This application is designed to study the relation of noninsulin dependent diabetes mellitus (NIDDM) to cardiovascular disease (CVD) including coronary, cerebral and lower extremity arterial disease in older adults from three ethnic groups. The proposal has two complementary components, as follow. 1. Continuation of the Rancho Bernardo Study (RBS) of 1000 community-dwelling older middle class men (400) and women (600) of Caucasian northern European ancestry, who have been previously characterized for most covariates of interest including a 75g oral glucose tolerance test (OGTT) performed in 1984-87 and again in 1992-95. Almost half of the RBS cohort (mean age 71 yrs.) have either NIDDM (17%) or impaired glucose tolerance (32%) and data are available on a wealth of other anthropometric, psychosocial, behavioral, biologic (including DNA) and outcome data, with 99% follow-up for morbidity and mortality. The present proposal will prospectively examine the contribution of glycemia status and covariates (at baseline and over time) to the risk of clinical and subclinical CVD, and determine the relation of NIDDM and CVD to other outcomes of importance in the elderly, including depression, cognition, physical function, and quality of well-being. 2. Completion of a study of 500 African American and 500 Filipina American women of similar age and social class to include an OGTT and most of the other components of the RBS, in order to provide comparable information about carbohydrate tolerance, CVD risk factors, and CVD prevalence. Cross-sectional analyses will be made within and between populations. These understudied minority groups are expected to have a high prevalence of NIDDM and (probably) a different prevalence of CVD than observed in RBS, differences they will use to help elucidate the role of diabetes specific vs. nonspecific risk factors for CVD.
Showing the most recent 10 out of 281 publications
