Discrepancy between subjectively reported symptoms and objectively measured clinical findings in dry eye: a population based analysis.
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ABSTRACT:
SUBMITTER: Hua R
PROVIDER: S-EPMC4156796 | biostudies-literature | 2014
REPOSITORIES: biostudies-literature
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Project description:Despite rapid increase of people aged 80 and over, concepts of successful ageing (SA) are primarily examined for people below that age. Therefore, successful ageing was examined in a population-based representative sample of N = 1863 people aged 80 to 102 (NRW80+) with 11% living in institutionalized settings. In this survey on quality of life and well-being, multiple linear and logistic regression models were used to calculate the distribution of successful agers. According to Rowe and Kahn's objective definition, 9% of the sample aged successfully, but one-third (33%) still met four to five SA criteria. This is in line with the theoretical a priori criterion of 10% in a normal distribution of a sample, while 80% age normally and 10% pathologically. However, averages of life satisfaction, affective well-being, positive ageing experience and valuation of life were high. The majority of the oldest old (65%) are successful agers in their own subjective perception, which is not in line with objective measurements. Moreover, 11% of objectively measured successful agers do not meet subjective criteria. These empirical findings reveal a remarkable discrepancy between objective and subjective criteria of SA. Future research on concepts that define successful ageing for the oldest old should consider more holistic markers of success, e.g., outcomes of productive social engagement.Supplementary informationThe online version contains supplementary material available at 10.1007/s10433-021-00609-7.
| S-EPMC8563904 | biostudies-literature
Project description:BackgroundWhiplash associated disorders (WAD) are the most common non-hospitalised injuries resulting from a motor vehicle crash. Half of individuals with WAD experience ongoing pain and disability. Furthermore, individuals with persistent WAD have lower levels of aerobic capacity and isometric strength compared with age-matched controls. It is not known whether these differences are associated with increased levels of pain and disability, or with reduced physical activity (PA) participation.ObjectiveOur primary aim was to compare PA levels in individuals with persistent WAD with healthy controls. Secondary aims were to: compare objective and subjective measurements of PA; explore factors that may influence PA; and describe proportions of these populations meeting World Health Organisation PA guidelines.MethodsObjective (ActiGraph accelerometer; seven days) and subjective (International Physical Activity Questionnaire (IPAQ)) PA data were collected for n = 53 age-matched participants (WAD n = 28; controls n = 25).ResultsIndependent sample t-tests showed no significant difference in objectively measured PA (p>0.05) between WAD and controls. For the subjective measure (IPAQ), controls reported more overall weekly PA (t = 0.219, p<0.05), while WAD participants reported more weekly walking minutes (t = -0.712, p<0.05). Linear regression showed mental health quality-of-life predicted objectively measured moderate intensity PA (R2 = 0.225, F (2, 44) = 6.379, p<0.004) and subjectively reported overall PA (R2 = 0.132, F (1, 41) = 6.226, p<0.017). Bland-Altman analyses indicated that subjects over-reported MVPA and under-reported sedentary time using the IPAQ.ConclusionsIndividuals with WAD had levels of physical and mental health quality-of-life significantly lower than controls and below population norms yet participated in similar levels of PA. Given that increased perceptions of mental health quality-of-life were positively associated with objectively measured MVPA and subjectively reported overall PA, strategies to help people with WAD achieve adequate doses of MVPA may be beneficial. ActiGraph-measured and IPAQ-reported PA were discordant. Hence, IPAQ may not be a reliable measure of habitual PA in WAD.
| S-EPMC10553333 | biostudies-literature
Project description:Because current evidence suggests that numeracy affects how people make decisions, it is an important factor to account for in studies assessing the effectiveness of medical decision support interventions. Subjective and objective numeracy assessment methods are available that vary in theoretical background, skills assessed, known relationship with decision making skills, and ease of implementation. The best way to use these tools to assess numeracy when conducting medical decision-making research is currently unknown.We conducted Internet surveys comparing numeracy assessments obtained using the subjective numeracy scale (SNS) and 5 objective numeracy scales. Each study participant completed the SNS and 1 objective numeracy measure. Following each assessment, participants indicated willingness to repeat the assessment and rated its user acceptability.The overall response rate was 78%, resulting in a total sample size of 673. Spearman correlations between the SNS and the objective numeracy measures ranged from 0.19 to 0.44. Acceptability assessments for the short form of the Numeracy Understanding in Medicine Instrument and the SNS did not differ significantly. The other objective scales all had lower acceptability ratings than the SNS.These findings are consistent with prior research suggesting that objective and subjective numeracy scales measure related but distinct constructs. Due to current uncertainty regarding which construct is more likely to influence the effectiveness of decision support interventions, these findings warrant further investigation to determine the proper use of objective versus subjective numeracy assessments in medical decision-making research. Pending additional information, a reasonable approach is to measure both objective and subjective numeracy so that the full range of actual and perceived numeracy skills can be taken into account.
| S-EPMC4636483 | biostudies-literature
Project description:ObjectiveThe study objective was to quantify the association between daily physical activity measured by accelerometer and 1-year changes in symptoms among people with knee osteoarthritis.MethodsParticipants from the Osteoarthritis Initiative had knee radiographs and physical activity assessed using GT1M ActiGraph (Pensacola, FL) uniaxial accelerometers at the 48-month visit. Physical activity was calculated and categorized as tertiles of average daily minutes in light and moderate-to-vigorous activity. Outcomes were 1-year change in symptoms measured by Western Ontario and McMaster Universities scales, including pain, stiffness, and physical function. Adjusted multivariable linear models estimated the relationship between tertiles of light or moderate-to-vigorous physical activity and changes in knee symptoms.ResultsAmong 1059 participants (55% were women; mean age, 66 ± 9 years), greater time in light activity was associated with a trend toward declined physical function (P = .01). Greater time in daily moderate-to-vigorous activity also was associated with declined physical function (P = .01) and increased pain (P = .08). None of these average changes in symptoms reached minimally important clinical differences. However, greater daily time in both activities was associated with a higher probability of worsening symptoms among persons with Kellgren-Lawrence grade 4 osteoarthritis.ConclusionsObjectively measured daily activity was not associated with 1-year symptom improvements among community-dwelling adults with knee osteoarthritis. In those with advanced disease (Kellgren-Lawrence grade 4), greater daily minutes in physical activity were associated with worsening symptoms. How best to implement exercise regimens in persons with advanced knee osteoarthritis to reduce the deleterious impact on symptoms needs to be explored.
| S-EPMC6768827 | biostudies-literature
Project description:BACKGROUND:Sedentary behavior (SED) is a potential risk factor for poor pregnancy outcomes. We evaluated the validity of several common and one new method to assess SED across three trimesters of pregnancy. METHODS:This cohort study of pregnant women measured objective and self-reported SED each trimester via thigh-worn activPAL3 micro (criterion), waist-worn Actigraph GT3X, and self-report from the Pregnancy Physical Activity Questionnaire (PPAQ) and the de novo Sedentary Behavior Two Domain Questionnaire (SB2D). SED (hours per day) and percent time in SED (SED%) from activPAL were compared to GT3X, SB2D, and PPAQ using Pearson's r, ICC, Bland-Altman analysis, and comparison of criterion SED and SED% across tertiles of alternative methods. RESULTS:Fifty-eight women (mean age 31.5 ± 4.8 years; pre-pregnancy BMI 25.1 ± 5.6 kg/m2; 76% white) provided three trimesters of valid activPAL data. Compared to activPAL, GT3X had agreement ranging from r = 0.54-0.66 and ICC = 0.52-0.65. Bland-Altman plots revealed small mean differences and unpatterned errors, but wide limits of agreement (greater than ±2 h and ± 15%). The SB2D and PPAQ had r < 0.5 and ICC < 0.3 vs. activPAL SED, with lower agreement during the 2nd and 3rd trimesters, and performed poorly in Bland-Altman analyses. SED% from the modified SB2D performed best of the self-reported instruments with modest mean differences, r ranging from 0.55 to 0.60, and ICCs from 0.31-0.33; though, limits of agreement were greater than ±35%. Significant trends in activPAL SED were observed across increasing tertiles of SB2D SED in the 1st and 3rd trimesters (both p ≤ 0.001), but not the 2nd trimester (p = 0.425); and for PPAQ SED in the 1st and 2nd trimesters (both p < 0.05), but not the 3rd trimester (p = 0.158). AcitvPAL SED and SED% increased significantly across tertiles of GT3X SED and SED% as well as SB2D SED% (all p-for-trend ≤ 0.001). CONCLUSIONS:Compared to activPAL, waist-worn GT3X produced moderate agreement, though similar mean estimates of SED across pregnancy. Self-report questionnaires had large absolute error and wide limits of agreement for SED hr./day; SB2D measurement of SED% was the best self-report method. These data suggest activPAL be used to measure SED when possible, followed by GT3X, and - when necessary - SB2D assessing SED% in pregnancy. TRIAL REGISTRATION:www.clinicaltrials.gov NCT03084302 on 3/20/2017.
| S-EPMC7014698 | biostudies-literature
Project description:PurposeThis study assessed the association of dry eyes with depression and suicidal ideation in a Korean adult population.MethodsData from 16408 participants (6972 men and 9436 women) aged ≥ 19 years included in the fifth Korea National Health and Nutrition Examination Survey, conducted from 2010-2012, were analyzed. For dry eyes, surveys of previous diagnosis of dry eye disease (DED) by an ophthalmologist and experience of subjective dry eye symptoms were separately used. Diagnosis of depression and suicidal ideation were obtained via responses to an interviewer-assisted questionnaire, and questions were asked in a closed-ended response format. Logistic regression was used to examine the associations between dry eyes, depression, and suicidal ideation.ResultsDED diagnosis exhibited an odds ratio (OR) of 1.32 (95% confidence interval [CI] 1.11-1.57) for depression and 1.24 (95% CI 1.05-1.48) for suicidal ideation compared to those without DED, after adjusting for sex, age, education, occupation, household income, body mass index, smoking behavior, alcohol consumption, physical activity, hypertension, diabetes, dyslipidemia, thyroid diseases, major cardiovascular disease, and cancer. Similarly, the adjusted OR (95% CI) of dry eye symptoms was 1.50 (95% CI 1.30-1.73) for depression and 1.47 (95% CI 1.27-1.70) for suicidal ideation.ConclusionOur findings suggest that dry eyes (either DED diagnosis or dry eye symptoms) may be associated with the prevalence of depression and suicidal ideation in the Korean adult population.
| S-EPMC6010274 | biostudies-literature
Project description:OBJECTIVES:Hyperkyphosis is associated with restricted pulmonary function and posture, potentially contributing to poor sleep. A previous study reported older women with hyperkyphosis had worse self-reported sleep quality, but it is less clear if this association exists in men. We examined the association between hyperkyphosis and subjective and objective sleep quality in a cohort of older men. DESIGN:Longitudinal analysis of data from large cohort of older men participating in the Osteoporotic Fractures in Men Study (MrOS). SETTING:Community. PARTICIPANTS:We studied 754 men participants in MrOS who had kyphosis measured during the 3rd clinic visit (2007-2009) and future subjective and objective sleep quality assessed between 2009-2012 (an average of 2.9 years later). INTERVENTION:N/A. MEASUREMENTS:To measure kyphosis, 1.7 cm thick wooden blocks were placed under the participant's head to achieve a neutral spine position while lying supine on a DXA table. We collected data on both subjective (Pittsburgh Sleep Quality Index [PSQI], and Epworth Sleepiness Scale [ESS]) and objective (wrist actigraphy: Total Sleep Time [TST], Wake After Sleep Onset [WASO], Sleep Efficiency [SE], Sleep Onset Latency [SOL]; and polysomnography: Apnea Hypopnea Index [AHI]) sleep measurements. Those who required >3 blocks were considered hyperkyphotic (n = 145 or 19.2%). RESULTS:In unadjusted and multivariable analyses, men with hyperkyphosis did not report having worse self-reported sleep characteristics based on PSQI and ESS. Similarly, there were no significant associations between hyperkyphosis and objective sleep measures. When examined as a continuous predictor (blocks ranging from 0-8), results were no different. CONCLUSIONS:Although we hypothesized that poor posture in those with hyperkyphosis would interfere with sleep, in this sample of older men, worse kyphosis was not associated with self-reported or objectively measured poor sleep quality.
| S-EPMC7012394 | biostudies-literature
Project description:PurposeTo investigate accommodative microfluctuations (AMFs) and visual function in short tear break-up time (BUT)-type dry eye (DE) and non-DE subjects.MethodsThis prospective comparative study included 48 volunteers with DE symptoms (mean age 34.8 ± 5.5 years, age range 25-42 years) and 73 without DE symptoms (mean age 30.6 ± 4.7 years, age range 25-42 years). The eyes were divided into two groups: (1) DE group with DE symptoms and BUT ≤ 5 s and (2) non-DE group without DE symptoms and BUT > 5 s. We excluded eyes with Schirmer score ≤ 5 mm and positive keratoconjunctival epithelial damage. Tear evaluation, AMF, and functional visual acuity (VA) examinations were performed. AMF parameters included total high-frequency component (HFC), HFC with low accommodation for the task of staring into the distance (HFC1), and HFC with high accommodation for deskwork (HFC2). Functional VA parameters included starting VA, functional VA, visual maintenance ratio, and blink frequency.ResultsA total of 33 and 34 eyes were categorized in the DE and non-DE groups, respectively. Mean blink frequency and HFC1 values were significantly higher in the DE group than they were in the non-DE group.ConclusionsDEs with symptoms showed abnormal AMF and visual function, which may be associated with DE symptoms.
| S-EPMC5590915 | biostudies-literature
Project description:PurposeTo assess the relationship between tear osmolarity and dry eye symptoms in patients with diabetes.Patients and methodsFifty patients with diabetes were enrolled. Demographic information and past medical history were recorded. Symptoms were assessed using the ocular surface disease index (OSDI). Tear osmolarity of each eye was measured with the TearLab® Osmolarity System.ResultsThe majority of the subjects were female (76%), African American (56%), and/or had a diagnosis of type 2 diabetes (82%). The mean ± standard deviation (SD) for age was 54.6±13.4, and maximum tear osmolarity was 304.6±12.7 mOsm/L. Men had higher osmolarity than women (mean ± standard error (SE) 311.8±4.0 mOsm/L versus 302.3±1.9 mOsm/L, P=0.02). Age, race, use of artificial tears, years of diabetes, and hemoglobin A1c did not have a statistically significant association with tear osmolarity. Longer duration of diabetes was associated with lower (less severe) OSDI scores (r=-0.35, P=0.01). Higher tear osmolarity was associated with lower (less severe) OSDI scores (r=-0.29, P=0.04).ConclusionApproximately half of the diabetic subjects in our study had elevated tear osmolarity, and half of our population also reported symptoms consistent with dry eye disease. However, the two were slightly inversely related in that those with higher osmolarity reported fewer symptoms. Subjects with a longer duration of diabetes also reported fewer dry eye symptoms. Therefore, health care providers should be aware that patients who are most likely to have ocular surface disease, including those with long-standing diabetes, may not experience symptoms and seek care in a timely manner.
| S-EPMC3956735 | biostudies-literature
Project description:The study of unconscious processing requires a measure of conscious awareness. Awareness measures can be either subjective (based on participant's report) or objective (based on perceptual performance). The preferred awareness measure depends on the theoretical position about consciousness and may influence conclusions about the extent of unconscious processing and about the neural correlates of consciousness. We obtained functional magnetic resonance imaging (fMRI) measurements from 43 subjects while they viewed masked faces and houses that were either subjectively or objectively invisible. Even for objectively invisible (perceptually indiscriminable) stimuli, we found significant category information in both early, lower-level visual areas and in higher-level visual cortex, although representations in anterior, category-selective ventrotemporal areas were less robust. For subjectively invisible stimuli, similar to visible stimuli, there was a clear posterior-to-anterior gradient in visual cortex, with stronger category information in ventrotemporal cortex than in early visual cortex. For objectively invisible stimuli, however, category information remained virtually unchanged from early visual cortex to object- and category-selective visual areas. These results demonstrate that although both objectively and subjectively invisible stimuli are represented in visual cortex, the extent of unconscious information processing is influenced by the measurement approach. Furthermore, our data show that subjective and objective approaches are associated with different neural correlates of consciousness and thus have implications for neural theories of consciousness.
| S-EPMC8128378 | biostudies-literature