Blue Mountains Cohort Study: Incidence Of Eye Disease, Hearing Loss And Other Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$813,250.00
Summary
The proposed study aims to determine the cumulative 10-year incidence and progression of the major eye diseases that threaten vision in older Australians, including age-related maculopathy, cataract, glaucoma and diabetic retinopathy. The cumulative 5-year incidence of age-related hearing loss and prevalence of loss of smell will also be determined. The study will assess risk factors and associations with these diseases, using information collected at the baseline, 5-year and 10-year examination ....The proposed study aims to determine the cumulative 10-year incidence and progression of the major eye diseases that threaten vision in older Australians, including age-related maculopathy, cataract, glaucoma and diabetic retinopathy. The cumulative 5-year incidence of age-related hearing loss and prevalence of loss of smell will also be determined. The study will assess risk factors and associations with these diseases, using information collected at the baseline, 5-year and 10-year examinations on medical history, ocular factors, vascular disease, smoking, diet, plus environmental and blood factors. The study aims to assess the impact of these sensory impairments on measures of dependence, quality of life, general health, age-related cognitive impairment, depression and on mortality. The study will be conducted in Katoomba on the cohort of residents from two postcode areas who originally attended the Blue Mountains Eye Study during the period 1992-4. Examinations will commence by May, 2002 and be completed by April, 2004. We hope to examine 2,032 of the original cohort of 3,654 people. This project will build on the data already collected by the Blue Mountains Eye Study, one of the most successful community surveys conducted in Australia. The 10-year follow-up period will provide increased statistical power and precision to assess the role of possible risk factors for eye disease already identified by the earlier baseline and 5-year studies of this population. The hearing component of the study will provide the first longitudinal data on hearing loss from a large older Australian population.Read moreRead less
Low-yield Cigarettes And Diminution Of Small Airways Lung Function In Long-term Smokers
Funder
National Health and Medical Research Council
Funding Amount
$209,500.00
Summary
The modern cigarette has been designed to produce low yields of tar when the tobacco in the cigarette is burnt. The tar contains human carcinogens, and monitoring and regulating yields of tar has long been part of the comprehensive tobacco control strategy in Australia. This focus on tar has given an implicit endorsement of the low-yield cigarette as a safer cigarette. Recently, however, controversy has emerged about whether smoking low-yield cigarettes has reduced the harm done by smoking. The ....The modern cigarette has been designed to produce low yields of tar when the tobacco in the cigarette is burnt. The tar contains human carcinogens, and monitoring and regulating yields of tar has long been part of the comprehensive tobacco control strategy in Australia. This focus on tar has given an implicit endorsement of the low-yield cigarette as a safer cigarette. Recently, however, controversy has emerged about whether smoking low-yield cigarettes has reduced the harm done by smoking. The concern is that adenocarcinoma of the lung, a type of lung cancer that is most common in the small peripheral airways, has increased in frequency. This could be because the low-yield cigarette, with reduced yields of nicotine as well as tar, is smoked more intensely by smokers to compensate for the low nicotine. By smoking more intensely, we mean taking larger and more frequent puffs, inhaling the smoke deeply into the lungs, and holding the breath before expiring. This method of smoking would result in more tar particles being deposited in the peripheries of the lung where adenocarcinoma is most common. Because cigarette smoking has been linked also with other structural changes in the small airways of the lung, resulting in obstruction of airflow, we will test whether smoking low-yield cigarettes is associated with greater obstruction of the small airways than is smoking higher-yield cigarettes. To test whether the mechanism is the method of smoking, we will carefully describe and quantify each subject's pattern of smoking including the deposition of smoke-like Technegas particles in the peripheral lung.Read moreRead less
Genes And Environment In The Risk Of Early Age-Related Macular Degeneration: A Population-based Case-Control Study
Funder
National Health and Medical Research Council
Funding Amount
$949,588.00
Summary
This study will pool data from three well-conducted population-based cohorts of older persons to gain a large sample size in order to investigate the interplay of genes and environmental factors on the risk of age-related macular degeneration (AMD). The study will give insights into AMD pathogenesis, and enable potential targeting of people with AMD susceptibility genes for preventive approaches. These could ultimately reduce the burden of this blinding condition.
Osteoporosis is a major and increasing public health problem. Fracture, the ultimate consequence of osteoporosis is associated with significant morbidity, mortality and economic costs. The Dubbo Osteoporosis Epidemiology Study, starting in 1989, with over 2000 women and men, is one of the longest running epidemiological studies in osteoporosis worldwide. It has been at the forefront of epidemiological advances in osteoporosis. It has identified osteoporotic fracture risks including low bone dens ....Osteoporosis is a major and increasing public health problem. Fracture, the ultimate consequence of osteoporosis is associated with significant morbidity, mortality and economic costs. The Dubbo Osteoporosis Epidemiology Study, starting in 1989, with over 2000 women and men, is one of the longest running epidemiological studies in osteoporosis worldwide. It has been at the forefront of epidemiological advances in osteoporosis. It has identified osteoporotic fracture risks including low bone density and bone loss, muscle weakness and postural instability, as well as the extent of the problem in men, and the significant costs, ill-heath and mortality associated with fracture. Despite the clarification of risk factors over the past decade, there are significant gaps in knowledge about osteoporosis, particularly in the accurate prediction of fracture risk and in identification of factors related to fracture-associated mortality and survival post fracture. Although bone density is one of the best predictors of fracture risk, it incompletely discriminates between those who will fracture from those who will not. Although a number of clinical risk factors, and other measures of bone strength, such as quantitative ultrasound and geometry, have been shown to be independent predictors of fracture risk, it is not clear that these measures can be integrated with BMD to improve fracture prediction. The aim of the current study, is to develop and validate models using bone density, other measures of bone strength and clinical parameters that will more accurately predict fracture risk and mortality following fracture in older men and women. The more precise identification of those at high risk of fracture and at risk for poor outcomes following fracture will provide a rational basis for the development of more cost effective interventions for prevention of fracture and its associated morbidity and mortality.Read moreRead less
Genes And Environment In Late AMD: Pooling A State And Population Resource
Funder
National Health and Medical Research Council
Funding Amount
$701,642.00
Summary
This study will pool cases from the West Australian Macular Degeneration database with the Blue Mountains Eye Study (NSW), to investigate the interplay of genes and environmental factors on risk of age-related macular degeneration (AMD), in particular the late, vision threatening stage. It will provide insights into the underlying causes of AMD, and could allow us to target people with AMD susceptibility genes for preventive approaches, which could reduce the burden of this disease.
I am a cancer epidemiologist, specialising in molecular epidemiology. I investigate the genetic and environmental causes of gynaecological cancers, and their consequences (prognosis, survival, quality of life, economic).
A Population-based Study Of Progression And Risk Factors For Age-related Maculopathy
Funder
National Health and Medical Research Council
Funding Amount
$776,022.00
Summary
Age-related macular degeneration (AMD) is a progressive disease, commencing with the less severe age-related maculopathy (ARM), that ultimately can lead to the loss of fine central vision and personal independence. People with advanced AMD generally retain some mobility if their peripheral vision is maintained, but they are unable to perform tasks such as reading, hobbies or recognising people's faces. Unfortunately, the available treatment for AMD, macular laser photocoagulation, benefits only ....Age-related macular degeneration (AMD) is a progressive disease, commencing with the less severe age-related maculopathy (ARM), that ultimately can lead to the loss of fine central vision and personal independence. People with advanced AMD generally retain some mobility if their peripheral vision is maintained, but they are unable to perform tasks such as reading, hobbies or recognising people's faces. Unfortunately, the available treatment for AMD, macular laser photocoagulation, benefits only a minority of people with this disease. Until safe and effective treatments for AMD can be developed, identification of major risk factors for the development and progression of AMD is essential to determine if interventions aimed at primary prevention can be initiated. This project will expand on the initial findings of the Visual Impairment Project (VIP), a population-based study of age-related eye disease in a cohort of more than 5000 Victorians aged 40 years and older. Data from the VIP have shown that AMD is the most important ophthalmologic public health problem, particularly since AMD is the major cause of vision impairment in Australia and has the least available treatment options. This study will follow individuals who were identified in the VIP with ARM-AMD to determine the natural history and risk factors associated with the longer term progression of AMD. Particular emphasis will be on determining the role of cardiovascular disease risk factors in AMD progression.Read moreRead less
Concord Hormones And Ageing In Men Project (CHAMP)
Funder
National Health and Medical Research Council
Funding Amount
$1,780,887.00
Summary
Throughout life men have poorer health than women, a health difference that extends into old age. In Australia in 2001, life expectancy for a 65 year old man was 20% less than for a 65 year old woman (81.6 years for men and 85.2 years for women). The study proposed here will fill major gaps in knowledge about key health problems in older men. The study will be called CHAMP: Concord Hormones and Ageing in Men Project. As people grow older, health problems that cause loss of independence and reduc ....Throughout life men have poorer health than women, a health difference that extends into old age. In Australia in 2001, life expectancy for a 65 year old man was 20% less than for a 65 year old woman (81.6 years for men and 85.2 years for women). The study proposed here will fill major gaps in knowledge about key health problems in older men. The study will be called CHAMP: Concord Hormones and Ageing in Men Project. As people grow older, health problems that cause loss of independence and reduced quality of life become increasingly important. The term 'geriatric giants' is sometimes used to describe these disabling syndromes: falls and fractures, cognitive impairment and dementia, urinary incontinence, and poor mobility and functional dependence. CHAMP has been designed to investigate the causes of, and inter-relationships between, these geriatric syndromes in men. Reproductive hormones are responsible for the fundamental biological differences between men and women. Underpinning CHAMP is the idea that age-related changes in reproductive hormones play an important role in the development of the geriatric syndromes in older men. There have been numerous studies of oestrogen and health in older women but only limited research on testosterone and other reproductive hormones in older men. CHAMP will be the largest study of the geriatric syndromes in older men ever conducted. The study will inlvolve 2800 men aged 65 years and over recruited from the community around Concord Hospital in Sydney. These men will each spend 3 hours at the study centre, where they will have a comprehensive physical examination and tests for osteoporosis, muscle weakness, dementia and urinary problems, as well as blood tests. This will all be repeated 2 years later.Read moreRead less
Investigating The Application Of Population Data To Improve Maternal And Child Health Services In Two Remote Communities
Funder
National Health and Medical Research Council
Funding Amount
$83,281.00
Summary
This project will contribute to the understanding of how routinely collected population health data relate to remote Aboriginal communities and how such data can be used in two field sites. Population data are widely used, but the opportunity to investigate these matters is limited. The nesting of this study within a larger project aimed at improving health services for mothers and babies provides a unique opportunity to investigate aspects of applying macro level data at a local level.