Tag Archives: older people

A reliable smart app ‘DryEyeRhythm’ to assess Dry eye disease; What is the disease [Details]

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Dry eye disease (DED) is a condition characterized by an array of different symptoms, including dryness, ocular discomfort, fatigue, and visual disturbances. This condition has become increasingly common in recent years owing to an aging society, increased screen time, and a highly stressful social environment. There are about 1 billion people, worldwide, who have DED. Undiagnosed and untreated DED can lead to a variety of symptoms, including ocular fatigue, sensitivity to light, lower vision quality, and a lower quality of life. Given the widespread prevalence of the condition, this can further lead to reduced work productivity and economic loss.

Despite the obvious disadvantages of DED, a large portion of the population remains undiagnosed, which ultimately leads to increased disease severity. DED is currently diagnosed through a series of questionnaires and ocular examinations (which can be invasive). But this method of diagnosis is not ideal. DED examinations do not always correspond with  patients’ subjective DED symptoms. Furthermore, non-invasive and non-contact dry eye examinations are required in the COVID-19 pandemic. These flaws point to a need for a simple, reliable, and accessible screening method for DED to improve diagnosis and prognosis of the disease.

To answer this need, a research group, led by Professor Akira Murakami and Associate Professor Takenori Inomata of the Juntendo University Graduate School of Medicine, developed a smartphone application called DryEyeRhythm. “DryEyeRhythm leverages the cameras in smartphones to measure users’ blink characteristics and determine maximum blink interval (MBI)—a substitute for tear film breakup time, an important diagnostic criterion of DED,” explains Associate Prof. Inomata. “The app also administers Ocular Surface Disease Index (OSDI) questionnaires, which are also a crucial component of DED diagnosis.”

The research team conducted a prospective, cross-sectional, observational, single-center study.

The study revealed that the J-OSDI collected with DryEyeRhythm showed good internal consistency. Moreover, the app-based questionnaire and MBI yielded significantly higher discriminant validity. The app also showed good positive and negative predictive values, with 91.3% and 69.1%, respectively. The area under the Receiver operating characteristic (ROC) curve—a measure of clinical sensitivity and specificity—for the concurrent use of the app-based J-OSDI and MBI was also high, with a value of 0.910. These results demonstrate that the app is a reliable, valid, and moreover non-invasive, instrument for assessing DED.

“Non-contact and non-invasive DED diagnostic assistance, like the kind provided by DryEyeRhythm, could help facilitate the early diagnosis and treatment of patients, as well as, DED treatment through telemedicine and online medical care,” says Associate Prof. Inomata. The research team plans to further validate its results by conducting a multi-institutional collaborative study in the future. They are also planning to obtain medical device approval and insurance reimbursement for the smartphone application.

The development of DryEyeRhythm is crucial step forward toward the management of DED and improving vision and quality of life among the population.

 

Higher coffee consumption associated with lower risk of death

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Higher coffee consumption is associated with a lower risk of death, according to research presented today at ESC Congress.1 The observational study in nearly 20 000 participants suggests that coffee can be part of a healthy diet in healthy people.

“Coffee is one of the most widely consumed beverages around the world,” said Dr Adela Navarro, a cardiologist at Hospital de Navarra, Pamplona, Spain. “Previous studies have suggested that drinking coffee might be inversely associated with all-cause mortality but this has not been investigated in a Mediterranean country.”

The purpose of this study was to examine the association between coffee consumption and the risk of mortality in a middle-aged Mediterranean cohort. The study was conducted within the framework of the Seguimiento Universidad de Navarra (SUN) Project, a long-term prospective cohort study in more than 22 500 Spanish university graduates which started in 1999.

This analysis included 19 896 participants of the SUN Project, whose average age at enrolment was 37.7 years old. On entering the study, participants completed a previously validated semi-quantitative food frequency questionnaire to collect information on coffee consumption, lifestyle and sociodemographic characteristics, anthropometric measurements, and previous health conditions.

Patients were followed-up for an average of ten years. Information on mortality was obtained from study participants and their families, postal authorities, and the National Death Index. Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for incident mortality according to baseline total coffee consumption adjusted for potential confounders.

During the ten year period, 337 participants died. The researchers found that participants who consumed at least four cups of coffee per day had a 64% lower risk of all-cause mortality than those who never or almost never consumed coffee (adjusted HR, 0.36; 95% CI, 0.19-0.70). There was a 22% lower risk of all-cause mortality for each two additional cups of coffee per day (adjusted HR, 0.78; 95% CI, 0.66-0.92).

The researchers examined whether sex, age or adherence to the Mediterranean diet had any influence on the association between baseline coffee consumption and mortality. They observed a significant interaction between coffee consumption and age (p for interaction=0.0016). In those who were at least 45 years old, drinking two additional cups of coffee per day was associated with a 30% lower risk of mortality during follow-up (adjusted HR, 0.70; 95% CI, 0.58-0.85). The association was not significant among younger participants.

Dr Navarro said: “In the SUN project we found an inverse association between drinking coffee and the risk of all-cause mortality, particularly in people aged 45 years and above. This may be due to a stronger protective association among older participants.”

She concluded: “Our findings suggest that drinking four cups of coffee each day can be part of a healthy diet in healthy people.”