Objectives
To determine plasma homocysteine levels in indigenous Australians living in urban areas, and the relationship of these levels with other risk factors in this population.
Design
Cross‐sectional study.
Subjects and setting
365 urban indigenous Australian subjects, 153 men and 212 women, mean (SE) age 42 (1) years, ascertained without regard to history of atherosclerotic disease, in collaboration with community‐based health centres in five indigenous communities in south‐east Queensland, 1997‐1998.
Main outcome measures
Plasma homocysteine levels, age, sex, smoking history, metformin therapy, history of atherosclerotic vascular disease, serum creatinine level, red cell folate and serum vitamin B12 levels.
Results
89 subjects (24%) had plasma homocysteine levels 15µmol/L or above. Homocysteine levels were higher in men than in women (men: 14.4µmol/L; 95% confidence interval [Cl], 13.6‐15.2; women: 11.9 µmol/L; 95% Cl, 11.4‐12.5) (P< 0.001); correlated with age (P< 0.001); higher in current smokers (P= 0.02); higher in subjects taking metformin therapy (P=0.007); and higher in subjects with a history of atherosclerotic vascular disease (P< 0.001). Homocysteine levels were also correlated with serum levels of creatinine (P< 0.001), red cell folate (P< 0.001), and vitamin B12 (P<0.001).
Conclusions
These data indicate that the high plasma levels of homocysteine of Australian indigenous subjects are associated with a history of vascular disease, and correlated with, among other things, smoking, and folate and vitamin 812 nutritional deficiency. These are potentially reversible risk factors, and our data suggest that focusing public health initiatives on these issues may reduce the high prevalence of cardiovascular disease in the Australian indigenous population.
Abstract:Objective: To determine prevalence of cognitive impairment (CI) and to estimate life expectancy with and without cognitive impairment in the Australian population over age 60.
Method:Adults aged 60 and older participating in the 12 year follow-up of the Australia Diabetes Obesity and Lifestyle Study (AusDiab) were included in the sample (n=1666). The mean age was 69.5 years, and 46.3% of the sample was male. The Mini-Mental State Examination was used to assess cognitive impairment. Logistic regression analysis was used to determine the effect of predictor variables (age, gender, education), measured at baseline, on cognitive impairment status. The Sullivan Method was used to estimate Total Life Expectancy (TLE), Cognitively Impaired (CILE) and Cognitive Impairment-free life expectancies (CIFLE).Results: Odds of CI were greater for males than females (OR 2.1, 95% confidence interval: 1.2-3.7) and among Australians with low education levels compared with Australians with high education levels (OR 2.1, 95% confidence interval: 1.2-3.7). The odds of CI also increased each year with age (OR 1.1, (95% confidence interval: 1.0-1.1). It was found that in all age groups females have greater TLE and CIFLE when compared to their male counterparts.
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