Cataract: Health Disparity for Older African-Americans

白内障：老年非洲裔美国人的健康差距

• 批准号: 6851421
• 负责人: SHEILA K WEST
• 金额: $ 6.93万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6851421
• 关键词: African American; aging; alcoholic beverage consumption; cataract; cataract surgery; caucasian American; diabetes mellitus; disease /disorder classification; disease /disorder proneness /risk; epidemiology; eye fundus photography; health behavior; health care service utilization; health disparity; health services research tag; human data; human old age (65+); hypertension; longitudinal human study; mathematical model; model design /development; pathologic process; racial /ethnic difference; smoking; ultraviolet radiation; vision

African Americans have more visual impairment from cataract, and less cataract surgery, compared to Caucasians. While risk factors for cataract have been studied, specific determinants of cataract incidence and progression, and time to cataract surgery, comparing factors and their importance within racial groups has not been done. The aims of this research are: to determine the incidence and progression of cataract in an older population-based sample of African Americans compared to Caucasians; to determine predictive factors and their relative importance for incidence and progression; and to determine factors predicting time to cataract surgery for those with visually disabling cataract in each racial group. Prospective data have already been collected as part of the NIA funded SEE project; baseline, 2, 6, and 8 year data are available from the 2520 participants on UV exposure, alcohol and tobacco use, medications, diseases such as hypertension and diabetes, and other key risk factors. Ocular photographs were taken at baseline and graded for presence and severity of cortical, nuclear, and posterior sub-capsular cataract, and taken but not yet graded for follow up visits. Vision and physical function measures were taken at each round, enabling analyses of functional impact of cataract and predictors of seeking cataract surgery. Models will be constructed to determine risk factors for cataract incidence and progression, testing for interactions by racial groups. Level of visual impairment due to cataract and effect on physical function within racial groups will be used to model triggers for subsequent cataract surgery. Such data will increase knowledge of cataractogenic mechanisms within racial groups, and provide more understanding of disparites in seeking cataract surgery. These data will advance the goal of reducing health disparity in visual disability from cataract among older African Americans.

与白人相比，非洲裔美国人有更多的白内障视力障碍，白内障手术较少。虽然已经研究了白内障的风险因素，但尚未研究白内障发病率和进展的特定决定因素以及白内障手术时间，还没有在种族群体中比较因素及其重要性。本研究的目的是：确定白内障的发病率和进展，在一个老年人口为基础的样本的非裔美国人相比，高加索人;确定预测因素和他们的相对重要性的发病率和进展;并确定因素预测白内障手术的时间为那些视力残疾白内障在每个种族群体。作为NIA资助的SEE项目的一部分，已经收集了前瞻性数据; 2520名参与者的基线、2年、6年和8年数据，包括紫外线暴露、酒精和烟草使用、药物、高血压和糖尿病等疾病以及其他关键风险因素。在基线时拍摄眼部照片，并对皮质、核和后囊下白内障的存在和严重程度进行分级，并在随访访视时拍摄但尚未分级。在每一轮进行视力和身体功能测量，从而能够分析白内障的功能影响和寻求白内障手术的预测因素。将构建模型以确定白内障发病率和进展的风险因素，并检测种族组的相互作用。将使用白内障引起的视力损害水平和对种族内身体功能的影响来模拟后续白内障手术的触发因素。这些数据将增加种族群体内白内障发生机制的知识，并提供更多的了解寻求白内障手术的非裔美国人。这些数据将推进减少老年非裔美国人白内障视力残疾的健康差异的目标。