DISPARITIES IN ASTHMA AMONG ELDERLY IN WEST TEXAS

哮喘在美国和世界范围内的患病率一直在上升。从1980年到1994年，美国的患病率上升了75%。据报道，65岁及以上老年人的哮喘患病率为7%至10%。然而，这一估计可能是低估的，因为有证据表明，老年人的哮喘被低估了。拉美裔是美国增长最快的少数群体，但很少有研究涉及拉美裔样本，特别是 老年人。德克萨斯理工学院5000调查是一项以大规模人口为基础的纵向流行病学研究，对象是西德克萨斯州5000名老年居民。德州理工5000样本是从西德克萨斯州108个县的住宅家庭电话列表中随机挑选出来的。我们建议对德州理工5000的第三浪进行二次数据分析 这将使我们能够评估哮喘、哮喘症状和过敏在该人群中的患病率、预测因素和后果。德州理工学院5000次调查的第三波是从20001年10月到2001年12月进行的。共有3392名受试者参加了调查，应答率为86.7%。样本中包括大约12%的拉美裔美国人。这项分析的具体目标是1)估计和比较老年人中哮喘、哮喘症状和过敏的发生率，2)检验哮喘症状不太可能导致西班牙裔老年人和农村地区老年人进行医疗评估、诊断和治疗的假设，3)使用通用的(SF-12)和 4)确定和比较哮喘患者和非哮喘患者使用处方药的平均费用，以及药物费用对生活质量的影响。为了定义哮喘，将使用两个可操作的定义：确定哮喘(基于医生诊断)和可能哮喘(基于哮喘症状)。健康相关生活质量的平均得分和平均就诊次数将被计算出来，并在患有和不患有哮喘的受试者中进行比较。哮喘(明确的和可能的)与独立变量之间的联系分为五类：1)社会人口学变量，2)环境和家庭特征，3)过敏，4)哮喘症状，5)卫生保健可获得性，将使用Logistic回归分析。有哮喘症状的拉美裔和非拉美裔老年受试者的比例将在医疗保健机会方面进行比较，包括使用卡方统计进行医疗评估和诊断。将进行类似的比较，以评估城乡差异。

The prevalence of asthma has been increasing both in the US and worldwide. The prevalence increased by 75% in the U.S. from 1980 to1994. The prevalence of asthma among elderly aged 65 and above is reported to be 7% to 10%. However, this estimate may be an underestimate since there is evidence that asthma is under-diagnosed in the elderly. Hispanics are the fastest growing minority in the US, yet very few studies involve Hispanic samples, especially the elderly. The Texas Tech 5000 survey is a large population based longitudinal epidemiological study of 5000 elderly West Texas residents. The Texas Tech 5000 sample was randomly selected from residential household telephone listings in the 108 counties of West Texas. We propose to conduct a secondary data analysis of the wave-3 of the Texas Tech 5000 survey, which will permit us to assess the prevalence, predictors, and consequences of asthma, asthma symptoms and allergy in this population. The wave-3 of the Texas Tech 5000 survey was conducted from October 20001 through December 2001. A total of 3392 subjects participated in the survey for a response rate of 86.7%. The sample includes approximately 12% Hispanics. The specific objectives of this analysis are 1) to estimate and compare the revalence of asthma, asthma symptoms, and allergies among the elderly persons, 2) to test hypotheses that asthma symptoms are less likely to result in medical assessment, diagnosis and treatment among Hispanic elderly persons and among elderly persons in rural areas, 3) to assess impact of asthma and asthma symptoms on daily life, using generic (SF-12) and asthma specific health related quality of life (HRQoL) questionnaire, and 4) to determine and compare the average cost of prescription medicine used by subjects with and without asthma and how the cost of medication affects quality of life. To define asthma, two operational definitions will be used: definite asthma (based on physician-diagnosis) and probable asthma (based on asthma symptoms). Mean scores on health related quality of life, and mean number of physician office visits will be computed and compared among subjects with and without asthma. The association between asthma (definite and probable) and independent variables grouped into five categories: 1) socio-demographic variables, 2) environmental and household characteristics, 3) allergies, 4) asthma symptoms, and 5) health care access, will be analyzed using logistic regression. Proportion of elderly Hispanics and non-Hispanic subjects with asthma symptoms will be compared with regard to health care access, including medical assessment and diagnosis using chi-square statistics. A similar comparison will be made to evaluate urban/rural differences.