and data from at least one follow-up. In a multivariable model including age, sex, education, and head injury, visual impairment (hazard ratio = 2.59, 95% confidence interval = 1.34, 5.02), olfactory impairment (hazard ratio = 3.18, 95% confidence interval = 1.53, 6.59), CVD (hazard ratio = 2.37, 95% confidence interval = 1.24, 4.52), and not consuming alcohol in the past year (hazard ratio = 2.21, 95% confidence interval = 1.16, 4.19) were associated with the 10-year cumulative incidence of cognitive impairment. Current smoking and diabetes were associated with increased risk, and exercise with decreased risk, of 10-year decline in cognitive function. Conclusions: Visual and olfactory impairments, CVRF, and CVD were associated with the 10-year cumulative incidence of cognitive impairment and decline in middle-aged adults. Identifying modifiable factors associated with cognitive decline and impairment in midlife may provide opportunities for prevention or treatment and improve cognitive health later in life.Item type:Item, Subclinical atherosclerosis and increased risk of hearing impairment(2015-02-01) ;Fischer, Mary E. ;Schubert, Carla R. ;Nondahl, David M. ;Dalton, Dayna S.Huang, Guan-HuaObjective: The study\'s purpose was to test if subclinical atherosclerosis was associated with the risk of developing HI in a large cohort of middle-aged participants. Methods: Study subjects were members of the Beaver Dam Offspring Study (BOSS), a longitudinal study of adult children of participants in the population-based Epidemiology of Hearing Loss Study (1993-present). BOSS examinations took place in 2005-2008 (baseline) and 2010-2013 (5-year follow-up). The 5-year incidence of hearing impairment was defined as a pure-tone average (PTA) of thresholds at 0.5, 1, 2 and 4 kHz > 25 dB Hearing Level (dB HL) in either ear at follow-up among participants at risk (baseline PTA in both ears < = 25 dB HL; n = 2436, mean age = 47.7 years). Atherosclerosis was measured as the mean carotid intima-media thickness and the presence of carotid artery plaque. Results: Among the 1984 participants at-risk with a follow-up audiometric examination, the 5-year incidence of hearing impairment was 8.3% (95% Confidence Interval (C.I.) 7.1, 9.5). With multivariable adjustment, carotid intima- media thickness was positively associated with hearing impairment incidence (Relative Risk (RR) = 1.14 per 0.1 mm, 95% C.I. 1.04, 1.24). The number of sites (0-6) with plaque was also positively associated with the incidence of impairment (RR = 1.16 per site, 95% C.I. 1.01, 1.32). Conclusion: Atherosclerosis was associated with the 5-year incidence of hearing impairment in this predominantly middle-aged cohort. Interventions targeting atherosclerosis prevention may help to prevent or delay the onset of hearing impairment. (C) 2014 Elsevier Ireland Ltd. All rights reserved.