scholarly journals A longitudinal study of dehydroepiandrosterone sulphate (DHEAS) change in older men and women: the Rancho Bernardo Study

2004 ◽  
pp. 717-725 ◽  
Author(s):  
C Tannenbaum ◽  
E Barrett-Connor ◽  
GA Laughlin ◽  
RW Platt
Keyword(s):  
Smoking Status ◽  
Community Dwelling ◽  
Statistical Regression ◽  
Dehydroepiandrosterone Sulphate ◽  
Regression To The Mean ◽  
Age Related ◽  
Baseline Weight ◽  
The Mean ◽  
Underlying Mechanisms ◽  
Definition Of

OBJECTIVE: To examine the age-related and sex-specific rates and determinants of change in endogenous dehydroepiandrosterone sulphate (DHEAS) levels in older community-dwelling adults, taking into account regression to the mean. DESIGN: Prospective cohort study from Rancho Bernardo, California, USA. METHODS: Plasma for DHEAS was collected at baseline and 10-14 years later from 242 men and 207 postmenopausal women (age range, 60-77 years), who were not taking hormone therapy or corticosteroids. Age-related and sex-specific changes in DHEAS were calculated according to four different definitions of change: absolute change, annual percentage change, change exceeding 10% of baseline and change exceeding that expected from statistical regression to the mean. Determinants of DHEAS change were assessed using regression analyses. RESULTS: Baseline DHEAS levels were higher for men than women (age-adjusted means, 1.37+/-0.73 mug/ml (3.72+/-1.98 mumol/l) vs 0.73+/-0.48 mug/ml (1.98+/-1.30 mumol/l) respectively, P<0.0001), with more pronounced declines observed in men (-4.0%/year) compared with women (-2.1%/year; P<0.001). Some 28% of women and 5% of men had DHEAS levels that increased or stayed the same according to a 10% definition of change. When regression to the mean artifact was accounted for, only 15% of women and 5% of men showed true increases in DHEAS. In both sexes, baseline DHEAS levels accounted for three-quarters of the variability in absolute DHEAS change over time, with higher baseline levels resulting in greater loss. Sex, baseline weight, age and smoking status were significantly associated with DHEAS change in univariate models; only sex remained independently associated with DHEAS change in multivariate analyses, with men showing greater annual declines than women (estimated coefficient=0.006, P=0.008). CONCLUSION: In this sample, over 30% of the observed changes in DHEAS could be attributed to regression to the mean. Potential underlying mechanisms of change in DHEAS levels, and sex differences, are discussed.

scholarly journals Development of a Comprehensive Chinese Successful Aging Scale: Incorporating the Viewpoints of Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 215-216
Author(s):  
Edwin K H Chung ◽  
Dannii Yeung
Keyword(s):  
Older Adults ◽  
Successful Aging ◽  
Well Being ◽  
Community Dwelling ◽  
Survey Study ◽  
Age Related ◽  
Initial Item ◽  
Civic Awareness ◽  
Definition Of ◽  
Community Dwelling Older Adults

Abstract Inspiring by Martinson and Berridge’s (2015) systematic review, the current definition of successful aging (SA) fails to acknowledge the laypeople’s conceptualization of SA. Adopting a mixed-method approach, two studies were conducted with the aim of soliciting older adults’ perceptions of SA and to develop a multidimensional instrument for assessing SA. Study 1 was a qualitative study and 27 community-dwelling older adults (Mage=68.07 years, SD=7.10, range=60–83; 56.3% females) were interviewed. Interview transcripts were analyzed, and seven themes were emerged. An initial item pool for the Successful Aging Scale (SAS) was then established based on these themes as well as those in the SA literature, such as acceptance and independence. Study 2 was a survey study which was conducted among 414 community-dwelling older adults (Mage=64.50 years, SD=4.01, range=60–82; 55.3% females) to identify optimal items for constitution of the SAS. Exploratory factor analysis revealed a 12-factor solution, accounting for 62% of the variance. The 12 factors are adequate health, perceived constraints, flexible attitudes toward life, acceptance of age-related change, life embracement, active engagement, harmonious family, supportive friendship, civic awareness, social contribution, living independently, and adaptive coping strategies. The 12 factors exhibit similar strength of associations with most of the well-being measures, but certain factors show stronger correlation with depressive symptoms and social relationship, suggesting the uniqueness of each factor. Overall, the SAS demonstrates promising psychometric properties. These findings disclose that the older adults’ perceptions of SA could cover broader dimensions than those in Rowe and Kahn’s model (1997).

scholarly journals Transformations in Embryonic Motility in Chick: Kinematic Correlates of Type I and II Motility at E9 and E12

1999 ◽  
Vol 81 (4) ◽  
pp. 1486-1494 ◽  
Author(s):  
Nina S. Bradley
Keyword(s):  
Type I ◽  
Type Ii ◽  
In Ovo ◽  
Movement Experience ◽  
Age Related ◽  
Behavioral Studies ◽  
Kinematic Analyses ◽  
Underlying Mechanisms ◽  
Definition Of ◽  
Embryonic Motility

Transformations in embryonic motility in chick: kinematic correlates of type I and II motility at E9 and E12. Soon after hatching, chicks exhibit an array of adaptive, coordinated behaviors. Chick embryos also acquire nearly 18 days of movement experience, referred to as embryonic motility, before hatching. The chick expresses three forms of motility, types I, II, and III, and each emerges at a different stage of embryonic development. Although much is known about the mechanisms associated with motility at early embryonic stages and at the onset of hatching, the transformations in behavior and underlying mechanisms are not fully understood. Thus the purpose of this study was to determine how motility is modified during the first expected transformation, from type I to type II. It was hypothesized that kinematic features for motility at embryonic day 12 (E12) would differ significantly from features at E9 because type II motility emerges during E11. Embryos were video taped for extended intervals in ovo at E9 or E12 and entire sequences of motility were computer digitized for kinematic analyses. Results reported here indicate that several of the kinematic features characteristic of motility at E9 are also reliable features at E12. On the basis of these findings, a kinematic definition of type I motility is posed for use in subsequent behavioral studies. Several parameters distinguished motility at E12 from E9. The most notable difference between ages was the less regular timing of repetitive limb movements at E12, a finding consistent with recent reports suggesting early motility is an emergent product of a transient neural network rather than a specialized pattern generator. As predicted from established definitions for type II motility, startle-like movements were common at E12; however, they also were present in many kinematic plots at E9, suggesting the discreet age-dependent boundaries in the established definition for type II motility may require modification. Some age-related differences, such as increased intralimb coordination and excursion velocity, may be prerequisites for adaptive behavior after hatching.

A modern view of placebo and placebo-related effects

2020 ◽  
pp. 193-243
Author(s):  
Fabrizio Benedetti
Keyword(s):  
Placebo Effect ◽  
Placebo Response ◽  
Spontaneous Remission ◽  
Point Of View ◽  
Therapeutic Interventions ◽  
Statistical Regression ◽  
Related Effect ◽  
Regression To The Mean ◽  
Nocebo Effect ◽  
The Mean

This chapter approaches the placebo effect from a modern point of view, namely, as a psychobiological phenomenon worthy of scientific inquiry. By definition, the placebo effect is the effect that follows the administration of an inert treatment (the placebo), whereas in a placebo-related effect no placebo is given but similar mechanisms are at work. Today, the placebo effect, or placebo response, is considered a psychobiological phenomenon that must not be confounded with other phenomena such as spontaneous remission and statistical regression to the mean. The nocebo effect, or nocebo response, is a negative placebo effect which goes in the opposite direction. There is not a single but many placebo effects across different medical conditions and therapeutic interventions, and different biological mechanisms are involved. Expectation of a future outcome plays a central role but learning is important as well.

Association of Lewy Bodies With Age-Related Clinical Characteristics in Black and White Decedents

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012324
Author(s):  
Sukriti Nag ◽  
Lisa L Barnes ◽  
Lei Yu ◽  
Aron S Buchman ◽  
David A Bennett ◽  
...  
Keyword(s):  
Racial Differences ◽  
Clinical Manifestations ◽  
Lewy Bodies ◽  
Brain Regions ◽  
Community Dwelling ◽  
Regression Analyses ◽  
Black And White ◽  
Age Related ◽  
Olfactory Testing ◽  
The Mean

ObjectiveThe associations of Lewy bodies (LBs) with olfactory dysfunction, parkinsonism, and higher odds of dementia were assessed in Black and White community-dwelling elders and racial differences in these associations were tested.MethodsBlack decedents (n=81) were matched two-to-one by age, sex, years of education and follow-up time in the study with White decedents (n=154), from four longitudinal studies of dementia and aging. Participants underwent uniform clinical examination, cognitive, motor and olfactory testing. LBs were detected in 7 brain regions by α-synuclein immunohistochemistry and racial differences in their association with olfaction, parkinsonism and odds of dementia were determined using regression analyses.ResultsThe mean scores of the odor test, global parkinsonism signs, and global cognition were lower in Black than White decedents while the frequency of dementia was similar in both groups. The frequency of LBs was similar in Black and White decedents (∼ 25 %) as was the frequency of LBs in individual brain regions while the mean LB counts/mm2 were similar in all regions except the cingulate cortex which showed higher mean LB counts in Black decedents. In regression analyses, LBs were associated with impaired olfaction (-2.23, 95% CI -3.45 to -1.01) and higher odds of dementia (OR 3.0, 95% CI 1.10 to 8.17) in both racial groups while an association with parkinsonism was stronger in Black than White decedents.ConclusionsThe frequency, distribution, and clinical manifestations of LBs are similar in Black and White elders.

The Impact of Anemia on Mortality, Cognition and Function in a Racially Diverse Community-Dwelling Elderly Population.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1627-1627
Author(s):  
Susan Denny ◽  
Maragatha Kuchibhatla ◽  
Harvey Jay Cohen
Keyword(s):  
Disease Status ◽  
The Elderly ◽  
Epidemiologic Studies ◽  
Cognitive Status ◽  
Community Dwelling ◽  
Mild Anemia ◽  
Age Related ◽  
Definition Of ◽  
And Function ◽  
The Impact

Abstract The WHO definition of anemia, Hgb<12g/dL (W) and <13g/dL (M) is largely based on studies in younger populations. As our population is aging it is important to explore the impact of varying Hgb levels on mortality and function in representative populations of older persons. The Duke Established Populations for Epidemiologic Studies for the Elderly (EPESE) is a random household sample, over sampled for African Americans (AA), initiated in 1986. In 1992 we obtained Hgb levels for 1744 subjects age >71 and evaluated functional and cognitive status at baseline and 4 years later, and mortality for 8 years. Using WHO criteria, the prevalence of anemia was 24%. It was age related; 17% (65–74), 25% (75–79), 32% (>80) p<.0001, but not gender related. There was a strong racial difference, 33.6% AA, 13.8% Caucasians (p=<.0001) with an odds ratio, adjusted for age, education, renal insufficiency and comorbidity of 3.0 (95%CI 2.3 – 3.9) Baseline functional status was worse in anemic subjects (p<.0001) but cognition was not (p=.06). The risk ratio for 8 year mortality was 1.7 (95% CI 1.5, 2.0) for anemic subjects (p=.0001). This did not differ by gender nor, despite the increased prevalence, by race (RR AA: caucasian = 0.85; 95% CI 0.6–1.2). Assessing survival by Hgb level, a nonlinear relationship was seen, with highest % survival between 13–14 g/dL for women (p<.0001) and 14–15g/dL for men (p=.09). Using the WHO standard as reference, controlling for baseline characteristics, women with Hgb 10–11 g/dL had higher mortality (RR 2.1, 95% CI. 1.5 –3.1) but with 11–12 g/dL did not. Similarly men with Hgb 10–11 g/dL had increased mortality (RR2.0, 95% CI 1.1, 3.7). In women there was a progressively greater decline in function at 4 years with each decrement of Hgb level from 16 to 10g/dL, but not in men. Both women and men with mild anemia (11–12 g/dL and 10–11g/dL respectively) had greater decreases in cognition than those at higher levels (p=.01). Thus in an elderly community based population, anemia is significantly more common in AA independent of disease status, and is independently associated with increased mortality over eight years for both races and genders, and with declines in function and cognition most prominently in women. Further investigation of the etiology of these relationships is warranted.

scholarly journals Defining the optimal disease duration of early diffuse systemic sclerosis for clinical trial design

Rheumatology ◽  
2021 ◽  
Author(s):  
Robyn T Domsic ◽  
Shiyao Gao ◽  
Maureen Laffoon ◽  
Steven Wisniewski ◽  
Yuqing Zhang ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Systemic Sclerosis ◽  
Disease Duration ◽  
Disease Onset ◽  
Clinical Trial Design ◽  
Primary Outcome Measure ◽  
Inclusion Criteria ◽  
Regression To The Mean ◽  
The Mean ◽  
Definition Of

Abstract Objectives Clinical trials in early diffuse cutaneous systemic sclerosis (SSc) using the modified Rodnan skin score (mRSS) as the primary outcome measure have most often been negative. We wanted to assess how the definition of disease onset (first SSc manifestation vs first non-Raynaud manifestation), and varying lengths of disease duration at trial entry as an inclusion criteria functioned. Our objective was to optimize trial inclusion criteria Methods We used the prospective, observational University of Pittsburgh Scleroderma Cohort to identify early diffuse SSc patients first evaluated between 1980 and 2015. All had &lt;3 years from first SSc (n = 481) or first non-Raynaud manifestation (n = 514) and 3 or more mRSS scores. We used descriptive, survival and group-based trajectory analyses to compare the different definitions of disease onset and disease duration as inclusion criteria for clinical trials. Results There was no appreciable difference between using first SSc manifestation compared with first non-Raynaud manifestation as the definition of disease onset. Compared with other disease durations, &lt;18 months of disease had &gt;70% of patients fitting into trajectories with worsening cutaneous disease over six months of follow-up. Longer disease durations demonstrated the majority of patients with trajectories showing an improvement in mRSS (regression to the mean) over six months. Conclusions Regardless of whether the first SSc or first non-Raynaud manifestation is used to define disease onset, duration of &lt; 18 months at enrolment is preferable. Longer disease duration criteria more frequently results in regression to the mean of the mRSS score, and likely contributes to negative trial outcomes.

Comparison of Fluorine(18)-fluorodeoxyglucose and Gallium(68)-citrate PET/CT in patients with tuberculosis

2019 ◽  
Vol 58 (05) ◽  
pp. 371-378
Author(s):  
Alfred O. Ankrah ◽  
Ismaheel O. Lawal ◽  
Tebatso M.G. Boshomane ◽  
Hans C. Klein ◽  
Thomas Ebenhan ◽  
...  
Keyword(s):  
Tracer Uptake ◽  
Pet Ct ◽  
The Mean ◽  
18F Fdg ◽  
Definition Of ◽  
Gallium 68 ◽  
Attending Physician ◽  
Pet Scans ◽  
The Brain

Abstract 18F-FDG and 68Ga-citrate PET/CT have both been shown to be useful in the management of tuberculosis (TB). We compared the abnormal PET findings of 18F-FDG- and 68Ga-citrate-PET/CT in patients with TB. Methods Patients with TB on anti-TB therapy were included. Patients had a set of PET scans consisting of both 18F-FDG and 68Ga-citrate. Abnormal lesions were identified, and the two sets of scans were compared. The scan findings were correlated to the clinical data as provided by the attending physician. Results 46 PET/CT scans were performed in 18 patients, 11 (61 %) were female, and the mean age was 35.7 ± 13.5 years. Five patients also had both studies for follow-up reasons during the use of anti-TB therapy. Thirteen patients were co-infected with HIV. 18F-FDG detected more lesions than 68Ga-citrate (261 vs. 166, p < 0.0001). 68Ga-citrate showed a better definition of intracerebral lesions due to the absence of tracer uptake in the brain. The mean SUVmax was higher for 18F-FDG compared to 68Ga-citrate (5.73 vs. 3.01, p < 0.0001). We found a significant correlation between the SUVmax of lesions that were determined by both tracers (r = 0.4968, p < 0.0001). Conclusion Preliminary data shows 18F-FDG-PET detects more abnormal lesions in TB compared to 68Ga-citrate. However, 68Ga-citrate has better lesion definition in the brain and is therefore especially useful when intracranial TB is suspected.

Age related volume of cadaver-prostates in Bangladesh

1970 ◽  
Vol 4 (2) ◽  
pp. 74-77
Author(s):  
Rukshana Ahmed ◽  
Shamim Ara
Keyword(s):  
Prostate Gland ◽  
Age Groups ◽  
Clinical Settings ◽  
Cross Sectional ◽  
Medical College ◽  
Age Related ◽  
Group A ◽  
Key Words Prostate ◽  
The Mean ◽  
Group B

Pathological changes in the prostate gland occur commonly with advancing age including inflammation, atrophy, hyperplasia and carcinoma and a change in volume is also evident. Estimation of volume of prostate may be useful in a variety of clinical settings. A cross-sectional descriptive study was designed to see the changes in volume of the prostate with advancing age and done in the Department of Anatomy, Dhaka Medical College, Dhaka from August 2006 to June 2007. The study was performed on 70 post-mortem human prostates collected from the unclaimed dead bodies that were under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age groups; group A (10-20 years), group B (21-40 years) and group C (41-70 years). Volume of the sample was measured by using the ellipsoid formula. The mean ± SD volume of prostate was 7.68 ± 3.64 cm3 in group A, 10.61 ± 3.99 cm3 in group B and 15.40 ± 6.31 cm3 in group C. Mean difference in volume between group A and group C, group B and group C were statistically significant (p<0.001). Statistically significant positive correlation was found between age and volume of prostate (r = + 0.579, p < 0.001). Key Words: Prostate; volume; Bangladeshi. DOI: 10.3329/imcj.v4i2.6501Ibrahim Med. Coll. J. 2010; 4(2): 74-77

Effect of the Interaction Between Hypertension and Cerebral White Matter Changes on the Progression of Alzheimer Disease

2018 ◽  
Vol 15 (14) ◽  
pp. 1354-1360 ◽  
Author(s):  
Ping-Song Chou ◽  
Yi-Hui Kao ◽  
Meng-Ni Wu ◽  
Mei-Chuan Chou ◽  
Chun-Hung Chen ◽  
...  
Keyword(s):  
White Matter ◽  
Alzheimer Disease ◽  
Rating Scale ◽  
Vital Role ◽  
Independent Effect ◽  
Cerebral White Matter ◽  
Clinical Dementia Rating ◽  
White Matter Changes ◽  
Age Related ◽  
The Mean

Background: Cerebrovascular pathologies and hypertension could play a vital role in Alzheimer disease (AD) progression. However, whether cerebrovascular pathologies and hypertension accelerate the AD progression through an independent or interaction effect is unknown. Objective: To investigate the effect of the interactions of cerebrovascular pathologies and hypertension on AD progression. Method: A retrospective longitudinal study was conducted to compare AD courses in patients with different severities of cerebral White Matter Changes (WMCs) in relation to hypertension. Annual comprehensive psychometrics were performed. WMCs were rated using a rating scale for Age-related WMCs (ARWMC). Results: In total, 278 patients with sporadic AD were enrolled in this study. The mean age of the patients was 76.6 ± 7.4 years, and 166 patients had hypertension. Among AD patients with hypertension, those with deterioration in clinical dementia rating-sum of box (CDR-SB) and CDR had significantly severe baseline ARWMC scales in total (CDR-SB: 5.8 vs. 3.6, adjusted P = 0.04; CDR: 6.4 vs. 4.4, adjusted P = 0.04) and frontal area (CDR-SB: 2.4 vs. 1.2, adjusted P = 0.01; CDR: 2.4 vs. 1.7, adjusted P < 0.01) compared with those with no deterioration in psychometrics after adjustment for confounders. By contrast, among AD patients without hypertension, no significant differences in ARWMC scales were observed between patients with and without deterioration. Conclusion: The effect of cerebrovascular pathologies on AD progression between those with and without hypertension might differ. An interaction but not independent effect of hypertension and WMCs on the progression of AD is possible.

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