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Study Title and Description

Lifestyle practices and cardiovascular disease mortality in the elderly: The leisure world cohort study



Key Questions Addressed
1 For [population], is caffeine intake above [exposure dose], compared to intakes [exposure dose] or less, associated with adverse effects on cardiovascular outcomes?
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Primary Publication Information
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TitleData
Title Lifestyle practices and cardiovascular disease mortality in the elderly: The leisure world cohort study
Author A. Paganini-Hill
Country
Year 2011
Numbers

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: Cardiovascular Design
Design Details
Question... Follow Up Answer Follow-up Answer
What outcome is being evaluated in this paper? Cardiovascular
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What is the objective of the study (as reported by the authors)? As part of a prospective cohort study of the effect of modifiable lifestyle practices on longevity and successful aging, we explored the association of smoking, alcohol consumption, caff eine intake, physical activity, and body mass index on CVD mortality in a large cohort (over 13,000) of elderly (median age 74 years) men and women followed for 26 years.
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Provide a general description of the methods as reported by the authors. Information should be extracted based on relevance to the SR (i.e., caffeine related methods) The LeisureWorld Cohort Study was established in the early 1980s when 13,978 (8877 female and 5101 male) residents of a California retirement community (Leisure World Laguna Hills) completed a postal health survey. The population and the cohort are mostly Caucasian, well educated, upper-middle class, and elderly. The baseline survey asked about demographic information (birth date, sex, marital status, number of children, height, weight); brief medical history (high blood pressure, angina, heart attack, stroke, diabetes, rheumatoid arthritis, fractures after age 40, cancer, gallbladder surgery, glaucoma, cataract surgery); medication use (hypertensive medication, digitalis, nonprescription pain medication); personal habits (cigarette smoking, exercise, alcohol consumption, vitamin supplement use); usual frequencies of consumption of 58 food (or food groups) that are common sources of dietary vitamin A and C; beverage intake (milk, regular coffee, decaffeinated coffee, black or green tea, and soft drinks). Lifestyle Factors (caffeine only) We estimated daily caffeine intake by summing the frequency of consumption of each beverage and chocolate multiplied by its average caffeine content (mg/standard unit) as 115, 3, 50, 50, and 6 for regular coffee, decaffeinated coffee, tea, cola soft drinks, and chocolate, respectively. Caffeine intake was categorized as < 50, 50–99, 100–199, 200–399, 400+ mg/day. Determination of Outcome Follow-up of the cohort is maintained by periodic resurvey and determination of vital status by search of governmental and commercial death indexes and ascertainment of death certificates. Participants were followed to death or December 31, 2007, whichever came first. To date 55 cohort members have been lost to follow up; search of death indices did not reveal that these individuals were deceased. Cause of death was determined from death certificates or by codes provided by the California Department of Vital Statistics. We included as CVD deaths those coded 390–459 in International Classification of Diseases 9 (years 1981–1998) and I00–I99 in International Classification of Diseases 10 (years 1999–2007). Statistical Analysis Hazard ratios (HRs) and 95% confidence intervals (CIs) were obtained using Cox regression analysis. For the Cox models, chronological age was used as the fundamental time scale with study entry being the age when the survey was completed and the event of interest being age at CVD death. Separate analyses were performed for four age groups (< 70, 70–74, 75–79, and 80+ years) within the two sexes. HRs were calculated for each lifestyle factor adjusted for age (continuous) [Model 1] and then additionally adjusted for the other lifestyle variables plus seven separate histories (no, yes) of hypertension, angina, heart attack, stroke, diabetes, rheumatoid arthritis, and cancer [Model 2]. Statistical analyses were performed using SAS version 9.2 (SAS Institute Inc., Cary, NC). No adjustment in the P values was made for multiple comparisons. To account for the possibility that recent disease development may have influenced lifestyle practices as well as be related to mortality, we repeated the analyses excluding the first five years of follow-up.
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How many outcome-specific endpoints are evaluated? 1
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What is the (or one of the) endpoint(s) evaluated? (Each endpoint listed separately) Cardiovascular disease mortality
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List additional health endpoints (separately). 2
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List additional health endpoints (separately).3
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List additional health endpoints (separately).4
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List additional health endpoints (separately).5
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List additional health endpoints (separately).6
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Clinical, physiological, other Clinical
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What is the study design? Cohort
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Randomized or Non-Randomized?
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What were the diagnostics or methods used to measure the outcome? Objective
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Optional: Name of Method or short description
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Caffeine (general) Caffeine (general)
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Coffee, Chocolate, energy drink, gum, medicine/supplement, soda, tea, other?
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Measured or self reported? Self-report
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Children, adolescents, adults, or pregnant included? Adults
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What was the reference, comparison, or control group(s)? (e.g. high vs low consumption, number of cups, etc.) High vs. low consumption
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What were the listed confounders or modifying factors as stated by the authors? (e.g. multi-variable components of models.  Copy from methods) Hypertension, angina, heart attack, stroke, diabetes, rheumatoid arthritis, and cancer
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What conflicts of interest were reported? No information provided
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Refid 10362
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What were the sources of funding? This research was funded by Grants from the National Institutes of Health (R01CA32197 and R01AG21055), the Earl Carroll Trust Fund, andWyeth-Ayerst Laboratories.
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Results & Comparisons

No Results found.