المؤلفون: Preeti Gupta, Aurora Chan, Vu Tai-Anh, Ryan E. K. Man, Eva K. Fenwick, Amudha Aravindhan, Chay Junxing, Joanne M. Wood, Alex A. Black, Jia Hui Ng, Ching-Yu Cheng, Charumathi Sabanayagam, Ecosse L. Lamoureux

المصدر: BMC Public Health, Vol 24, Iss 1, Pp 1-12 (2024)

مصطلحات موضوعية: Vision, Hearing, Olfaction, Multiple sensory impairment, Population-based design, Older adults, Public aspects of medicine, RA1-1270

الوصف: Abstract Background To determine the prevalence, risk factors; and impact on patient health and economic outcomes across the laterality spectrum of multiple sensory impairment (MSI) in a multi-ethnic older Asian population. Methods In this population-based study of Singaporeans aged ≥ 60 years, MSI was defined as concomitant vision (visual acuity > 0.3 logMAR), hearing (pure-tone air conduction average > 25 dB), and olfactory (score

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2458Test

الوصول الحر: https://doaj.org/article/8b699f75523e427fbf7afc3b4cb8b243Test

المؤلفون: Amudha Aravindhan, Eva K. Fenwick, Aurora Wing Dan Chan, Ryan Eyn Kidd Man, Ngiap Chuan Tan, Wei Teen Wong, Wern Fern Soo, Shin Wei Lim, Sabrina Yi-Mei Wee, Charumathi Sabanayagam, Eric Finkelstein, Gavin Tan, Haslina Hamzah, Bibhas Chakraborty, Sanchalika Acharyya, Tai E. Shyong, Peter Scanlon, Tien Yin Wong, Ecosse L. Lamoureux

المصدر: BMC Public Health, Vol 24, Iss 1, Pp 1-13 (2024)

مصطلحات موضوعية: Diabetic retinopathy, Diabetic macular edema, Screening, Risk stratification, Public aspects of medicine, RA1-1270

الوصف: Abstract Background The Diabetic Retinopathy Extended Screening Study (DRESS) aims to develop and validate a new DR/diabetic macular edema (DME) risk stratification model in patients with Type 2 diabetes (DM) to identify low-risk groups who can be safely assigned to biennial or triennial screening intervals. We describe the study methodology, participants’ baseline characteristics, and preliminary DR progression rates at the first annual follow-up. Methods DRESS is a 3-year ongoing longitudinal study of patients with T2DM and no or mild non-proliferative DR (NPDR, non-referable) who underwent teleophthalmic screening under the Singapore integrated Diabetic Retinopathy Programme (SiDRP) at four SingHealth Polyclinics. Patients with referable DR/DME (> mild NPDR) or ungradable fundus images were excluded. Sociodemographic, lifestyle, medical and clinical information was obtained from medical records and interviewer-administered questionnaires at baseline. These data are extracted from medical records at 12, 24 and 36 months post-enrollment. Baseline descriptive characteristics stratified by DR severity at baseline and rates of progression to referable DR at 12-month follow-up were calculated. Results Of 5,840 eligible patients, 78.3% (n = 4,570, median [interquartile range [IQR] age 61.0 [55–67] years; 54.7% male; 68.0% Chinese) completed the baseline assessment. At baseline, 97.4% and 2.6% had none and mild NPDR (worse eye), respectively. Most participants had hypertension (79.2%) and dyslipidemia (92.8%); and almost half were obese (43.4%, BMI ≥ 27.5 kg/m2). Participants without DR (vs mild DR) reported shorter DM duration, and had lower haemoglobin A1c, triglycerides and urine albumin/creatinine ratio (all p

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2458Test

الوصول الحر: https://doaj.org/article/5d144abbb9874124a993f8fda8c08e70Test

المؤلفون: Matthew Wong Yu Heng, Aurora W. D. Chan, Ryan E. K. Man, Eva K. Fenwick, Samuel T. H. Chew, Laura Tay, Ng Yee Sien, David Ng, Frederick H. Koh, Eu-Leong Yong, Preeti Gupta, Ecosse L. Lamoureux

المصدر: BMC Geriatrics, Vol 23, Iss 1, Pp 1-9 (2023)

مصطلحات موضوعية: Sarcopenia, Osteoporosis, Obesity, Frailty, Osteosarcopenia, Sarcopenic obesity, Geriatrics, RC952-954.6

الوصف: Abstract Background We explored the relationships between sarcopenia (SP), osteoporosis (OP), obesity (OB), (alone and in combination) with physical frailty (PF) in a multi-ethnic, population-based study of Asians aged ≥ 60 years. Methods Participants were enrolled from the PopulatION HEalth and Eye Disease PRofile in Elderly Singaporeans Study (PIONEER) study. PF was defined using the modified Fried phenotype; SP using the Asian Working Group for Sarcopenia 2019; OP using bone mineral density scores; and OB using the fat mass index. Modified Poisson regression models investigated the associations between exposures and PF, and the relative excess rates of PF due to interactions (RERI) to determine synergistic or antagonistic interactions. Results Of the 2643 participants, 54.8% was female; and 49.8%, 25.1%, 25.0% were Chinese, Indians, and Malays, respectively. 25%, 19.0% and 6.7% participants had OB only, SP only, and OP only, respectively. A total of 356 (17.5%), 151 (7.4%) and 97 (4.8%) had osteosarcopenia (OSP), sarcopenic obesity (SOB) and osteo-obesity (OOB), respectively; while 70 (3.5%) had all 3 morbid conditions (osteosarcopenic obesity, OSO). Both SP only and OB only were strongly associated with increased rates of PF (RR: 2.53, 95% CI: 1.95, 3.29; RR: 2.05, 95% CI: 1.58, 2.66 respectively); but not OP. Those with OSP, OOB and SOB were also associated with high risks of PF (RR: 2.82, 95% CI: 2.16, 3.68; RR: 2.34, 95% CI: 1.69, 3.23; and RR: 2.58, 95% CI: 1.95, 3.41, respectively) compared to robust individuals. Critically, individuals with OSO had the highest relative risk of having PF (RR: 3.06, CI: 2.28, 4.11). Only the sarcopenia-obesity interaction was significant, demonstrating negative synergism (antagonism). The concurrent presence of SP and OB was associated with a 100% lower rate of PF compared to the sum of the relatively rates of SP only and OB only. Conclusion The prevalence of SP, OB and OP, alone and combined, is substantial in older Asians and their early identification is needed to mitigate the risk of frailty. OB may interact with SP in an antagonistic manner to moderate rates of frailty. Further longitudinal studies are needed to address causality and mechanistic underpinnings our findings.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2318Test

الوصول الحر: https://doaj.org/article/6c2cd9f6edfd483ead0aa9b5f492a36dTest

المؤلفون: Gerald Liew, Jing Xie, Helen Nguyen, Lisa Keay, M. Kamran Ikram, Kevin McGeechan, Barbara EK. Klein, Jie Jin Wang, Paul Mitchell, Caroline CW. Klaver, Ecosse L. Lamoureux, Tien Y. Wong

المصدر: International Journal of Cardiology. Cardiovascular Risk and Prevention, Vol 17, Iss , Pp 200180- (2023)

مصطلحات موضوعية: Coronary artery disease, Epidemiology, Risk factors, Stroke, Diagnostic imaging, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Background: The cardiovascular risk associated with different levels of hypertensive retinopathy, including mild, remains unclear. We performed an individual participant meta-analysis from 6 population-based cohort studies to determine the relationship of hypertensive retinopathy with incident cardiovascular outcomes. Methods: We identified cohort studies that objectively assessed hypertensive retinopathy from photographs, documented incident cardiovascular outcomes, and were population-based. Six studies contributed data from 11,013 individuals at baseline with 5–13 years follow-up. Participants were recruited if they had hypertension and did not have confounding conditions such as diabetic retinopathy. Main outcome measures were incident coronary heart disease (CHD), stroke and a composite endpoint of cardiovascular disease (CHD or stroke). Pooled estimates of incident risk ratios (IRR) were obtained after adjusting for age, gender, systolic blood pressure, serum total cholesterol, high density lipoprotein and smoking. Results: Among eligible participants with hypertension and without diabetes, there were 1018/9662 (10.5%) incident CHD events, 708/11,013 (6.4%) incident stroke events and 1317/9378 (14.0%) incident CVD events. Mild hypertensive retinopathy was associated with increased risk of CVD (IRR 1.13, 95% CI 1.00 to 1.27) and CHD (IRR 1.17, 95% CI 1.02 to 1.34) but not stroke; moderate hypertensive retinopathy was associated with increased risk of CVD (IRR 1.25 95% CI 1.02 to 1.53) but not stroke or CHD individually. Conclusions: In persons with hypertension, both mild and moderate hypertensive retinopathy were associated with higher CVD risk.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2772487523000132Test; https://doaj.org/toc/2772-4875Test

الوصول الحر: https://doaj.org/article/3209ad0e12a148beb1631571e5b24fc1Test

المؤلفون: Eva K. Fenwick, Belicia Lim, Ryan E. K. Man, Mani Baskaran, Monisha E. Nongpiur, Chelvin C. A. Sng, Jayant V. Iyer, Rahat Husain, Shamira A. Perera, Tina T. Wong, Jin Rong Low, Olivia Huang Shimin, Katherine Lun, Tin Aung, Ecosse L. Lamoureux

المصدر: Journal of Patient-Reported Outcomes, Vol 6, Iss 1, Pp 1-13 (2022)

مصطلحات موضوعية: Glaucoma, Quality of life, Item bank, Computerized adaptive testing, Eyedrops, Qualitative, Public aspects of medicine, RA1-1270

الوصف: Abstract Background A glaucoma-specific health-related quality of life (HRQoL) item bank (IB) and computerized adaptive testing (CAT) system relevant to Asian populations is not currently available. We aimed to develop content for an IB focusing on HRQoL domains important to Asian people with glaucoma; and to compare the content coverage of our new instrument with established glaucoma-specific instruments. Methods In this qualitative study of glaucoma patients recruited from the Singapore National Eye Centre (November 2018-November 2019), items/domains were generated from: (1) glaucoma-specific questionnaires; (2) published articles; (3) focus groups/semi-structured interviews with glaucoma patients (n = 27); and (4) feedback from glaucoma experts. Data were analyzed using the constant comparative method. Items were systematically refined to a concise set, and pre-tested using cognitive interviews with 27 additional glaucoma patients. Results Of the 54 patients (mean ± standard deviation [SD] age 66.9 ± 9.8; 53.7% male), 67 (62.0%), 30 (27.8%), and 11 (10.2%) eyes had primary open angle glaucoma, angle closure glaucoma, and no glaucoma respectively. Eighteen (33.3%), 11 (20.4%), 8 (14.8%), 12 (22.2%), and 5 (9.3%) patients had no, mild, moderate, severe, or advanced/end-stage glaucoma (better eye), respectively. Initially, 311 items within nine HRQoL domains were identified: Visual Symptoms, Ocular Comfort Symptoms, Activity Limitation, Driving, Lighting, Mobility, Psychosocial, Glaucoma management, and Work; however, Driving and Visual Symptoms were subsequently removed during the refinement process. During cognitive interviews, 12, 23 and 10 items were added, dropped and modified, respectively. Conclusion Following a rigorous process, we developed a 221-item, 7-domain Asian glaucoma-specific IB. Once operationalised using CAT, this new instrument will enable precise, rapid, and comprehensive assessment of the HRQoL impact of glaucoma and associated treatment efficacy.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2509-8020Test

الوصول الحر: https://doaj.org/article/be494021a8464572bdf8440b1dd97407Test

المؤلفون: Preeti Gupta, Eva K. Fenwick, Ryan E. K. Man, Alfred T. L. Gan, Charumathi Sabanayagam, Debra Quek, Chaoxu Qian, Chui Ming Gemmy Cheung, Ching-Yu Cheng, Ecosse L. Lamoureux

المصدر: Scientific Reports, Vol 12, Iss 1, Pp 1-11 (2022)

مصطلحات موضوعية: Medicine, Science

الوصف: Abstract To determine the differential impact of the irreversible eye diseases on vision-related quality of life (VRQoL) in a multi-ethnic Asian population. 2652 participants from the Singapore Epidemiology of Eye Disease Study, with any of the following early and late-stage eye conditions including age-related macular degeneration (AMD, n = 158), diabetic retinopathy (DR, n = 105; non vision threatening [non-VTDR]; VTDR), glaucoma (n = 57) and myopic macular degeneration (MMD, n = 106), or none of the above (controls, 2226 [83.9%]) were included. Rasch-scaled scores of the Emotional well-being Mobility and Reading subscales of the Impact of Vision Impairment (IVI) questionnaire, collectively referred to as “VRQoL” were assessed. Multivariable linear regression analyses and pairwise comparisons adjusting for age, gender, ethnicity, socio-economic status, BMI, smoking, alcohol use, presence of systemic diseases and presenting VI were performed to assess and compare the impact of the presence and severity of each eye condition on the three IVI domains. Multivariable adjusted pairwise comparisons of VRQoL between early stages of the four eye diseases showed no significant differences (all P > 0.05). For late stage diseases, individuals with VTDR had significantly larger decrements in Emotional well-being compared to glaucoma (β − 0.81; 95% CI − 1.47 to − 0.16) and MMD (β − 1.17; 95% CI − 2.16 to − 0.18); and Reading decrements compared to glaucoma (β − 0.66; 95% CI − 1.22 to − 0.11). When compared to late glaucoma, individuals with late AMD (β − 0.76; 95% CI − 1.50 to − 0.01) had significantly larger IVI Mobility subscale decrements. VTDR and late AMD, appear to have the greatest impact on VRQoL, compared to late glaucoma and MMD, suggesting a differential impact of late-stage eye disease categorization on VRQoL.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2045-2322Test

الوصول الحر: https://doaj.org/article/b37184cd662c42d9b84f2ed83932ccc6Test

المؤلفون: Kam Chun Ho, Preeti Gupta, Eva K. Fenwick, Ryan E.K. Man, Alfred T.L. Gan, Ecosse L. Lamoureux

المصدر: Journal of Cachexia, Sarcopenia and Muscle, Vol 13, Iss 2, Pp 811-823 (2022)

مصطلحات موضوعية: Sarcopenia, Sensory impairment, Visual impairment, Hearing impairment, Taste impairment, Smell impairment, Diseases of the musculoskeletal system, RC925-935, Human anatomy, QM1-695

الوصف: Abstract Sensory impairments and sarcopenia are both highly prevalent age‐related conditions, with the former having been postulated to contribute to the pathogenesis of the latter condition. Confirming this hypothesis may therefore help to better inform strategies for early treatment and intervention of sarcopenia. We performed a systematic review of the current literature examining the relationships between four major sensory impairments [vision (VI), hearing (HI), smell (SI), and taste (TI)] with (i) sarcopenia; and (ii) its associated components (low handgrip strength, slow gait speed, and low muscle mass). PubMed, EMBASE, CINAHL, and Cochrane Library databases were searched for observational studies investigating the relationship of VI, HI, SI, and TI with sarcopenia, low handgrip strength, slow gait speed, and low muscle mass, in adults aged 50 years or older, from inception until 24 May 2021. The risk of bias of the included studies was assessed using the Newcastle‐Ottawa Scale. This study was registered with PROSPERO, reference CRD42021247967. Ten cross‐sectional and three longitudinal population‐based studies of community‐dwelling adults (N = 68 235) were included, with five studies investigating more than one sensory impairment. In total, 8, 6, 3, and 1 studies investigated the relationship between VI, HI, SI, and TI and sarcopenia and its related components, respectively. Follow‐up duration for the longitudinal studies ranged from 4 to 11 years. All studies had a low or moderate risk of bias. We found that the presence of VI and SI, but not TI, independently increased the odds of sarcopenia. In addition, VI and SI were each independently associated with low muscle mass; and VI, HI, and SI were each independently associated with slow gait speed. However, we found inconclusive evidence for the associations between VI, HI and SI, and low handgrip strength. Our systematic review suggests a potential association between the presence of single or multiple sensory impairments and a greater likelihood of sarcopenia and/or deficits in its associated components, especially for VI, HI, and SI. Prospective studies are needed to untangle the relationship between sensory impairment and sarcopenia to better inform clinical guidelines for disease prevention and management.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2190-5991Test; https://doaj.org/toc/2190-6009Test

الوصول الحر: https://doaj.org/article/e2b137b7c5c44a7bb549f98b188d7963Test

المؤلفون: Ryan E. K. Man, Alvin Hong Wei Gan, Eva K. Fenwick, Alfred Tau Liang Gan, Preeti Gupta, Charumathi Sabanayagam, Nicholas Tan, Kah Hie Wong, Tien Yin Wong, Ching-Yu Cheng, Ecosse L. Lamoureux

المصدر: Population Health Metrics, Vol 17, Iss 1, Pp 1-10 (2019)

مصطلحات موضوعية: Awareness, Cardiovascular risk factor, Hypercholesterolemia, Hypertension, Diabetes, Determinant, Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270

الوصف: Abstract Background To explore the prevalence and determinants of unawareness of diabetes, hypertension and hypercholesterolemia and its association with poor disease control in a multi-ethnic Asian population without cardiovascular disease (CVD). Methods We included 6904 Chinese, Malay and Indian individuals (mean age [SD] 58.2 [10.2] years; 52.6% female) with diabetes, hypertension and/or hypercholesterolemia from the cross-sectional population-based Singapore Epidemiology of Eye Diseases study (2004–2011). Diabetes was defined as random blood glucose ≥ 11.1 mmol/L or HbA1c > 6.5% or self-reported use of diabetes medication; hypertension as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or self-reported use of anti-hypertensive treatment; and hypercholesterolemia as total cholesterol ≥ 6.2 mmol/L or self-reported use of lipid-lowering medications. Unawareness was based on participants’ answers to the questions: “Did your medical practitioner ever tell you that you have diabetes/hypertension/high cholesterol?” The determinants of unawareness, and its association with poor disease control, were assessed using multivariable binary logistic regression models adjusted for known potential confounders. Results Of the 2380 (34.5%), 5386 (78.0%) and 3607 (52.2%) with diabetes, hypertension and hypercholesterolemia, respectively, unawareness rates were 30.7%, 43.1% and 40.9%, respectively. Having a higher BMI, particularly if obese, and Malay ethnicity were associated with greater unawareness of diabetes; Malay and Indian ethnicities and current smoking with greater unawareness of hypertension; and education ≤6 years, current smoking, and blue collar jobs or unemployment with greater unawareness of hypercholesterolemia (all P < 0.05). Lack of awareness of each condition was independently associated with poorer disease control in the case of hypertension and hypercholesterolemia, while the converse was true for diabetes (all P < 0.05). Conclusions Unawareness of diabetes, hypertension, or hypercholesterolemia is high in Singapore, with risk factors varying across all three diseases, although Malay ethnicity is a consistent one. Unawareness was also associated with poor management for hypertension and hypercholesterolemia. Public health education and screening programs should target at-risk individuals, especially Malays, to reduce the likelihood of incident CVD.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1478-7954Test

الوصول الحر: https://doaj.org/article/550a06132d564c8fa14db04ff50d9cf7Test

المؤلفون: Edith E. Holloway, Marios Constantinou, Jing Xie, Eva K. Fenwick, Eric A. Finkelstein, Ryan E. K. Man, Michael Coote, Jonathan Jackson, Gwyn Rees, Ecosse L. Lamoureux

المصدر: Trials, Vol 19, Iss 1, Pp 1-10 (2018)

مصطلحات موضوعية: Vision impairment, Residential care, Eye care model, Protocol, Trial, Medicine (General), R5-920

الوصف: Abstract Background Older adults in residential aged care facilities have unnecessarily high levels of vision impairment (VI) which are largely treatable or correctable. However, no current comprehensive eye health service model exists in this setting in Australia. We aimed to determine the clinical, person-centered, and economic effectiveness of a novel eye care model, the Residential Ocular Care (ROC). Methods/design This protocol describes a multicentered, prospective, randomized controlled trial. A total of 395 participants with distance vision

وصف الملف: electronic resource

العلاقة: http://link.springer.com/article/10.1186/s13063-018-3025-5Test; https://doaj.org/toc/1745-6215Test

الوصول الحر: https://doaj.org/article/fbbc78846dee44eaa32bd1f6fb870385Test

المؤلفون: Preeti Gupta, Alfred Tau Liang Gan, Ryan Eyn Kidd Man, Eva K. Fenwick, Yih-Chung Tham, Charumathi Sabanayagam, Tien Yin Wong, Ching-Yu Cheng, Ecosse L. Lamoureux

المصدر: Scientific Reports, Vol 8, Iss 1, Pp 1-8 (2018)

مصطلحات موضوعية: Second-generation Indian, Risk Factors, Incident CVD, First-generation Immigrants, Risk Determinants, Medicine, Science

الوصف: Abstract Population-based data investigating generational differences in the risk of incident cardiovascular disease (CVD) and its risk determinants are rare. We examined the 6-year incidence of CVD and its risk factors in first- and second-generation ethnic Indians living in Singapore. 1749 participants (mean age [SD]: 55.5 [8.8] years; 47.5% male) from a population-based, longitudinal study of Indian adults were included for incident CVD outcome. Incident CVD was defined as self-reported myocardial infarction, angina pectoris or stroke which developed between baseline and follow-up. CVD-related risk factors included incident diabetes, hypertension, hyperlipidemia, obesity and chronic kidney disease (CKD). For incident CVD outcome, of the 1749 participants, 406 (23.2%) and 1343 (76.8%) were first and second-generation Indians, respectively. Of these, 73 (4.1%) reported incident CVD. In multivariable models, second-generation individuals had increased risk of developing CVD (RR = 2.04; 95% CI 1.04, 3.99; p = 0.038), hyperlipidemia (RR = 1.27; 95% CI 1.06, 1.53; p = 0.011), and CKD (RR = 1.92; 95% CI 1.22, 3.04; p = 0.005), compared to first-generation Indians. Second-generation Indians have increased risk of developing CVD and its associated risk factors such as hyperlipidemia and CKD compared to first-generation immigrants, independent of traditional CVD risk factors. More stratified and tailored CVD prevention strategies on second and subsequent generations of Indian immigrants in Singapore are warranted.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2045-2322Test

الوصول الحر: https://doaj.org/article/d6500981209c4af2b679de40d45cc418Test