Search

2022 AUG 13 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- A new study on public health is now available. According to news [...]

2022 JUL 4 (NewsRx) -- By a News Reporter-Staff News Editor at Stem Cell Week -- Investigators publish new report on age-related macular degeneration. According to news reporting out of [...]

2020 DEC 12 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on obesity have been published. According to news reporting [...]

2020 OCT 3 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- A new study on Life Science Research - Toxicology is now available. [...]

2020 SEP 5 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Data detailed on Nutritional and Metabolic Diseases and Conditions - Obesity have [...]

2020 JUL 18 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Drugs and Therapies - Antimicrobial Chemotherapy have been [...]

2020 JUN 27 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Data detailed on obesity have been presented. According to news reporting originating [...]

2020 MAY 16 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Neurodegenerative Diseases and Conditions - Alzheimer Disease have [...]

2020 APR 4 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Researchers detail new data in Cardiovascular Diseases and Conditions - Peripheral Artery [...]

2020 MAR 21 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Investigators publish new report on environmental research and public health. According to [...]

2020 MAR 21 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Research findings on environmental research and public health are discussed in a [...]

2019 NOV 16 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Drugs and Therapies - Pharmacology and Therapeutics have [...]

2019 APR 20 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Oncology - Breast Cancer have been published. According [...]

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2010.03144.x Keywords: lean mass; weight loss; function; hospitalization; strength Abstract: OBJECTIVES: To examine the association between hospitalization and annual changes in body composition and strength in older adults. DESIGN: Cohort study. SETTING: Clinic examinations in Pittsburgh, Pennsylvania, or Memphis, Tennessee. PARTICIPANTS: Well-functioning adults aged 70 to 79 who participated in the Health, Aging and Body Composition Study. MEASUREMENTS: Hospitalizations were reported at annual clinic visits and in semiannual phone interviews. In the event of death or reported hospitalization, hospitalizations were adjudicated according to medical record review. Dual X-ray absorptiometry (DXA) assessments of total, lean, and fat mass were conducted in six annual examinations, and measures of knee extensor strength were conducted in two annual examinations. RESULTS: DXA assessments followed 2,309 hospitalizations. In men and women, hospitalization in the previous year was associated with greater declines in total mass (-0.76 and -0.81 kg, respectively), fat mass (-0.41 and -0.54 kg), and lean mass (-0.33 and -0.25 kg) (P CONCLUSION: Hospitalization is associated with significant changes in body composition and strength in older persons. These effects appear particularly important in persons hospitalized for 8 or more days per year. Author Affiliation: (*)Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland ([dagger])Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland ([double dagger])Research Institute, California Pacific Medical Center, San Francisco, California (s.)Longitudinal Studies Section, National Institute on Aging, Baltimore, Maryland; Departments of ([parallel])Medicine (s.s.)Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania (#)Veterans Affairs Greater Los Angeles Healthcare System, Geriatric Research, Education and Clinical Center, Los Angeles, California (**)Sticht Center on Aging, School of Medicine, Wake Forest University, Winston-Salem, North Carolina ([dagger][dagger])College of Public Health, University of Georgia, Athens, Georgia ([double dagger][double dagger])Department of Epidemiology, University of Tennessee, Memphis, Tennessee. Article note: Address correspondence to Dawn E. Alley, University of Maryland School of Medicine, Department of Epidemiology and Public Health, Baltimore, MD 21201. E-mail: dalley@epi.umaryland.edu

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajo.2010.05.030 Byline: Anne L. Coleman (a)(b), Fei Yu (a)(c), Kristine E. Ensrud (d), Katie L. Stone (e), Jane A. Cauley (f), Kathryn L. Pedula (g), Marc C. Hochberg (h), Carol M. Mangione (i) Abstract: To assess vision-specific quality of life (QOL), based on abbreviated surveys derived from the National Eye Institute Visual Function Questionnaire (NEI-VFQ), in a cohort of United States women who participated in the Study of Osteoporotic Fractures. Author Affiliation: (a) Jules Stein Eye Institute and the Department of Ophthalmology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California (b) Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, California (c) Department of Biostatistics, School of Public Health, University of California, Los Angeles, Los Angeles, California (d) Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota, and the Center for Chronic Disease Outcomes Research, VA Medical Center, Minneapolis, Minnesota (e) Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California (f) Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania (g) The Kaiser Permanente Center for Health Research, Portland, Oregon (h) Departments of Medicine and Epidemiology and Preventive Medicine, University of Maryland, Baltimore, Maryland (i) Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California Article History: Accepted 20 May 2010

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2009.02620.x Keywords: physical performance; elderly; cancer; disability; survival Abstract: OBJECTIVES: To evaluate objective physical performance measures as predictors of survival and subsequent disability in older patients with cancer. DESIGN: Longitudinal cohort study. SETTING: Health, Aging and Body Composition (Health ABC) Study. PARTICIPANTS: Four hundred twenty-nine individuals diagnosed with cancer during the first 6 years of follow-up of the Health ABC Study. MEASUREMENTS: The associations between precancer measures of physical performance (20-m usual gait speed, 400-m long-distance corridor walk (LDCW), and grip strength) and overall survival and a short-term outcome of 2-year progression to disability or death were evaluated. Cox proportional hazards and logistic regression models, stratified for metastatic disease, respectively, were used for outcomes. RESULTS: Mean age was 77.2, 36.1% were women, and 45.7% were black. Faster 20-m usual walking speed was associated with a lower risk of death in the metastatic group (hazard ratio=0.89, 95% confidence interval (CI)=0.79-0.99) and lower 2-year progression to disability or death in the nonmetastatic group (odds ratio (OR)=0.77, 95% CI=0.64-0.94). Ability to complete the 400-m LDCW was associated with lower 2-year progression to disability or death in the nonmetastatic group (OR=0.24, 95% CI=0.10-0.62). There were no associations between grip strength and disability or death. CONCLUSION: Lower extremity physical performance tests (usual gait speed and 400-m LDCW) were associated with survival and 2-year progression to disability or death. Objective physical performance measures may help inform pretreatment evaluations in older adults with cancer. Author Affiliation: (*)Comprehensive Cancer Center ([dagger])Division of Public Health Sciences ([double dagger])Departments of Epidemiology (s.)Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania ([parallel])Department of Kinesiology, University of Wisconsin, Madison, Wisconsin (#)Department of Medicine, University of California, San Francisco, California (**)Department of Preventative Medicine, University of Tennessee, Memphis, Tennessee ([dagger][dagger])Department of Internal Medicine, Duke University, Durham, North Carolina ([double dagger][double dagger])Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina. Article note: Address correspondence to Heidi D. Klepin, Comprehensive Cancer Center of Wake Forest University, Medical Center Boulevard, Winston-Salem, NC 27157. E-mail: hklepin@wfubmc.edu

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajo.2009.07.025 Byline: Anne L. Coleman (a)(b), Robin L. Seitzman (a), Steven R. Cummings (d), Fei Yu (a)(c), Jane A. Cauley (e), Kristine E. Ensrud (f), Katie L. Stone (d), Marc C. Hochberg (g), Kathryn L. Pedula (h), Edgar L. Thomas (i), Carol M. Mangione (j) Abstract: To estimate the incidence of age-related macular degeneration (AMD) and the association of smoking and alcohol in a population of older women. Author Affiliation: (a) Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine at UCLA, School of Public Health, UCLA, Los Angeles, California (b) Department of Epidemiology, School of Public Health, UCLA, Los Angeles, California (c) Department of Biostatistics, School of Public Health, UCLA, Los Angeles, California (d) San Francisco Coordinating Center, California Pacific Medical Center Research Institute, San Francisco, California (e) Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania (f) Veterans Affairs Medical Center and Departments of Medicine and Epidemiology, University of Minnesota, Minneapolis, Minnesota (g) Division of Rheumatology, University of Maryland, Baltimore, Maryland (h) Kaiser Permanente Center for Health Research, Northwest/Hawaii, Portland, Oregon (i) The Retina-Vitreous Associates Medical Group, Beverly Hills, California (j) Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California Article History: Accepted 18 July 2009

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2009.02479.x Keywords: alcohol intake; functional decline; aging Abstract: OBJECTIVES: To investigate the prospective relationship between alcohol consumption and incident mobility limitation. DESIGN: Cohort study. SETTING: The Health Aging and Body Composition study, conducted in Memphis, Tennessee, and Pittsburgh, Pennsylvania. PARTICIPANTS: Three thousand sixty-one adults aged 70 to 79 without mobility disability at baseline. MEASUREMENTS: Incidence of mobility limitation, defined as self-report at two consecutive semiannual interviews of any difficulty walking one-quarter of a mile or climbing stairs, and incidence of mobility disability, defined as severe difficulty or inability to perform these tasks at two consecutive reports. Alcohol intake, lifestyle-related variables, diseases, and health status indicators were assessed at baseline. RESULTS: During a follow-up time of 6.5 years, participants consuming moderate levels of alcohol had the lowest incidence of mobility limitation (total: 6.4 per 100 person-years (person-years); men: 6.4 per 100 person-years; women: 7.3 per 100 person-years) and mobility disability (total: 2.7 per 100 person-years; men: 2.5 per 100 person-years; women: 2.9 per 100 person-years). Adjusting for demographic characteristics, moderate alcohol intake was associated with lower risk of mobility limitation (hazard ratio (HR)=0.70, 95% confidence interval (CI)=0.55-0.89) and mobility disability (HR=0.66, 95% CI=0.45-0.95) than never or occasional consumption. Additional adjustment for lifestyle-related variables substantially reduced the strength of the associations (HR=0.85, 95% CI=0.66-1.08 and HR=0.81, 95% CI=0.56-1.18, respectively). Adjustment for diseases and health status indicators did not affect the strength of the associations, suggesting that lifestyle is most important in confounding this relationship. CONCLUSION: Lifestyle-related characteristics mainly accounted for the association between moderate alcohol intake and lower risk of functional decline over time. These findings do not support a direct causal effect of alcohol intake on physical function. Author Affiliation: (*)Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatric, University of Ferrara, Ferrara, Italy ([dagger])Laboratory of Epidemiology, Demography and Biometry, Intramural Research Program, National Institute on Aging, Bethesda, Maryland; Departments of ([double dagger])Epidemiology and (s.)Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania ([parallel])Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina (#)Institute on Aging, University of Florida, Gainesville, Florida (**)University Of Tennessee Health Science Center, Memphis, Tennessee; and ([dagger][dagger])Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California. Article note: Address correspondence to Cinzia Maraldi, Department of Clinical and Experimental Medicine, Section of Internal Medicine, Gerontology and Geriatric, University of Ferrara, Via Savonarola 9, 44100, Ferrara, Italy. E-mail: mrlcnz@unife.it

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2009.02285.x Byline: Erin Gaffney-Stomberg (*[dagger]), Karl L. Insogna ([double dagger]), Nancy R. Rodriguez ([dagger]), Jane E. Kerstetter (*) Keywords: sarcopenia; osteoporosis; dietary protein; nutrition; aging Abstract: Osteoporosis and sarcopenia are degenerative diseases frequently associated with aging. The loss of bone and muscle results in significant morbidity, so preventing or attenuating osteoporosis and sarcopenia is an important public health goal. Dietary protein is crucial for development of bone and muscle, and recent evidence suggests that increasing dietary protein above the current Recommended Dietary Allowance (RDA) may help maintain bone and muscle mass in older individuals. Several epidemiological and clinical studies point to a salutary effect of protein intakes above the current RDA (0.8 g/kg per day) for adults aged 19 and older. There is evidence that the anabolic response of muscle to dietary protein is attenuated in elderly people, and as a result, the amount of protein needed to achieve anabolism is greater. Dietary protein also increases circulating insulin-like growth factor, which has anabolic effects on muscle and bone. Furthermore, increasing dietary protein increases calcium absorption, which could be anabolic for bone. Available evidence supports a beneficial effect of short-term protein intakes up to 1.6 to 1.8 g/kg per day, although long-term studies are needed to show safety and efficacy. Future studies should employ functional measures indicative of protein adequacy, as well as measures of muscle protein synthesis and maintenance of muscle and bone tissue, to determine the optimal level of dietary protein. Given the available data, increasing the RDA for older individuals to 1.0 to 1.2 g/kg per day would maintain normal calcium metabolism and nitrogen balance without affecting renal function and may represent a compromise while longer-term protein supplement trials are pending. J Am Geriatr Soc 57:1073-1079, 2009. Author Affiliation: (*)Allied Health Sciences ([dagger])Nutritional Sciences, University of Connecticut, Storrs, Connecticut ([double dagger])Section of Endocrinology, Department of Internal Medicine, Yale University, New Haven, Connecticut. Article note: Address correspondence to Jane E. Kerstetter, Department of Allied Health Sciences, 358 Mansfield Road, Box U-2101, University of Connecticut, Storrs, CT 06269. E-mail: Jane.Kerstetter@uconn.edu

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2008.02127.x Keywords: cognition; aged; medications Abstract: OBJECTIVES: To evaluate whether combined use of multiple central nervous system (CNS) medications over time is associated with cognitive change. DESIGN: Longitudinal cohort study. SETTING: Pittsburgh, Pennsylvania, and Memphis, Tennessee. PARTICIPANTS: Two thousand seven hundred thirty-seven healthy adults (aged [greater than or equal to]65) enrolled in the Health, Aging and Body Composition study without baseline cognitive impairment (modified Mini-Mental State Examination (3MS) score [greater than or equal to]80). MEASUREMENTS: CNS medication (benzodiazepine- and opioid-receptor agonists, antipsychotics, antidepressants) use, duration, and dose were determined at baseline (Year 1) and Years 3 and 5. Cognitive function was measured using the 3MS at baseline and Years 3 and 5. The outcome variables were incident cognitive impairment (3MS score RESULTS: By Year 5, 7.7% of subjects had incident cognitive impairment; 25.2% demonstrated cognitive decline. CNS medication use increased from 13.9% at baseline to 15.3% and 17.1% at Years 3 and 5, respectively. It was not associated with incident cognitive impairment (adjusted hazard ratio (adj HR)=1.11, 95% confidence interval (CI)=0.73-1.69) but was associated with cognitive decline (adj HR 1.37, 95% CI=1.11-1.70). Longer duration (adj HR=1.39, CI=1.08-1.79) and higher doses (>3 standardized daily doses) (adj HR=1.87, 95% CI=1.25-2.79) of CNS medications suggested greater risk of cognitive decline than with nonuse. CONCLUSION: Combined use of CNS medications, especially at higher doses, appears to be associated with cognitive decline in older adults. Future studies must explore the effect of combined CNS medication use on vulnerable older adults. Author Affiliation: (*)Department of Medicine, Division of Geriatrics, School of Medicine ([dagger])Department of Epidemiology, School of Public Health ([double dagger])Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania (s.)Center for Health Equity Research and Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania ([parallel])Geriatric Research Education and Clinical Center, North Florida/South Georgia Veterans Health System, Gainesville, Florida (#)Division of General Internal Medicine, University of California at San Francisco, San Francisco, California (**)Division of Geriatric Medicine and Gerontology, Johns Hopkins University Medical Institutions, Baltimore, Maryland ([dagger][dagger])Intramural Research Program, National Institute on Aging, Baltimore, Maryland ([double dagger][double dagger])University of Sydney and Royal North Shore Hospital, Sydney, Australia. Article note: Address correspondence to Rollin M. Wright, Department of Medicine (Geriatrics), University of Pittsburgh, Kaufmann Medical Building-Suite 500, 3471 5th Ave, Pittsburgh, PA 15213. E-mail: rmw27@pitt.edu

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1532-5415.2008.02126.x Keywords: Short Physical Performance Battery; functional limitation; death; hospitalization; usual gait speed Abstract: OBJECTIVES: To determine how three different physical performance measures (PPMs) combine for added utility in predicting adverse health events in elders. DESIGN: Prospective cohort study. SETTING: Health, Aging and Body Composition Study. PARTICIPANTS: Three thousand twenty-four well-functioning older persons (mean age 73.6). MEASUREMENTS: Timed gait, repeated chair stands, and balance (semi- and full-tandem, and single leg stands each held for 30 seconds) tests were administered at baseline. Usual gait speed was categorized to distinguish high- and low-risk participants using the previously established 1-m/s cutpoint. The same population-percentile (21.3%) was used to identify cutpoints for the repeated chair stands (17.1 seconds) and balance (53.0 seconds) tests. Cox proportional hazard analyses were performed to evaluate the added value of PPMs in predicting mortality, hospitalization, and (severe) mobility limitation events over 6.9 years of follow-up. RESULTS: Risk estimates for developing adverse health-related events were similarly large for each of the three high-risk groups considered separately. Having more PPM scores at the high-risk level was associated with a greater risk of developing adverse health-related events. When all three PPMs were considered, having only one poor performance was sufficient to indicate a highly significantly higher risk of (severe) lower extremity and mortality events. CONCLUSION: Although gait speed is considered to be the most important predictor of adverse health events, these findings demonstrate that poor performance on other tests of lower extremity function are equally prognostic. This suggests that chair stand and standing balance performance may be adequate substitutes when gait speed is unavailable. Author Affiliation: (a)Department of Aging and Geriatric Reseach, Institute on Aging, University of Florida, Gainesville, Florida (b)Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, School of Medicine, Wake Forest University, Winston-Salem, North Carolina (c)Department of Epidemiology, Graduate School of Public Health (g)Department of Physical Therapy, University of Pittsburgh, Pittsburgh, Pennsylvania (d)Clinical Research Branch, National Institute on Aging, Baltimore, Maryland (e)Intramural Research Program, Laboratory of Epidemiology, Demography, and Biometry, National Institute on Aging, Bethesda, Maryland (f)Department of Psychiatry and EMGO Institute, Vrije University Medical Center, Amsterdam, the Netherlands (h)Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee (i)Division of General Internal Medicine (j)Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California (k)Institute of Health Sciences, Faculty of Earth and Life Sciences, Vrije Universiteit, Amsterdam, the Netherlands. Article note: Address correspondence to Matteo Cesari, Department of Aging and Geriatric Research, Institute on Aging, University of Florida, 210 E. Mowry Road, Gainesville, FL 32611. E-mail: macesari@gmail.com

Background: Fish consumption advisories are developed to prevent overexposure to various contaminants. Recently, discussion has centered on the need to consider the benefits of fish consumption alongside possible risks when providing guidance. Objective: As part of the Arsenic Mercury Intake Biometric Study involving the Japanese and Korean communities living in Washington State, we obtained fish and nutrient intake data. Japanese and Korean women of childbearing age (n = 214) participated in this longitudinal study. We used these data, along with hair-mercury data to determine the need for both the nutritional benefits and concern about contaminants to be included when providing guidance. Design: We examined the intake of 2 n-3 long-chain fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), found in fish and associated with a variety of beneficial health effects. Intakes of these lipids were used as surrogates to characterize the beneficial effect from fish consumption, and the intake of mercury was used to establish the risk from consumption. Results: These 2 populations provided an ideal basis from which to examine this issue because their fish consumption rates were identical and higher than national rates, but their mercury intakes vary substantially because of different consumption behaviors. Results indicate that basing fish consumption guidelines on contaminant concentrations alone can have the unintended consequence of causing a portion of the population to have inadequate intake of required nutrients. Conclusion: Public health goals may be better served if nutritional elements and contaminant concerns are quantitatively incorporated into fish consumption guidelines.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajo.2005.06.043 Byline: Siobhan E. Moriarty-Craige (a), Joanne Adkison (f), Michael Lynn (b), Gary Gensler (c), Susan Bressler (d), Dean P. Jones (a), Paul Sternberg (e) Abstract: Determine whether antioxidant supplements alter the plasma glutathione and/or cysteine redox potential in age-related macular degeneration (AMD) patients. Author Affiliation: (a) Department of Ophthalmology, Biochemistry, and Medicine, Emory University, Atlanta, Georgia (b) the Department of Biostatistics, Rollins School of Public Health of Emory University, Atlanta, Georgia (c) The EMMES Corporation, Rockville, Maryland (d) Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland (e) Department of Ophthalmology & Visual Sciences, Vanderbilt University, Nashville, Tennessee (f) Division of Emergency Medicine, Children's Hospital Boston, Instructor of Pediatrics, Harvard Medical School Article History: Accepted 11 January 2005 Article Note: (footnote) Supported in part by NIH grant EY07892, which supported all aspects of the study including design, conduct, data collection and analysis, as well as preparation of the manuscript, NIH training grant T32 EY07092-19, which supported sample collection, analysis, and manuscript preparation, an NEI Core Grant to Emory University EY06360, which supported the collection, management, analysis and interpretation of the manuscript, an NEI Core Grant to Vanderbilt University EY08126, which supported the preparation, review, and approval of the manuscript, the Foundation Fighting Blindness, which supported the design and conduct of the study, and a Research to Prevent Blindness Inc Challenge Grant to Vanderbilt, which supported the data analysis and interpretation, as well as the preparation of the article in manuscript.