EPIDEMIOLOGY OF CARDIOVASCULAR DISEASES IN THE ELDERLY

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The objective of this research is to 1) identify and 2) describe the distribution of risk factors for cardiovascular disease (CVD) 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 were collected by the Dunedin Program, a population- based geriatric health program designed to screen persons 65+ years 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 risk factors are gathered at each visit. Information is available from questionnaires (i.e. family history, drug use, smoking, alcohol use), physical exams (i.e. EKGs, pulse rate, blood pressure) and laboratory measures (i.e. glucose, lipids, uric acid). Currently (1986) 5,085 men and women have been screened at least once and 1,540 persons have been screened for eight years. This participation represents 14,783 person-years of observation with an average follow-up of 4.9 years. The analysis will consist of three phases. First, follow-up time for each participant will be computed, and changes in risk factor status will be analyzed. Descriptive data on the distribution of risk factors and the prevalence of CVD in the entire cohort will be presented. CVD incidence and mortality rates will be calculated. In the second phase, incidence rates of CVD will be computed 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 is multivariable analyses. Regression models will be used to determine independent and interactive effects of the identified risk factors on the incidence of and mortality from CVD. This study will provide information of the prevalence and risk of CVD in a large, free-living elderly population. The identification of factors which may both increase the risk of CVD in the aged, and be modifiable/treatable is of significant public health importance, as changes in these factors may lead to further reduction of events/deaths in this large and growing segment of our population.