Browsing by Author "Nondahl, David M."

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Generational Differences in the 5-Year Incidence of Age-Related Macular Degeneration
(2017-12-01)
Cruickshanks, Karen J.
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Nondahl, David M.
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Johnson, Lauren J.
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Dalton, Dayna S.
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Fisher, Mary E.
IMPORTANCE Whether a reported decline in the risk of developing age-related macular degeneration (AMD) continued for people born during the Baby Boom years (1946-1964) or later is unknown. These data are important to plan for ocular health care needs in the 21st century. OBJECTIVES To determine whether the 5-year risk for AMD declined by generation and to identify factors that contributed to improvement in risk. DESIGN, SETTING, AND PARTICIPANTS Data came from the longitudinal cohort Beaver Dam Eye Study (March 1, 1988, through September 15, 1990, and March 1, 1993, through June 15, 1995) and the Beaver Dam Offspring Study (June 8, 2005, through August 4, 2008, and July 12, 2010, through March 21, 2013). These population-based studies examined residents of Beaver Dam, Wisconsin, aged 43 to 84 years in 1987 through 1988 and their adult offspring aged 21 to 84 years in 2005 through 2008. A total of 4819 participants were at risk for developing AMD based on fundus images obtained at baseline visits. Data were analyzed from February 18, 2016, through June 22, 2017, with additional analyses ending September 22, 2017. MAIN OUTCOMES AND MEASURES Fundus images were graded for AMD using the Wisconsin Age-related Maculopathy Grading System. The incidence of AMD was defined as the presence at the 5-year follow-up examination of pure geographic atrophy or exudative macular degeneration, any type of drusen with pigmentary abnormalities, or soft indistinct drusen without pigmentary abnormalities. RESULTS Among the 4819 participants, the mean (SD) baseline age of the cohort was 54 (11) years; 2117 were men (43.9%) and 2702 were women (56.1%). The 5-year age-and sex-adjusted incidence of AMD was 8.8% in the Greatest Generation (born during 1901-1924), 3.0% in the Silent Generation (born during 1925-1945), 1.0% in the Baby Boom Generation (born during 1946-1964), and 0.3% in Generation X (born during 1965-1984). Adjusting for age and sex, each generation was more than 60% less likely to develop AMD than the previous generation (relative risk, 0.34; 95% CI, 0.24-0.46). The generational association (relative risk, 0.40; 95% CI, 0.28 to 0.57) remained significant after adjusting for age, sex, smoking, educational attainment, exercise, levels of non-high-density lipoprotein cholesterol and high-sensitivity C-reactive protein, and use of nonsteroidal anti-inflammatory drugs, statins, and multivitamins. CONCLUSIONS AND RELEVANCE The 5-year risk for AMD declined by birth cohorts throughout the 20th century. Factors that explain this decline in risk are not known. However, this pattern is consistent with reported declines in risks for cardiovascular disease and dementia, suggesting that aging Baby Boomers may experience better retinal health at older ages than did previous generations.
Generational Differences in the Reporting of Tinnitus
(2012-09-01)
Nondahl, David M.
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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
Objectives: 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.
Odor identification and cognitive function in the Beaver Dam Offspring Study
(2013-08-19)
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
Olfactory impairment is associated with cognitive impairment in older adults but less is known about the association of olfactory impairment and cognitive function in middle-aged adults. The association between olfactory impairment and cognitive function tests of attention, processing speed, and executive and psychomotor function was explored in 2837 participants (21-84 years; mean age 49 years) in the Beaver Dam Offspring Study. Among middle-aged participants (aged 35-64 years), those with impairment on an odor identification test took significantly longer to complete the Trail Making Test (TMT-A and TMT-B) and the Grooved Peg Board (GPB) test, than those without olfactory impairment in regression models adjusted for multiple factors. Similar results were found for the TMT-A and TMT-B, but not the GPB, in the whole cohort. Olfactory impairment was associated with poorer performance on cognitive function tests in a primarily middle-aged cohort.
Olfactory Impairment in an Adult Population: The Beaver Dam Offspring Study
(2012-05-01)
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, 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.
Subclinical atherosclerosis and increased risk of hearing impairment
(2015-02-01)
Fischer, Mary E.
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Schubert, Carla R.
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Nondahl, David M.
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Dalton, Dayna S.
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Huang, Guan-Hua
Objective: 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.
Tinnitus and its risk factors in the Beaver Dam Offspring Study
(2011-05-01)
Nondahl, David M.
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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, Ron
Objective: To assess the prevalence of tinnitus along with factors potentially associated with having tinnitus. Design: Data were from the Beaver Dam Offspring Study, an epidemiological cohort study of aging. Study Sample: After a personal interview and audiometric examination, participants (n == 3267, ages 21--84 years) were classified as having tinnitus if in the past year they reported having tinnitus of at least moderate severity or that caused difficulty in falling asleep. Results: The prevalence of tinnitus was 10.6%. In a multivariable logistic regression model adjusting for age and sex, the following factors were associated with having tinnitus: hearing impairment (Odds Ratio (OR) == 3.20), currently having a loud job (OR == 1.90), history of head injury (OR == 1.84), depressive symptoms (OR == 1.82), history of ear infection (men, OR == 1.75), history of target shooting (OR == 1.56), arthritis (OR == 1.46), and use of NSAID medications (OR == 1.33). For women, ever drinking alcohol in the past year was associated with a decreased risk of having tinnitus (OR == 0.56). Conclusions: These results suggest that tinnitus is a common symptom in this cohort and may be associated with some modifiable risk factors.