Casecontrol Studies

Case-control studies are an efficient way to examine possible causal mechanisms, and the background, conduct, and interpretation of these study designs is well summarized (Schesselmann, 1982). In nutritional gerontology, it would be usual first to specify criteria for the presence/ absence of a condition and then to identify a group with a condition (cases) and a group without that condition (control subjects). The prior exposures of the cases and controls to a putative causal agent or process could then be compared. There is wide discussion on the need to match cases and controls, and when this is done, how exactly matching should take place. It will seem obvious that the best solution is to match cases and controls as closely as possible. However, this sometimes can remove important differences between groups in particular where exposure and matching variables are linked (positively or negatively), as is the case within a wide range of socio-demographic variables. Concerns about measurement errors ensure that case-control studies are not the design of choice in nutritional gerontology. This is largely because it is necessary in nutritional research to obtain estimates of measurement error while evaluating the diet-disease relationship. This is difficult to achieve in case-control studies that rely on historical data. Instead, it is better to undertake a prospective longitudinal study with repeated measurements of diet and even better to employ several methods to measure diet. The cohort study design can meet these requirements.

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