Browsing by Author "Pinto, A. Alex"

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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.
;
Fischer, Mary E.
;
Huang, Guan-Hua
;
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.
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. Alex
;
Chen, Yanjun
Background: 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.