The aims of the proposed work are twofold: 1. Teaching, learning, and administration. Specific goals are: (a) organization of the Preventive Pulmonary Medical Education Committee, which will be charged with serving as a liaison with the College of Medicine Curriculum Committee; serving as a speaker's bureau for Continuing Medical Education programs throughout the State; serving as an advisory board to Doctoral candidates pursuing degrees in related areas; serving as a resource for organizations desiring information about potential occupational hazards; (b) development of a 4th year medical student elective in Preventive Pulmonary Medicine; (c) service to the Tobacco Free Young Kentuckians, a coalition of the American Lung Association, American Cancer Society and American Heart Association; (d) teaching in and development of the William Osler Program of the College of Medicine, a mentorship program for medical students; (e) teaching in the Pulmonary Pathophysiology Course for second year medical students, with emphasis on prevention of tobacco related lung disease; (f) pursuit of the Master of Science in Public Health Degree. 2. Research. The primary objective of this work is to continue a comprehensive, longitudinal followup of the incidence and natural history of sleep-disordered breathing in the elderly. This goal will be accomplished through yearly re-administration of selected measures of medical, sleep/wake, and psychological status to a large group of healthy older persons (> 50y) who were initially studied with polysomnography and other tests beginning in 1986. Followup data from subjects who originally demonstrated high levels of SDB will be contrasted with that from remaining subjects in a test of the hypothesis that sleep disordered breathing leads to an accelerated deterioration of health status in older persons. These data will bear on the possible importance of early detection and treatment of high levels of sleep disordered breathing in the otherwise asymptomatic elderly.
