02616nas a2200301 4500008004100000022001400041245009700055210006900152260001300221300001100234490000600245520179400251653000902045653002202054653002802076653001902104653002602123653001102149653001102160653000902171100001502180700001502195700001702210700001702227700001702244700001702261856003602278 1993 eng d a1047-279700aRecruitment of adults 65 years and older as participants in the Cardiovascular Health Study.0 aRecruitment of adults 65 years and older as participants in the  c1993 Jul a358-660 v33 a

Few large-scale epidemiologic studies have enrolled older adults; hence, little is known about the feasibility of recruiting this group for long-term population-based studies. In this article we present the recruitment experience of the Cardiovascular Health Study (CHS), a population-based, longitudinal study of cardiovascular diseases in adults 65 years and older. Participants were sampled from the Health Care Financing Administration's (HCFA) Medicare eligibility lists in four US communities. Letters were mailed to 11,955 sampled individuals. Persons recruited were required to complete an extensive home interview and then a 4-hour in-clinic examination. Excluded were persons who were expected to be able to complete the baseline examination and who were not expected to return for the 3-year follow-up. Some 3654 participants were recruited from those randomly selected from the Medicare sampling frame. In addition, 1547 other age-eligible persons living in the household with the sampled individuals also participated, yielding a total of 5201 participants. Of those who were contacted, 9.6% were ineligible and 34.9% refused participation. Among those eligible, 38.6% refused and 57.3% were enrolled (the remaining did not refuse but were not enrolled before the recruitment ended). Data from a subsample indicate that compared to those who were ineligible or who refused, enrolled participants were younger, more highly educated, more likely to be married, and less likely to report limitations in activity. Compared to those who were eligible but refused, enrolled participants were less likely to have high blood pressure and stroke and more likely to have quit smoking and to perceive their health status as very good or excellent.(ABSTRACT TRUNCATED AT 250 WORDS)

10aAged10aAged, 80 and over10aCardiovascular Diseases10aCohort Studies10aEpidemiologic Methods10aFemale10aHumans10aMale1 aTell, G, S1 aFried, L P1 aHermanson, B1 aManolio, T A1 aNewman, A, B1 aBorhani, N O uhttps://chs-nhlbi.org/node/143602834nas a2200325 4500008004100000022001400041245019000055210006900245260001300314300001100327490000700338520187600345653000902221653002202230653002102252653002102273653001902294653001102313653001102324653000902335653001202344653002002356100001502376700001602391700001502407700001802422700001702440700001502457856003602472 1994 eng d a0009-732200aRelation of smoking with carotid artery wall thickness and stenosis in older adults. The Cardiovascular Health Study. The Cardiovascular Health Study (CHS) Collaborative Research Group.0 aRelation of smoking with carotid artery wall thickness and steno c1994 Dec a2905-80 v903 a

BACKGROUND: Cigarette smoking has been associated with increased risk of atherosclerotic diseases in hospital-based studies and in studies of middle-aged populations but not in population-based studies of older adults with and without clinical cardiovascular disease.

METHODS AND RESULTS: We investigated the relation of smoking to carotid artery atherosclerotic disease, expressed as intimal-medial wall thickness and arterial lumen narrowing (stenosis) measured by ultrasound. Subjects were 5116 older adults participating in the baseline examination of the Cardiovascular Health Study, a community-based study of cardiovascular diseases in older age. With increased smoking there was significantly greater internal and common carotid wall thickening and internal carotid stenosis: current smokers > former smokers > never-smokers; for instance, the unadjusted percent stenosis was 24%, 20%, and 16%, respectively (P < .0001). A significant dose-response relation was seen with pack-years of smoking. These findings persisted after adjusting for other cardiovascular risk factors and were also confirmed when analyses were restricted to those without prevalent cardiovascular disease. The difference in internal carotid wall thickness between current smokers and nonsmokers was greater than the difference associated with 10 years of age among never-smoking participants (0.39 mm versus 0.31 mm). Among all participants, the prevalence of clinically significant (> or = 50%) internal carotid stenosis increased from 4.4% in never-smokers to 7.3% in former smokers to 9.5% in current smokers (P < .0001).

CONCLUSIONS: These findings extend previous reports of a positive relation between smoking and carotid artery disease to a population-based sample of older adults using several different indicators of atherosclerotic disease.

10aAged10aAged, 80 and over10aCarotid Arteries10aCarotid Stenosis10aCohort Studies10aFemale10aHumans10aMale10aSmoking10aUltrasonography1 aTell, G, S1 aPolak, J, F1 aWard, B, J1 aKittner, S, J1 aSavage, P, J1 aRobbins, J uhttps://chs-nhlbi.org/node/142602386nas a2200301 4500008004100000022001400041245010700055210006900162260001300231300000900244490000700253520156300260653002101823653000901844653001001853653002001863653001101883653001101894653003101905653000901936653002101945653001701966100001501983700002001998700001302018700001702031856003602048 1998 eng d a0003-994200aRelationship between balance and abnormalities in cerebral magnetic resonance imaging in older adults.0 aRelationship between balance and abnormalities in cerebral magne c1998 Jan a73-90 v553 a

BACKGROUND: Falling is a major cause of disability and morbidity among older adults. Because poor balance is a major reason for frequent falls, assessment of balance and its risk factors are important. In this study, we postulated that cerebral changes identified on magnetic resonance (MR) imaging are related to balance, and that older adults with balance problems would have significantly greater prevalence of such brain abnormalities than older adults without balance problems.

DESIGN AND MEASUREMENTS: Several measures of balance were examined in more than 700 community-dwelling older men and women, blacks and whites. Balance measures included dynamic posturography, functional reach, Romberg and 1-foot stand tests, tandem stand, and 1-foot stand. Cerebral MR imaging assessments included ventricular size, sulcal widening, white matter disease, and ischemic infarctions. Cardiovascular disease and hypertension were determined and controlled for in the analyses.

RESULTS: A summary of the balance measures was significantly related to each of the 4 MR imaging measures, with those with poorer balance having more disease. The strongest associations with balance were seen for white matter disease and ventricular size. All but the ischemic infarction variable remained significantly associated with balance after adjustments for sex, race, age, cardiovascular disease, and hypertension.

CONCLUSION: Cerebral changes identified by MR imaging are associated with poorer balance among older adults.

10aAccidental Falls10aAged10aAging10aCerebral Cortex10aFemale10aHumans10aMagnetic Resonance Imaging10aMale10aPostural Balance10aRisk Factors1 aTell, G, S1 aLefkowitz, D, S1 aDiehr, P1 aElster, A, D uhttps://chs-nhlbi.org/node/1492