Rationale, design and methods for a community-based study of clustering and cumulative effects of chronic disease processes and their effects on ageing: the Busselton healthy ageing study

BMC Public Health

AW Bill Musk⁸  Lyle J Palmer⁹  Robert U Newton²  David A Mackey⁶  Matthew Knuiman⁸  Joe Hung^1,11  Jennie Hui⁸  David Hillman⁵  Robert H Eikelboom¹  Tim Davis⁷  Romola Bucks³  John Beilby⁴  Leon Straker^1,10  Michael Hunter⁸  Alan James^1,11 

[1] Ear Science Institute Australia, Ear Sciences Centre; School of Surgery, The University of Western Australia, Crawley, Perth, Australia;Health and Wellness Institute, Edith Cowan University, Joondalup, Perth, Australia;School of Psychology, The University of Western Australia, Crawley, Perth, Australia;Pathwest, The University of Western Australia, Crawley, Perth, Australia;School of Anatomy and Surgery, The University of Western Australia, Crawley, Perth, Australia;Lions Eye Institute, Centre for Ophthalmology and Visual Science, The University of Western Australia, Crawley, Perth, Australia;Fremantle Hospital; School of Medicine and Health, The University of Western Australia, Crawley, Perth, Australia;School of Population Health, The University of Western Australia, Crawley, Perth, Australia;Ontario Institute for Cancer Research and Samuel Lunenfeld Research Institute, University of Toronto, Toronto, Canada;School of Physiotherapy and Curtin Health Innovation Research Institute, Curtin University, Bentley, Perth, Australia;School of Medicine and Pharmacology, The University of Western Australia, Crawley, Perth, WA, Australia

关键词: Multi-morbidity;    Prevalence;    Cross-sectional;    Clusters of illness;    Healthy ageing;    Busselton;   

Others  :  1161686
DOI  :  10.1186/1471-2458-13-936

 received in 2012-09-14, accepted in 2013-09-13,  发布年份 2013

【 摘 要 】

Background

The global trend of increased life expectancy and increased prevalence of chronic and degenerative diseases will impact on health systems. To identify effective intervention and prevention strategies, greater understanding of the risk factors for and cumulative effects of chronic disease processes and their effects on function and quality of life is needed.

The Busselton Healthy Ageing Study aims to enhance understanding of ageing by relating the clustering and interactions of common chronic conditions in adults to function. Longitudinal (3–5 yearly) follow-up is planned.

Methods/design

Phase I (recruitment) is a cross-sectional community-based prospective cohort study involving up to 4,000 'Baby Boomers’ (born from 1946 to 1964) living in the Busselton Shire, Western Australia. The study protocol involves a detailed, self-administered health and risk factor questionnaire and a range of physical assessments including body composition and bone density measurements, cardiovascular profiling (blood pressure, ECG and brachial pulse wave velocity), retinal photography, tonometry, auto-refraction, spirometry and bronchodilator responsiveness, skin allergy prick tests, sleep apnoea screening, tympanometry and audiometry, grip strength, mobility, balance and leg extensor strength. Cognitive function and reserve, semantic memory, and pre-morbid intelligence are assessed. Participants provide a fasting blood sample for assessment of lipids, blood glucose, C-reactive protein and renal and liver function, and RNA, DNA and serum are stored. Clinically relevant results are provided to all participants. The prevalence of risk factors, symptoms and diagnosed illness will be calculated and the burden of illness will be estimated based on the observed relationships and clustering of symptoms and illness within individuals. Risk factors for combinations of illness will be compared with those for single illnesses and the relation of combinations of illness and symptoms to cognitive and physical function will be estimated.

Discussion

This study will enable a thorough characterization of multiple disease processes and their risk factors within a community-based sample of individuals to determine their singular, interactive and cumulative effects on ageing. The project will provide novel cross-sectional data and establish a cohort that will be used for longitudinal analyses of the genetic, lifestyle and environmental factors that determine whether an individual ages well or with impairment.

【 授权许可】

   
2013 James et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Australian Bureau of Statistics: Australian social trends, 2006: chronic conditions and disability. Canberra: Commonwealth of Australia; 2006.
• [2]The Treasury, Australia: Intergenerational report 2010: Australia to 2050: future challenges. Canberra: Commonwealth of Australia; 2010.
• [3]Australian Bureau of Statistics: National health survey 2004–2005: summary of results. Canberra: Commonwealth of Australia; 2006.
• [4]Barondess JA: Toward healthy aging: the preservation of health. J Am Geriatr Soc 2008, 56(1):145-148.
• [5]Holden L, Scuffham PA, Hilton MF, Ware RS, Vecchio N, Whiteford HA: Health-related productivity losses increase when the health condition is co-morbid with psychological distress: findings from a large cross-sectional sample of working Australians. BMC Public Health 2011, 11:417. BioMed Central Full Text
• [6]Franco OH, Karnik K, Osborne G, Ordovas JM, Catt M, van der Ouderaa F: Changing course in ageing research: the healthy ageing phenotype. Maturitas 2009, 63(1):13-19.
• [7]Davis TM, Bruce DG: Glycaemic levels triggering intensification of therapy in type 2 diabetes in the community: the Fremantle diabetes study. Med J Aust 2006, 184(7):325-328.
• [8]Siahpush M, English D, Powles J: The contribution of smoking to socioeconomic differentials in mortality: results from the Melbourne collaborative cohort study, Australia. J Epidemiol Community Health 2006, 60(12):1077-1079.
• [9]Smith W, Wang JJ, Wong TY, Rochtchina E, Klein R, Leeder SR, Mitchell P: Retinal arteriolar narrowing is associated with 5-year incident severe hypertension: the blue mountains eye study. Hypertension 2004, 44(4):442-447.
• [10]McEvoy M, Smith W, D’Este C, Duke J, Peel R, Schofield P, Scott R, Byles J, Henry D, Ewald B, et al.: Cohort profile: the hunter community study. Int J Epidemiol 2010, 39(6):1452-1463.
• [11]Cumming RG, Handelsman D, Seibel MJ, Creasey H, Sambrook P, Waite L, Naganathan V, Le Couteur D, Litchfield M: Cohort profile: the concord health and ageing in men project (CHAMP). Int J Epidemiol 2009, 38(2):374-378.
• [12]Banks E, Redman S, Jorm L, Armstrong B, Bauman A, Beard J, Beral V, Byles J, Corbett S, Cumming R, et al.: Cohort profile: the 45 and up study. Int J Epidemiol 2008, 37(5):941-947.
• [13]Olynyk JK, Hagan SE, Cullen DJ, Beilby J, Whittall DE: Evolution of untreated hereditary hemochromatosis in the Busselton population: a 17-year study. Mayo Clin Proc 2004, 79(3):309-313.
• [14]James AL, Palmer LJ, Kicic E, Maxwell PS, Lagan SE, Ryan GF, Musk AW: Decline in lung function in the Busselton health study: the effects of asthma and cigarette smoking. Am J Respir Crit Care Med 2005, 171(2):109-114.
• [15]Musk AW, Knuiman M, Hunter M, Hui J, Palmer LJ, Beilby J, Divitini M, Mulrennan S, James A: Patterns of airway disease and the clinical diagnosis of asthma in the Busselton population. Eur Respir J 2011, 38(5):1053-1059.
• [16]Adams C, Burke V, Beilin LJ: Cholesterol tracking from childhood to adult mid-life in children from the Busselton study. Acta Paediatr 2005, 94(3):275-280.
• [17]Hung J, Knuiman MW, Divitini ML, Langton PE, Chapman CL, Beilby JP: C-reactive protein and interleukin-18 levels in relation to coronary heart disease: prospective cohort study from Busselton Western Australia. Heart Lung Circ 2008, 17(2):90-95.
• [18]O’Leary CM, Knuiman MW, Divitini ML: Homocysteine and cardiovascular disease: a 17-year follow-up study in Busselton. Eur J Cardiovasc Prev Rehabil 2004, 11(4):350-351.
• [19]Chin MW, Mallon DF, Cullen DJ, Olynyk JK, Mollison LC, Pearce CB: Screening for coeliac disease using anti-tissue transglutaminase antibody assays, and prevalence of the disease in an Australian community. Med J Aust 2009, 190(8):429-432.
• [20]Bremner AP, Feddema P, Leedman PJ, Brown SJ, Beilby JP, Lim EM, Wilson SG, O’Leary PC, Walsh JP: Age-related changes in thyroid function: a longitudinal study of a community-based cohort. J Clin Endocrinol Metab 2012, 97(5):1554-1562.
• [21]Olynyk JK, Cullen DJ, Aquilia S, Rossi E, Summerville L, Powell LW: A population-based study of the clinical expression of the hemochromatosis gene. N Engl J Med 1999, 341(10):718-724.
• [22]Milward EA, Bruce DG, Knuiman MW, Divitini ML, Cole M, Inderjeeth CA, Clarnette RM, Maier G, Jablensky A, Olynyk JK: A cross-sectional community study of serum iron measures and cognitive status in older adults. J Alzheimers Dis 2010, 20(2):617-623.
• [23]Cullen K, Stenhouse NS, Wearne KL, Welborn TA: Multiple regression analysis of risk factors for cardiovascular disease and cancer mortality in Busselton, Western Australia–13-year study. J Chronic Dis 1983, 36(5):371-377.
• [24]Olynyk JK, Knuiman MW, Divitini ML, Davis TM, Beilby J, Hung J: Serum alanine aminotransferase, metabolic syndrome, and cardiovascular disease in an Australian population. Am J Gastroenterol 2009, 104(7):1715-1722.
• [25]Welborn TA: The Busselton study: mapping population health. Sydney: Australasian Medical Publishing Company; 1998.
• [26]Repapi E, Sayers I, Wain LV, Burton PR, Johnson T, Obeidat M, Zhao JH, Ramasamy A, Zhai G, Vitart V, et al.: Genome-wide association study identifies five loci associated with lung function. Nat Genet 2010, 42(1):36-44.
• [27]Moffatt MF, Gut IG, Demenais F, Strachan DP, Bouzigon E, Heath S, von Mutius E, Farrall M, Lathrop M, Cookson WO: A large-scale, consortium-based genomewide association study of asthma. N Engl J Med 2010, 363(13):1211-1221.
• [28]Daniels SE, Bhattacharrya S, James A, Leaves NI, Young A, Hill MR, Faux JA, Ryan GF, le Souef PN, Lathrop GM, et al.: A genome-wide search for quantitative trait loci underlying asthma. Nature 1996, 383(6597):247-250.
• [29]Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, et al.: International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003, 35(8):1381-1395.
• [30]Harris C, Straker L: Survey of physical ergonomics issues associated with school children’s use of laptop computers. Int J Ind Ergonomics 2000, 26:337-346.
• [31]Loyd B, Gressard C: Reliability and factorial validity of computer attitude scales. Educ Psychol Meas 1984, 44:501-505.
• [32]Bandalos D, Benson J: Testing the factor structure invariance of a computer attitude scale over two grouping conditions. Educ Psychol Meas 1990, 50:49-60.
• [33]Onyx J, Bullen P: Measuring social capital in five communities. J Appl Behav Sci 2000, 36(1):23-40.
• [34]Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, Jorgensen K: Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon 1987, 18(3):233-237.
• [35]Bjorksten MG, Boquist B, Talback M, Edling C: The validity of reported musculoskeletal problems. A study of questionnaire answers in relation to diagnosed disorders and perception of pain. Appl Ergon 1999, 30(4):325-330.
• [36]Dionne CE, Dunn KM, Croft PR, Nachemson AL, Buchbinder R, Walker BF, Wyatt M, Cassidy JD, Rossignol M, Leboeuf-Yde C, et al.: A consensus approach toward the standardization of back pain definitions for use in prevalence studies. Spine 2008, 33(1):95-103.
• [37]Wedderkopp N, Lebouef-Yde C, Bo Andersen L, Froberg K, Steen Hansen H: Back pain reporting pattern in a Danish population-based sample of children and adolescents. Spine (Phila Pa 1976) 2008, 26(17):1879-1883.
• [38]Linton SJ, Hallden K: Can we screen for problematic back pain? a screening questionnaire for predicting outcome in acute and subacute back pain. Clin J Pain 1998, 14(3):209-215.
• [39]Waddell G, Newton M, Henderson I, Somerville D, Main CJ: A fear-avoidance beliefs questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability. Pain 1993, 52(2):157-168.
• [40]Harland N, Georgieff K: Development of the coping strategies questionnaire 24, a clinically utilitarian version of the coping strategies questionnaire. Rehab Psychol 2003, 48(4):296-300.
• [41]Symonds TL, Burton AK, Tillotson KM, Main CJ: Do attitudes and beliefs influence work loss due to low back trouble? Occup Med (Lond) 1996, 46(1):25-32.
• [42]Fairbank JC, Pynsent PB: The oswestry disability index. Spine (Phila Pa 1976) 2000, 25(22):2940-2952. discussion 2952
• [43]Linton SJ, Boersma K: Early identification of patients at risk of developing a persistent back problem: the predictive validity of the Orebro musculoskeletal pain questionnaire. Clin J Pain 2003, 19(2):80-86.
• [44]Samet JM: A historical and epidemiologic perspective on respiratory symptoms questionnaires. Am J Epidemiol 1978, 108(6):435-446.
• [45]Johns MW: A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991, 14(6):540-545.
• [46]Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP: Using the Berlin questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med 1999, 131(7):485-491.
• [47]Lovibond SH, Lovibond PF: Manual for the depression anxiety stress scales. 2nd edition. Sydney: Psychology Foundation; 1995.
• [48]Kroenke K, Spitzer RL, Williams JB: The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001, 16(9):606-613.
• [49]Ware J Jr, Kosinski M, Keller SD: A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 1996, 34(3):220-233.
• [50]Mallampati SR, Gatt SP, Gugino LD, Desai SP, Waraksa B, Freiberger D, Liu PL: A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J 1985, 32(4):429-434.
• [51]Hankinson JL, Odencrantz JR, Fedan KB: Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med 1999, 159(1):179-187.
• [52]Margolis RH, Glasberg BR, Creeke S, Moore BC: AMTAS: automated method for testing auditory sensitivity: validation studies. Int J Audiol 2010, 49(3):185-194.
• [53]Newton RU, Prue Cormie and Marco Cardinale: Principles of athlete testing. Sydney: John Wiley & Sons, Ltd; 2010. [Strength and conditioning biological principles and practical applications]
• [54]Podsiadlo D, Richardson S: The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991, 39(2):142-148.
• [55]Buatois S, Miljkovic D, Manckoundia P, Gueguen R, Miget P, Vancon G, Perrin P, Benetos A: Five times sit to stand test is a predictor of recurrent falls in healthy community-living subjects aged 65 and older. J Am Geriatr Soc 2008, 56(8):1575-1577.
• [56]Desai A, Goodman V, Kapadia N, Shay BL, Szturm T: Relationship between dynamic balance measures and functional performance in community-dwelling elderly people. Phys Ther 2010, 90(5):748-760.
• [57]Keith MS, Stanislav SW, Wesnes KA: Validity of a cognitive computerized assessment system in brain-injured patients. Brain Inj 1998, 12(12):1037-1043.
• [58]Lezak MD: Neuropsychological assessment. 3rd edition. Oxford: Oxford University; 1995.
• [59]Hennessy M, Mackenzie B: AUSNART: the development of an Australian version of the NART. In Treatment issues and long-term outcomes: proceedings of the 18th annual brain impairment conference, Hobart, Australia 1994. Edited by Fourez J, Page N. Bowen Hills, Queensland: Australian Academic Press; 1995:183-188.
• [60]Folstein MF, Folstein SE, McHugh PR: “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975, 12(3):189-198.
• [61]Goss J: Projection of Australian health care expenditure by disease, 2003 to 2033. AIHW: Canberra; 2008.
• [62]Kivimaki M, Ferrie JE: Epidemiology of healthy ageing and the idea of more refined outcome measures. Int J Epidemiol 2011, 40(4):845-847.
• [63]Knuiman MW, Clarkson JP, Bulsara M, Bartholomew HC: Evaluating the impact of repeated community-wide health surveys on cardiovascular morbidity and mortality in the Busselton population. Aust NZ J Public Health 2004, 28:267-272.