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D L Wingard

Publications and source records attributed to D L Wingard.

At least 37 records · Page 2Linked to original sources
PubMed1995

Psychosocial and behavioral predictors of longevity. The aging and death of the "termites".

Impulsive, undercontrolled personalities and major family stresses are known predictors of impaired adjustment, but long-term health effects are unclear. In an archival prospective cohort design, we followed up on L. M. Terman's (Terman & Oden, 1947) sample of gifted children by collecting and coding death certificates for the half of the sample that is now dead. Statistical survival analyses were used to predict longevity and cause of death as a function of parental divorce during childhood, unstable marriage patterns in adulthood, childhood personality, adult adjustment, and possible mediating health behaviors. Psychosocial factors emerged as important risks for premature mortality.

Adolescent↗
PubMed1995

Childhood conscientiousness and longevity: health behaviors and cause of death.

Previous research showed that conscientiousness (social dependability) in childhood predicted longevity in an archival prospective cohort study of bright children first studied by Terman in the 1920s (H. S. Friedman et al., 1993). Possible behavioral mechanisms for this robust association are now examined by gathering cause of death information and by considering the possible mediating influences of drinking alcohol, smoking, and overeating. Survival analyses (N = 1,215) suggest that the protective effect of conscientiousness is not primarily due to accident avoidance and cannot be mostly explained by abstinence from unhealthy substance intake. Conscientiousness may have more wide-ranging effects on health-relevant activities.

Adolescent↗
PubMed1995

An archival prospective study of mental health and longevity.

The relationship between mental health status and longevity was examined in an archival prospective cohort study (N = 1,103) derived from work begun by Lewis Terman in the 1920s. Degree of psychological maladjustment, cumulatively rated by Terman and his colleagues as of 1950, was found to be related to higher risk of all-cause mortality over a 4-decade follow-up period. The differences among causes of death were nonsignificant, but there was some indication that mental health problems were more strongly related to deaths from injury and cardiovascular disease. The overall relationship was significant for men but weaker for women. The effect was not substantially mediated by alcohol consumption, obesity, or cigarette smoking.

Adolescent↗
PubMed1995

Sociodemographic and psychosocial factors in childhood as predictors of adult mortality.

OBJECTIVES: Childhood sociodemographic, psychosocial, and environmental factors are often assumed to affect adult health and longevity. These relationships were prospectively tested by using the 7-decade Terman Life Cycle Study of Children With High Ability (n = 1285). METHODS: Parental socioeconomic status, childhood health, objective childhood stressors (e.g., death or divorce of parents), and childhood personality were considered as potential predictors in hazard regression analyses of longevity through 1991. RESULTS: Parental divorce during childhood predicted decreased longevity, with sex controlled. Other potential social predictors failed to show significant associations with longevity. Three dimensions of childhood personality--conscientiousness, lack of cheerfulness, and permanency of mood (males only)--predicted increased longevity. The effects of parental divorce and childhood personality were largely independent and did not account for any of the gender difference in mortality. CONCLUSIONS: A small number of childhood factors significantly predicted mortality across the life span in this sample. Further research should focus on how these psychosocial factors influence longevity.

Aged↗
PubMed1995

Sex differences in insulin levels in older adults and the effect of body size, estrogen replacement therapy, and glucose tolerance status. The Rancho Bernardo Study, 1984-1987.

OBJECTIVE--To determine if insulin levels vary with sex, independent of estrogen replacement therapy (ERT), differences in body mass index (BMI), waist-to-hip ratio (WHR), and glycemia. RESEARCH DESIGN AND METHODS--In a population-based study of older adults, insulin levels were measured before and after a standardized oral glucose tolerance test in 673 men and 849 women, all free of known diabetes. RESULTS--Age-adjusted fasting insulin levels were highest in men, intermediate in women not taking estrogen, and lowest in estrogen-treated women (P < 0.01). Differences between men and women not taking estrogen disappeared after adjusting for age and BMI, but not glycemia; estrogen-treated women had significantly lower fasting insulin levels than did men (P < 0.01) and women not taking estrogen (P < 0.01). The association of estrogen use with lower fasting insulin levels persisted after adjusting for age and WHR (P < 0.001) and was stronger among women with abnormal glucose tolerance. Age-adjusted postchallenge insulin levels were higher in women than in men (P < 0.01). The sex difference persisted after adjusting for age and BMI or glycemia. Postchallenge insulin levels did not vary by ERT. CONCLUSIONS--Men have higher fasting insulin levels than do women, whether or not the women are using ERT. Differences between men and untreated women are explained by differences in BMI, but estrogen users have lower fasting insulin levels independent of BMI. Postchallenge insulin levels are higher in women than men and are independent of ERT, BMI, and glycemia. Clinical trials in women are needed to determine whether ERT can improve insulin and glucose metabolism.

Aged↗
PubMed1994

Relation of pregnancy history to insulin levels in older, nondiabetic women.

Pregnancy has been associated with increased risk for diabetes, but an association independent of obesity has been questioned. The hypothesis that the repeated demands of pregnancy lead to reduced sensitivity to insulin and hyperinsulinemia was tested by examining the relation of pregnancy history to fasting and postchallenge insulin levels and insulin sensitivity in 764 Caucasian, nondiabetic women aged 50-89 years from the Rancho Bernardo cohort. Between 1984 and 1987, an oral glucose tolerance test was administered, fasting and postchallenge levels of glucose and insulin were measured, and an index of insulin sensitivity was calculated. After adjustment for covariates, an increased number of pregnancies was associated with increased fasting insulin (p < 0.05) and decreased insulin sensitivity (p < 0.05). Postchallenge insulin was unrelated to pregnancy history. Obesity and fat distribution were associated with higher fasting and postchallenge insulin levels and lower insulin sensitivity (ps < 0.001), but did not explain the associations between pregnancy history and insulin or insulin sensitivity. Analyses restricted to women with normal glucose tolerance yielded similar results. Thus, there is a small, but significant increase in fasting insulin and a decrease in insulin sensitivity with increasing pregnancies many years after childbearing that is independent of obesity and present even in normoglycemic women. Confirmatory studies using insulin clamp techniques would be of interest.

Aged↗
PubMed1994

Finnmark Heart Study: employment status and parenthood as predictors of psychological health in women, 20-49 years.

This study examined the influence of employment status and presence of young children in the household on psychological health in a population-based sample of 3103 women aged 20-49 years. Women were classified by employment status and parental status, thus creating four groups for comparison. After excluding women reporting chronic diseases and women receiving sickness, rehabilitation, unemployment or disability benefits, analyses indicated that problems of coping, dissatisfaction with life, depression and loneliness were greatest among homemakers, particularly among those with young children. Analyses adjusted for age, education, marital status and place of residence yielded similar results. Stratification by marital status and place of residence revealed two exceptions to this general pattern: unmarried employed women with young children had the highest rate of coping problems--and parenthood, not employment status, was the most important factor for psychological health problems in rural areas. Discrepancies between an individual's behaviour and the norm in society regarding women's employment, may partly explain the findings.

Adaptation, Psychological↗
PubMed1994

Dyslipidemia and ischemic heart disease mortality among men and women with diabetes.

BACKGROUND: We investigated whether the greater increased risk of ischemic heart disease mortality associated with diabetes among women compared with men could be explained by their more pronounced lipoprotein abnormalities. METHODS AND RESULTS: Seventy-six men and 45 women with diabetes and 327 men and 496 women without diabetes were followed for an average of 16 years in a population-based study. Cox proportional hazards models were used to determine the relative hazard of ischemic heart disease mortality for changes in lipoprotein subfractions after adjustment for age, hypertension, obesity, smoking, exercise, alcohol consumption, and estrogen use (among women). The relative hazard of ischemic heart disease mortality among diabetic women was 1.76 (P = .10) for a 10-mg/dL decrement in high-density lipoprotein cholesterol (HDL-C) and 3.13 (P = .01) for a 1-U increment in log very-low-density lipoprotein cholesterol (VLDL-C). The risk of ischemic heart disease mortality among diabetic women relative to nondiabetic women for an HDL-C level of 50 mg/dL and a log(e) VLDL-C of 3 (about 20 mg/dL) were 4.1 and 3.4, respectively (P < .05). These lipoprotein changes were not associated with ischemic heart disease mortality among men or among nondiabetic women. CONCLUSIONS: Excess ischemic heart disease mortality among diabetic women is partially explained by deleterious levels of HDL-C and VLDL-C. HDL-C levels of < or = 50 mg/dL and VLDL-C levels of > or = 20 mg/dL appear to predict ischemic heart disease mortality among these women and may help identify women who would benefit most from intervention.

California↗
PubMed1994

Is breast-feeding in infancy associated with adult longevity?

OBJECTIVES: The purpose of the study was to determine whether breast-feeding is associated with increased longevity or cause-specific survival. METHODS: Teachers throughout California identified intellectually gifted children as part of a prospective study begun in the 1920s by Lewis Terman. Information on breast-feeding was available on 1170 subjects, who have been followed for more than 65 years. RESULTS: Survival analysis (Cox proportional hazards model) indicated that breast-feeding was associated with increased longevity, even after adjustment for age at baseline, birthweight, infant health, and childhood socioeconomic status, but only among men, and the association was not significant (P = .15). Neither cardiovascular disease nor cancer survival was significantly associated with duration of breast-feeding for either sex. Survival from deaths due to injuries was positively associated with breast-feeding after adjustment (P = .03) and demonstrated a clear gradient with duration, but only among men. CONCLUSIONS: Overall, the present study does not provide strong evidence that breast-feeding is associated with adult longevity. The reduced risk of death from injury may reflect chance, in that the association was significant only for men, or it may reflect psychosocial correlates of breast-feeding practices.

Aged↗
PubMed1993

Incidence of insulin-dependent diabetes mellitus in young adults: experience of 1,587,630 US Navy enlisted personnel.

First hospitalizations (n = 1,293) for diabetes mellitus between 1974 and 1988 were used as a surrogate for insulin-dependent diabetes mellitus incidence among 17-34-year-old US Navy enlisted personnel followed for 6,077,856 person-years. In the 15-year period, the overall incidence of insulin-dependent diabetes mellitus was 21.3 per 100,000 person-years. Incidence did not differ significantly by sex, but was higher for blacks than whites (28.4 vs. 20.2 per 100,000 person-years, respectively; p < 0.05). Incidence increased with age threefold for white men and fivefold for black men (p < 0.05) between the ages of 17-19 and 30-34 years.

Adolescent↗
PubMed1993

Plasma cholesterol and depressive symptoms in older men.

In several clinical trials of interventions designed to lower plasma cholesterol, reductions in coronary heart disease mortality have been offset by an unexplained rise in suicides and other violent deaths. We have tried to find out whether depressive illness is related to low plasma cholesterol concentrations in men of 50 years and older. In 1985-87, Beck depression inventories were obtained from 1020 white men, aged 50-89 years, in the Rancho Bernardo, California, cohort. Disease history and behaviours were assessed by standard questionnaires. Plasma cholesterol and weight were measured at this time, as they had been in 1972-74. Among men aged 70 years and older, categorically defined depression was three times more common in the group with low plasma cholesterol (< 4.14 mmol/L) than in those with higher concentrations (5/31 [16%] vs 22/363 [6%]; p = 0.033). Depressive symptom scores correlated significantly and inversely with plasma cholesterol concentrations, even after adjustment for age, health status, number of chronic illnesses, number of medications, and exercise, as well as measured weight loss and change in plasma cholesterol in the previous 13 years. Our finding that low plasma cholesterol is associated with depressive symptoms in elderly men is compatible with observations that a very low total cholesterol may be related to suicide and violent death. Since cholesterol lowering in the general population is widely recommended, this observation warrants further investigation.

Aged↗
PubMed1993

A comparative study of adolescent and adult mothers who intend to breastfeed.

The purpose of this study was to compare reasons for choosing to breastfeed, timing of the infant feeding decision, and intended duration of breastfeeding between adolescent and adult mothers. The study population consisted of primiparous teens and adults who were matched by ethnicity, and interviewed within 48 hours postpartum at the University of California, San Diego Medical Center from August to December, 1989. Of the 48 women in each age group, there were 40 Hispanics, 5 non-Hispanic whites, 2 blacks, and 1 Southeast Asian. Results showed that the teens differed from their adult counterparts in that they cited naturalness or convenience less often as a reason for breastfeeding. The adolescent mothers were also less likely than the adults to make the decision to breastfeed before the pregnancy, than during pregnancy or after birth. There was no difference in intended duration of breastfeeding between these two groups: the majority of women planned to breastfeed for less than 26 weeks. Early introduction of infant feeding education may serve to increase the adolescent's knowledge base from which to make the decision to breastfeed. Even though the adolescents intended to breastfeed for as long as the adults, they may benefit from increased exposure to prenatal care and childbirth classes as well as from a supportive school or work environment in order to achieve success in breastfeeding.

Adolescent↗
PubMed1993

Does childhood personality predict longevity?

Key models relating personality and health predict that personality in childhood is indicative of later health and longevity. Longevity predictions are tested using data derived from the 7-decade longitudinal study initiated by L. M. Terman 1921 (L. M. Terman & M. H. Oden, 1947). Variables representing major dimensions of personality are used in statistical survival analyses of longevity in 1,178 males and females. Conscientiousness in childhood was clearly related to survival in middle to old age. This finding (a) establishes that childhood personality is related to survival decades into the future, (b) confirms the validity of the conscientiousness dimension in conceptualizing personality, and (c) points to likely and unlikely pathways linking personality to health. Contrary to expectation, cheerfulness (optimism and sense of humor) was inversely related to longevity, suggesting a possible need for reconceptualization of its health relevance.

Adaptation, Psychological↗
PubMed1993

Prevalence of cardiovascular and renal complications in older adults with normal or impaired glucose tolerance or NIDDM. A population-based study.

OBJECTIVE: To determine the prevalence of CVD and renal disease by glucose tolerance status in a population-based study. RESEARCH DESIGN AND METHODS: The study consisted of 991 men and 1243 women, aged 50-89 yr, living in the upper-middle class community of Rancho Bernardo, CA. All participants received a standard OGTT between 1984 and 1987. RESULTS: A total of 159 men and 158 women had NIDDM, whereas 237 men and 348 women had IGT. Age-adjusted prevalence of complications generally was highest in those who were previously diagnosed with NIDDM. A significant correlation was observed between increases in the prevalence of complications and increases in glucose intolerance for microproteinuria, macroproteinuria, and myocardial infarction (borderline), as well as for stroke and claudication in men and myocardial infarction and stroke in women. In men with IGT or NIDDM, the age-adjusted prevalence of proteinuria and CVD was highest when other complications were present whereas in women such a prevalence was highest when other complications were absent. In men with diabetes, microproteinuria was associated with duration of disease. CONCLUSIONS: Prevalent CVD and renal disease were increased in adults with NIDDM and elevated in adults with IGT compared to those with normal glucose tolerance. The prevalence of complications in NIDDM subjects in this population-based study was substantially lower than that reported for clinic-based diabetic populations.

Adult↗
PubMed1992

Cigarette smoking, mortality, institutional and community-based care utilization in an adult community.

We evaluated mortality and health services utilization in a prospective study of 630 older residents of a Southern California community. All participants were 65 years or older when initially evaluated in 1973-1975. In addition to being followed for vital status each year, participants were reinterviewed in 1984-1986 and asked about nursing home, hospital, and community-based care for the interim period. Current cigarette use in 1973-1975 was a significant predictor of mortality for both men and women. In addition, former smoking status (before 1973-1975) significantly predicted both mortality and hospital inpatient utilization in men and women combined. However, smoking was not significantly associated with nursing home utilization or use of three categories of community-based care services. More research is necessary to identify the relationship between cigarette smoking and outpatient service use. The findings for mortality and inpatient hospital service utilization reaffirm the hazards of cigarette smoking.

Adult↗