Untitled Document

Research

Karen J. Cruickshanks

Ph.D., University of Pittsburgh
Professor, Departments of Ophthalmology and Visual Sciences and Population Health Sciences
cruickshanks@episense.wisc.edu
http://wieyemd.ophth.wisc.edu/faculty/cruickshanks

http://www.pophealth.wisc.edu/faculty/kcruicksh.html

Epidemiology of Age-related Sensory Disorders; Epidemiology of Diabetes and its Complications

My research program has two primary foci: the epidemiology of age-related sensory disorders and the epidemiology of diabetes and its complications. Most older people experience declines in vision and hearing with age. Using epidemiologic approaches, my research seeks to identify what factors (lifestyle, genetic or environmental) may place people at higher risk of developing sensory disorders: cataract, age-related maculopathy, diabetic retinopathy, age-related hearing loss, and olfactory impairment. The ultimate goal is to identify intervention strategies to prevent these diseases, delay progression, or lessen the consequences of the disorders. In addition, my research group is studying the impact of sensory impairments on quality of life and the ability to stay independent among older adults. This work has shown that hearing loss is a common problem and may be related to modifiable lifestyle factors such as noise exposure, smoking, alcohol consumption, exercise, and other atherosclerosis-related factors. Older people with hearing loss have a diminished quality of life compared to people with normal hearing and are more likely to have other sensory impairments such as vision loss.

My study of age-related hearing loss is the first population-based study of hearing since the Framingham Study which began in the 1970s. These studies are important to understanding the impact of hearing loss on the population, the need for hearing-related health care and rehabilitation services, and to identify strategies to delay or prevent hearing loss. Participants (n=3753) in this study were participants in Drs. Barbara and Ron Klein's study of age-related eye diseases (The Beaver Dam Eye Study). For the hearing study, participants completed an interview about hearing-related medical history, family history and lifestyle factors such as noise exposure, and self-assessed hearing difficulties and an audiologic examination. This study demonstrated that 46% of adults ages 48-92 years of age had a hearing loss. Preliminary results from the 5-yr follow-up of this cohort of older adults in Beaver Dam, WI, indicate that the 5-yr incidence is high (over 20%) and that hearing worsened for over half of the people with hearing loss at the baseline examination. Lifestyle factors such as having noisy hobbies and getting very little exercise and health conditions such as diabetes and atherosclerosis may be related to the risk of developing hearing loss and having hearing continue to worsen. We're now using ultrasound images of carotid arteries to investigate the role of atherosclerosis in age-related hearing loss, macular degeneration, and other health problems of aging.

Representative Publications
Sprague, B.L., Trentham-Dietz, A., Klein, B.E.K., Klein, R., Cruickshanks, K.J., Lee, K.E., & Hampton, J.M. (2008). Physical activity, white blood cell count, and lung cancer risk in a prospective cohort study. Cancer Epidemiol. Biomarkers Prev., 17(10), 2714-22. PMID: 18843014.

Schubert, C.R., Carmichael, L.L., Murpy, C., Klein, B.E.K., Klein, R., & Cruickshanks, K.J. (2008). Olfaction and the 5-year incidence of cognitive impairment in an epidemiologic study of older adults. J. Am. Geriatr. Soc., 56, 1517-21. PMID: 18662205.

Klein, R., Knudtson, M.D., Cruickshanks, K.J., & Klein, B.E.K. (2008). Further observations on the association between smoking and the long-term incidence and progression of age-related macular degeneration. Archives of Ophthalmology, 126(1), 115-121.

Trentham-Dietz, A., Sprague, B.L., Klein, R., Klein, B.E.K., Cruickshanks, K.J., Fryback, D.G., & Hampton, J.M. (2008). Health-related quality of life before and after a breast cancer diagnosis. Breast Cancer Res. Treat., 109(2), 379-87.

Nondahl, D.M., Cruickshanks, K.J., Dalton, D.S., Klein, B.E.K., Klein, R., Schubert, C.R., Tweed, T.S., & Wiley, T.L. (2007). The impact of tinnitus on quality of life in older adults. J. Am. Acad. Audiol., 18(3), 259-268.

Nondahl, D.M., Cruickshanks, K.J., Dalton, D.S., Klein, B.E.K., Klein, R., Tweed, T.S., & Wiley, T.L. (2006). The use of hearing protection by older adults during recreational noise exposure. Noise and Health, 8, 147-153.

Klein, R., Klein, B.E., Lee, K.E., Cruickshanks, K.J., & Gangnon, R.E. (2006). Changes in visual acuity in a population over a 15-year period: the Beaver Dam Eye Study. Am. J. Ophthalmol., 142, 539-49.

Nondahl, D.M., Klein, B.E., Klein, R., Cruickshanks, K.J., Tweed, T.S., & Wiley, T.L. (2005). Factors predicting severity of tinnitus: a population-based assessment. J. Am. Acad. Audiol., 16, 196; author reply 197.

Puent, B.D., Klein, B.E.K., Klein, R., Cruickshanks, K.J., & Nondahl, D.M. (2005). Factors related to vision care in an older adult cohort. Optom. Vis. Sci., 82, 612-616.

Torre, P.3rd, Cruickshanks, K.J., Klein, B.E., Klein, R., & Nondahl, D.M. (2005). The association between cardiovascular disease and cochlear function in older adults. J. Speech Lang. Hear. Res., 48(2), 473-81.

Knudtson, M.D., Klein, B.E., Klein, R., Cruickshanks, K.J., & Lee, K.E. (2005). Age-related eye disease, quality of life, and functional activity. Arch. Ophthalmol., 123, 807-814.

Klein, R., Klein, B.E.K., Moss, S.E., Wong, T.Y., Hubbard, L., Cruickshanks, K.J., & Palta, M. (2004). The relation of retinal vessel caliber to the incidence and progression of diabetic retinopathy. XIX: The Wisconsin Epidemiologic Study of Diabetic Retinopathy. Arch. Ophthalmol., 122, 76-83.

Tomany, S.C., Cruickshanks, K.J., Klein, R., Klein, B.E.K., & Knudtson, M.D. (2004). Sunlight and the 10-year incidence of age-related maculopathy: The Beaver Dam Eye Study. Arch. Ophthalmol., 122, 750-757.

Klein, B.E.K., Klein, R., McBride, P.E., Cruickshanks, K.J., Palta, M., Knudtson, M.D., Moss, S.E., & Reinke, J.O. (2004). Cardiovascular disease, mortality, and retinal microvascular characteristics in type 1 diabetes Wisconsin Epidemiologic Study of Diabetic Retinopathy. Arch. Intern. Med., 164, 1917-1924.

Nondahl, D.M., Cruickshanks, K.J., Dalton, D.S., Schubert, C.R., Klein, B.E.K., Klein, R., & Tweed, T.S. (2004). Serum cotinine and incident hearing loss: a case/control study. Arch. Otolaryngol.--Head & Neck Surg., 130, 1260-1264.

Klein, B.E.K., Moss, S.E., Klein, R., Lee, K.E., & Cruickshanks, K.J. (2003). Associations of visual function with physical outcomes and limitations five years later in an older population: The Beaver Dam Eye Study. Ophthalmology, 110, 644-650.

Klein, R., Klein, B.E.K., Tomany, S.C., & Cruickshanks, K.J. (2003). The association of cardiovascular disease with the long-term incidence of age-related maculopathy: The Beaver Dam Eye Study. Ophthalmology, 110(4), 636-643.

Klein, R., Klein, B.E.K., Tomany, S.C., & Cruickshanks, K.J. (2003). Association of emphysema, gout, and inflammatory markers with the long-term incidence of age-related maculopathy. Arch. Ophthalmol., 121, 674-678.

Klein, R., Klein, B.E.K., Tomany, S.C., Danforth, L.G., & Cruickshanks, K.J. (2003). Relation of statin use to the 5-year incidence and progression of age-related maculopathy. Arch. Ophthalmol., 121, 1151-1155.

Cruickshanks, K.J., Tweed, T.S., Wiley, T.L., Klein, B.E.K., Klein, R., Chappell, R., Nondahl, D.M., & Dalton, D.S. (2003). The 5-year incidence and progression of hearing loss: The Epidemiology of Hearing Loss Study. Arch. Otolaryngol.-- Head Neck Surg., 129, 1041-46.

Klein, R., Klein, B.E.K., Moss, S.E., Wong, T.Y., Hubbard, H., Cruickshanks, K.J., & Palta, M. (2003). Retinal vascular abnormalities in persons with type 1 diabetes: The Wisconsin Epidemiological Study of Diabetic Retinopathy XVIII. Ophthalmology, 110, 2118-2125.

Mitchell, J.L., Cruickshanks, K.J., Klein, B.E.K., Palta, M., & Nondahl, D.M. (2003). Postmenopausal hormone therapy and its association with cognitive impairment. Arch. Intern. Med., 163, 2485-2490.

Dalton, D.S., Cruickshanks, K.J., Klein, B.E.K., Klein, R., Wiley, T.L., & Nondahl, D.M. (2003). The impact of hearing loss on quality of life in older adults. Gerontologist, 43, 661-8.

Nondahl, D.M., Cruickshanks, K.J., Wiley, T.L., Klein, R., Klein, B.E., & Tweed, T.S. (2003). Comment on tinnitus in older adults from the Blue Mountains Study by Sindhusade et al and comparison with tinnitus data from the Epidemiology of Hearing Loss Study. Int. J. Audiol., 43, 60.

Nondahl, D.M., Cruickshanks, K.J., Klein, R., Klein, B.E.K., Wiley, T.L., Tweed, T.S., & Pasic, T.R. (2002). Prevalence and 5- year incidence of tinnitus among older adults: The Epidemiology of Hearing Loss Study. J. Am. Acad. Audiol., 13, 323-331.

Murphy, C., Schubert, C.R., Cruickshanks, K.J., Klein, B.E.K., Klein, R., & Nondahl, D.M. (2002). Prevalence of olfactory impairment in older adults: Results of an epidemiological study. JAMA, 288(18), 2307-2312.

Cruickshanks, K.J., Klein, R., Klein, B.E.K., & Nondahl, D.M. (2001). Sunlight and the 5-yr incidence of early age-related maculopathy: The Beaver Dam Eye Study. Arch. Ophthalmol., 119, 246-250.

Dalton, D.S., Cruickshanks, K.J., Wiley, T.L., Klein, B.E.K., Klein, R., & Tweed, T.S. (2001). Association of leisure time noise exposure and hearing loss. Audiology, 40, 1-9.

Rubin, G., & Cruickshanks, K.J. (2000). Sensory impairment in women. In M.B. Golman, & M.C. Hatch (Eds.), Women and health. San Diego: Academic Press.

Cruickshanks, K.J., Fryback, D.G., Nondahl, D.M., Robinson, N., Keesey, U., Dalton, D.S., Robertson, D.M., Chandra, et al. (1999). Treatment choice and quality of life in patients with choroidal melanoma. Arch. Ophthalmol., 117(4), 461-467.

Klein, R., Klein, B.E.K., Jensen, S.C., Mares-Perlman, J.A., Cruickshanks, K.J., & Palta, M. (1999). Age-related maculopathy in a multiracial United States population: The National Health and Nutrition Examination Survey III. Ophthalmology, 106, 1056-1065.

Cruickshanks, K.J., Klein, R., Klein, B.E.K., Wiley, T.L., Nondahl, D.M., & Tweed, T.S. (1998). Cigarette smoking and hearing loss: The Epidemiology of Hearing Loss Study. JAMA, 279(21), 1715-1719.

Popelka, M.M., Cruickshanks, K.J., Wiley, T.L., Tweed, T.S., Klein, B.E.K., & Klein, R. (1998). Low prevalence of hearing aid use among older adults with hearing loss: The Epidemiology of Hearing Loss Study. J. Am. Geriatr. Soc., 46, 1075-1078.

Cruickshanks, K.J., Wiley, T.L., Tweed, T.S., Klein, B.E.K., Klein, R., Mares- Perlman, J.A., & Nondahl, D.M. (1998). Prevalence of hearing loss in older adults in Beaver Dam, Wisconsin: The Epidemiology of Hearing Loss Study. Am. J. Epidemiol., 148(9), 879-886.

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