EPIDEMIOLOGY OF CARDIOVASCULAR DISEASES IN THE ELDERLY

本研究的目标是1)确定和2)描述 心血管疾病(CVD)发病率的危险因素分布和 一群自由生活的老年人的死亡率。身份识别 老年人心血管疾病的危险因素是重要的，因为1)心血管疾病是 美国老年人死亡和残疾的主要原因和2) 有证据表明CVD在这个年龄段是可以预防或延迟的。 这些分析中使用的数据是在达尼丁收集的 计划，一个以人口为基础的老年健康计划，旨在筛查 65岁及以上人群患有各种医疗疾病。 位于佛罗里达州达尼丁的达尼丁计划一直在进行中 自1975年7月开始运营。参与者每年都会接受筛查，并 在每次访问期间，都会收集有关心血管疾病和心血管疾病风险因素的大量数据。 信息可从问卷中获得(即，家族史， 既往和现在的疾病、吸毒、吸烟和酗酒)， 体检(即心电图、脉率、血压)和 实验室测量(即葡萄糖、胆固醇、尿酸)。目前 (1985)，5085名老年男女至少接受了一次筛查，以及 1540人参加了该方案整整八年。 这一参与共计14,783人年的观测 平均随访4.9年。 分析将由三个不同的阶段组成。在第一阶段， 将计算每个参与者的跟踪时间，以及风险的变化 将对因素状态进行分析。的描述性信息 危险因素的分布，以及整个地区心血管疾病的患病率 将公布队列。心血管疾病的发病率和死亡率将是 为所有参与者计算的。 在第二个分析阶段，将计算心血管疾病的发病率 (事件次数/跟踪人数-年)按风险因素类别分列 基线上的标高。心血管疾病的相对风险(年发病率 暴露量/未暴露量中的发病率)将针对每个假设计算 风险因素。 第三阶段将是多变量分析。考克斯回归模型将 用于确定已识别的 危险因素对该队列中心血管疾病的发病率和死亡率的影响。 这项研究将提供有关老年人心血管疾病患病率和风险的信息。 大量自由生活的老年人口。潜在的身份识别 既可能增加老年人心血管疾病风险的因素，也可能是 可改变或可治疗对公共卫生具有重大意义，如 这些因素的修改可能会导致进一步减少 在我们这一庞大且不断增长的人口群体中发生的事件/死亡。

The objective of this research is to 1) identify and 2) describe the distribution of risk factors for cardiovascular disease (CVD) incidence and mortality in a cohort of free-living elderly persons. The identification of risk factors for CVD in older persons is important as 1) CVD is the leading cause of death and disability in elderly Americans and 2) there is evidence that CVD can be prevented or delayed in this age group. The data to be used in these analyses were collected in the Dunedin Program, a population-based geriatric health program designed to screen persons 65 years of age and older for a wide range of medical disorders. The Dunedin Program, located in Dunedin, Florida, has been in continuous operation since July 1975. Participants are screened annually, and extensive data on CVD and CVD risk factors are gathered during each visit. Information is available from questionnaires (i.e., family history, previous and present illnesses, drug use, smoking and alcohol use), physical examinations (i.e., EKGs, pulse rate, blood pressures) and laboratory measures (i.e., glucose, cholesterol, uric acid). Currently (1985), 5,085 elderly men and women have been screened at least once, and 1,540 persons have participated in the Program for a full eight years. This participation represents a total of 14,783 person-years of observation with an average follow-up of 4.9 years. The analysis will consist of three distinct phases. In the first phase, follow-up time for each participant will be computed, and changes in risk factor status will be analyzed. Descriptive information of the distribution of risk factors, and the prevalence of CVD in the entire cohort will be presented. CVD incidence and CVD mortality rates will be calculated for all participants. In the second analysis phase, incidence rates of CVD will be computed (number of events/person-years of follow-up) by category of risk factor level at baseline. The relative risk of CVD (incidence in exposed/incidence in unexposed) will be calculated for each hypothesized risk factor. The third phase will be multivariable analyses. Cox regression models will be used to determine independent and interactive effects of the identified risk factors on the incidence of and mortality from CVD in this cohort. This study will provide information on the prevalence and risk of CVD in a large, free-living elderly population. The potential identification of factors which may both increase the risk for CVD in older persons, and be modifiable or treatable is of significant public health importance, as modification of these factors may lead to a further reduction of events/deaths in this large and growing segment of our population.