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Biomedical subjects

D R Wekstein

Publications and source records attributed to D R Wekstein.

17 recordsLinked to original sources

Self-perceived information needs and concerns of elderly persons.

The research was intended to identify the dimensions underlying self-perceived information needs and concerns of an elderly population. The spontaneously mentioned needs and concerns expressed in 271 letters from a sample of the population were extracted and a multidimensional scaling procedure was used to represent the 58 most frequently mentioned items in configurations of varying dimensionality. To interpret the multidimensional spaces, another sample of 176 elderly subjects was asked to rate the 58 concerns on eight properties. These ratings were then regressed onto the multidimensional configurations. The results indicate that the most frequently mentioned information needs and concerns of elderly persons can be parsimoniously understood in terms of three underlying dimensions: (1) Improving the Quality of Life vs Securing the Necessities of Life, (2) Health-related vs Not Health-related, and (3) Individual vs Societal Responsibility.

Activities of Daily Living

Laboratory values in fit aging individuals--sexagenarians through centenarians.

We determined approximately 15,000 laboratory values in 236 individuals between the ages of 60 and 90 y, 22 individuals between 90 and 99 y, and 69 individuals greater than or equal to 100 y, and compared these with values in young adults. We tested 47 different analytes in the 60-90-y group and 93 analytes in the greater than or equal to 90-y group. Na, K, Cl, and CO2 values were either identical or showed minimal change with age; pH decreased slightly. Differences in Ca values were only minor, but ionized Ca increased slightly. Phosphate decreased in men, but changed only minimally in women; parathyroid hormone increased with age. Increases with age were also observed for glucose, insulin, and C-peptide. Among the enzymes, alkaline phosphatase increased in women, but in men only greater than 90 y; gamma-glutamyltransferase increased in both sexes. Creatine kinase (CK) decreased slightly in individuals greater than 70 y and markedly in those greater than 90 y of age, whereas CK-MB decreased markedly greater than 70 y, reaching the detection limit in individuals greater than 90 y. Lactate dehydrogenase isoenzyme 5 decreased slightly with age. Urea nitrogen increased gradually with age, but creatinine increased only in individuals greater than or equal to 90 y. The increase in urea is not paralleled by a loss of protein in urine, suggesting that the possible cause of azotemia may not always be renal pathology. Urate increased in women but not in men. Liver function, as measured by total bilirubin and liver enzymes, was exceedingly well maintained. Concentrations of most proteins show little change, except for slight decreases in prealbumin, albumin, and transferrin, proteins used as an index of nutritional status. IgA values increased, IgG ranges were wider, IgM and IgD decreased, and the range for IgE was narrower than in young adults. Cholesterol, high-density lipoprotein cholesterol, and triglyceride values increased with age, but decreased in individuals greater than or equal to 90 y. Among the trace elements, magnesium changed little, zinc and lead decreased, and copper values increased with age. Total triiodothyronine and thyroxine decreased, with concomitant increases in thyroid-stimulating hormone. More individuals had increased microsomal antibodies and thyroglobulin titers in the aging population than in the young. In men, the free, percent free, bioactive, and total testosterone values decreased, but luteinizing hormone (LH) and follicle-stimulating hormone (FSH) values increased. In women, estrone and estradiol values decreased, with concomitant increases in LH and FSH. Androstenedione and progesterone decreased in both sexes.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult

Imaging the centenarian brain. A computed tomographic study.

Ten healthy and mentally alert centenarians underwent cranial computed tomography (CT) using a fourth-generation CT scanner. The subjects ranged in age from 100 to 102 years, and included six women and four men. Two of them used alcohol on a daily basis and five had systolic blood pressures of at least 160 mmHg. The CT scans demonstrated considerable variation in the degree of cerebral atrophy, which had no relation to either sex, alcohol use, or hypertension. Three of the centenarians had evidence of mild periventricular white matter lucency. Although progressive cerebral atrophy is an integral aspect of the normal aging process in the very elderly, its exact relationship to cognitive function remains unclear.

Aged

A two-year longitudinal reference range study for selected serum enzymes in a population more than 60 years of age.

The reference ranges for alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and creatine kinase (CK) in a population greater than 60 years were studied using commercially available reagents. All ranges except those for AST and ALT in women were higher than the ranges found in 20-50-year-old adults. A two-year longitudinal study indicated that individuals who had values above those found in younger adults did not show a greater incidence of disease than did individuals who had values in the lower portion of the distribution curve. Comparison of enzyme values at the beginning and at the end of the two-year study showed that mean ALP, AST, ALT, and LDH values (except for ALT values in men) increased gradually. It was concluded from these two findings that the higher values observed for the aging population were a result of the normal aging process, and thus these values were included in the reference range for this population. The range for CK in individuals greater than 60 years was also higher than that found for younger adults, but the mean value of the group was lower, except in women aged 60-69 years, in whom the mean value showed a slight increase over that found for normal adult women. This was believed to be the result of two independent processes; an increase in enzyme activity due to aging and a decrease in enzyme activity due to reduction in muscle mass as a result of the decreased muscular activity of some volunteers during retirement.

Adult