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I J Deary

Publications and source records attributed to I J Deary.

At least 37 records · Page 2Linked to original sources

The reliability and sensitivity to change of acoustic measures of voice quality.

This study aimed to evaluate the reliability and sensitivity to change of three commonly used acoustic parameters as measured by the Multi-Dimensional Voice Programme (MDVP); jitter, shimmer and noise-to-harmonic ratio. A total of 231 subjects' voices were recorded and analysed. The sample comprised 145 dysphonic patients who received intervention (surgery or voice therapy), 36 dysphonic patients who received no intervention, and 50 non-dysphonic (normal) subjects. All voices were recorded and analysed on two occasions (before and after treatment, or test-retest assessment) using a standard procedure. These data were analysed using standard psychometric procedures for assessing reliability and responsiveness. The acoustic analysis measures demonstrated poor to moderate reliability and effect size with respect to their sensitivity to change. Caution should be exercised in the injudicious use of computer-based acoustic analysis systems as an isolated measure of voice outcome in any clinical trial of interventions aimed at improving voice quality.

Adolescent↗

Enlarged perivascular spaces are associated with cognitive function in healthy elderly men.

OBJECTIVES: Increased white matter (WM) lesions on magnetic resonance imaging (MRI) are associated with worse cognitive function in older people. Enlarged perivascular spaces (EPVS) commonly coexist with and share some risk factors for WM lesions but are not quantified in published scales. It is not known whether the extent of EPVS is also associated with cognitive function. We tested the hypothesis that more EPVS would be associated with worse cognitive function. METHODS: Ninety seven healthy men (65-70 years), not on medications, underwent MRI scanning and comprehensive cognitive testing. EPVS were quantified in both the basal ganglia/centrum semiovale and the hippocampus, and WM lesions were measured. RESULTS: Scores on published WM lesion rating scales intercorrelated highly significantly and positively (rho = 0.61 to 0.91, p<0.0001). A summary (WML) factor derived from principal components analysis of the WM scales correlated with EPVS in the basal ganglia/centrum semiovale (rho = 0.48, p<0.0001) but not in the hippocampus. EPVS scores in the basal ganglia/centrum semiovale correlated significantly and negatively with non-verbal reasoning (rho = -0.21, p = 0.038) and general visuospatial ability (rho = -0.22, p = 0.032), adjusted for prior intelligence. The WML factor correlated significantly and negatively with visuospatial ability, as previously reported, and showed an unexpected positive correlation with one test of verbal memory (list-learning). CONCLUSIONS: These findings suggest that increased EPVS are correlated with worse cognitive function. Future studies examining changes in WM with ageing should consider incorporating measures of EPVS and examine the sequence of EPVS and WM lesion development over time. More work is needed to develop valid and reliable measures of EPVS.

Aged↗

The reliability of three perceptual evaluation scales for dysphonia.

Perceptual rating scales are widely used in voice quality assessment, yet apart from the GRBAS scale, their reliability has been poorly demonstrated. There are no studies that have compared the optimal reliability of experienced judges using different auditory rating scales in a controlled experimental environment. This study aimed to assess the reliability of three common scales (The Buffalo Voice Profile, The Vocal Profile Analysis Scheme (VPA) and GRBAS. Sixty-five varyingly dysphonic and five normal voices were recorded onto CD in random order. Thirty voices were recorded twice. Seven experienced and trained speech and language therapists rated all voices on the three scales. Only the overall grade was found to be reliable for the Buffalo Voice Profile. The reliability of the VPA scheme was found to be poor to moderate. The VPA may have a use as a multi-dimensional and in-depth evaluation of voice types, but its greater scope is at the expense of reliability. The GRBAS was reliable across all parameters except Strain. Our detailed reliability analysis comparing performance of three commonly used rating scales provides further evidence to support the GRBAS as a simple reliable measure for clinical use.

Adolescent↗

Plasma vitamin C, cholesterol and homocysteine are associated with grey matter volume determined by MRI in non-demented old people.

We studied 82 non-demented old people and, using MRI, derived measures of grey and white matter and intracranial volumes. Controlling for sex and intracranial volume, we related grey and white matter volumes to plasma concentrations of vitamins C, B(12), folate, homocysteine, cholesterol, triglycerides, high density and low density (LDL) lipoproteins, and to red blood cell folate and glycated haemoglobin concentrations (HbA1(c)). We found that lower grey matter volume was associated with lower plasma vitamin C and higher homocysteine, cholesterol and LDL. Lower blood cell folate was also associated with lower grey matter volume but HbA1(c) was not. These data are consistent with the putative benefits of dietary vitamin C and folate intake and the role of cholesterol in age related neurodegeneration.

Aged↗

Dietary supplement use in old age: associations with childhood IQ, current cognition and health.

AIMS: Dietary supplement (DS) use is actively promoted among old people but there is little evidence in favour of DS use or information about the demographic, health and cognitive characteristics of DS users. METHOD: We examined 176 healthy, old people without dementia all born in 1921 and living independently in the community. IQ scores aged about 11 years were available for all subjects. DS users were more often female, had a lower BMI and were taking fewer prescribed medications than non-users. RESULTS: Usual dietary intake, as measured by food frequency questionnaire, did not differ between DS users and DS non-users. DS users were seen to have higher Vitamin C (p<0.05), alpha-carotene (p<0.05) and lower gamma-tocopherol (p<0.001) and homocysteine (p<0.01). DS users did not differ from DS non-users in years of education, indices of occupational code, current socio-economic category or parameters of cardiovascular or respiratory functions. DS users had higher (p<0.05) childhood IQ scores but did not differ in current Mini-Mental State Examination (MMSE) score or performance on Raven's Progressive Matrices (RPM) either before or after adjustment for childhood IQ. CONCLUSIONS: DS users may enjoy somewhat better general health than non-users but the source of this difference is unknown. Possible health benefits of DS use merit further study.

Aged↗

The Scottish mental survey 1932 linked to the Midspan studies: a prospective investigation of childhood intelligence and future health.

The Scottish mental survey of 1932 (SMS1932) recorded mental ability test scores for nearly all children born in 1921 and at school in Scotland on 1 June 1932. The Collaborative and Renfrew/Paisley studies, two of the Midspan studies, obtained health and social data by questionnaire and a physical examination in the 1970s. Some Midspan participants were born in 1921 and may also have taken part in the SMS1932, so there was a possibility that their mental ability data from childhood would be available. The 1921 born Midspan participants were matched with the computerized SMS1932 database, and in total, 1032 of 1251 people (82.5%) were matched successfully. Of those matched, 938 (90.9%) had a mental ability test score recorded. The mean score of the matched sample was 37.2 (standard deviation (SD) 13.9) out of a possible score of 76. The mean (SD) for the boys and girls was 38.3 (14.2) and 35.7 (13.9), respectively. This compared with 38.6 (15.7) and 37.2 (14.3) for boys and girls in all of Scotland. Graded relationships were found between mental ability in childhood, and social class and deprivation category of residence in adulthood. Being in a higher social class or in a more affluent deprivation category was associated with higher childhood mental ability scores, and the scores reduced with increasing deprivation. Future plans for the matched data include examining associations between childhood mental ability and other childhood and adult risk factors for disease in adulthood, and modelling childhood mental ability, alongside other factors available in the Midspan database, as a risk factor for specific illnesses, admission to hospital and mortality.

Adult↗

The dysphonic voice heard by me, you and it: differential associations with personality and psychological distress.

Voice production is subject to and indicative of psychological status. The precise relationships of voice disorders and psychological variables remain unclear. We compared the correlations of self-reported and more objective measures of voice quality in dysphonic patients with personality, coping, affect and somatization. Two hundred and four subjects participating in a randomized, controlled trial of speech therapy underwent self-report, observer rating and computer acoustic analysis of voice quality. These three indices of voice quality were compared with regard to their correlations with individual differences in neuroticism, alexithymia, negative emotion coping, anxiety, depression, neurotic symptoms, medically unexplained symptoms and quality of life. Significant correlations were observed between self-reported voice problems and all of the personality/coping and clinical psychological distress measures. People who reported more voice problems had: higher neuroticism and alexithymia; a tendency to use emotion-oriented coping; more psychological distress; poorer quality of life; and more past medically unexplained symptoms. Expert voice rating correlated weakly with neurotic disturbance, quality of life and previous medically unexplained symptoms. Objective voice assessment (amplitude perturbation) showed no significant associations with any psychological measure. The strongest associations of psychological variables and voice measures are with self-report measures. This suggests that it is in part the patients' perception of their own voice quality which accounts for the association of voice production and psychological factors in subjects presenting to voice clinics.

Adolescent↗

Psychosocial factors and diabetes-related outcomes following diagnosis of Type 1 diabetes in adults: the Edinburgh Prospective Diabetes Study.

AIMS: To examine prospectively the relationships between psychosocial variables and diabetes-related outcomes in adults with newly diagnosed Type 1 diabetes. METHODS: A total of 84 adults (48 male) with a median (range) age of 30.8 (17-51) years with newly diagnosed Type 1 diabetes were recruited for the study. Shortly after initial diagnosis each participant's personality, cognitive ability, and recent psychiatric distress were assessed. At 4 months (n = 69) and at 12 months (n = 66) after diagnosis diabetes-related outcomes were measured, including each respondent's knowledge of diabetes, satisfaction with diabetes treatment and diabetes-related quality of life. Glycated haemoglobin (HbA1c) was recorded at each clinic attendance. RESULTS: Social class (Spearman's correlation r = -0.30 and -0.28, respectively, P < 0.05) and scores on the National Adult Reading Test (r = 0.38 and 0.36, respectively, P < 0.01) were consistently associated with knowledge of diabetes at 4 months and at 12 months after diagnosis. Hierarchical regression revealed that alcohol consumption recorded at diagnosis and knowledge of diabetes at 4 months were independent predictors of glycaemic control at 12 months (adjusted r2 = 0.16). Total scores on the Diabetes Treatment Satisfaction Questionnaire (DTSQ) at 12 months were significantly predicted by age at diagnosis (adjusted r2 = 0.08). High neuroticism at diagnosis was consistently associated with poorer self-reported diabetes quality of life at 4 months and at 12 months after diagnosis (rs between -0.30 and -0.39, P < 0.05). CONCLUSIONS: Long-standing psychosocial factors have a significant influence on self-reported outcomes during the 12 months following diagnosis of Type 1 diabetes but may not be reliable predictors of glycaemic control. Further follow-up is necessary to determine the longer-term predictors of objective (e.g. glycaemic control) and subjective (e.g. quality of life) indicators of coping in people with diabetes.

Adaptation, Psychological↗

Hypoglycaemia in insulin-treated Type 2 diabetes: frequency, symptoms and impaired awareness.

AIMS: Hypoglycaemia is considered to be less common in people with insulin-treated Type 2 diabetes than in Type 1 diabetes. A retrospective survey was made of 215 people with insulin-treated Type 2 diabetes to quantify the frequency and nature of hypoglycaemia experienced. METHODS: The frequencies of mild (self-treated) and severe (required assistance) hypoglycaemia during the preceding year were estimated retrospectively. The usual symptoms of hypoglycaemia and state of awareness of hypoglycaemia were scored using validated questionnaires and any history suggestive of impaired hypoglycaemia awareness was documented. RESULTS: In this cohort, 157 (73%) had experienced hypoglycaemia since commencing insulin, the frequency of which increased with duration of diabetes and of insulin therapy and was inversely related to current HbA1c (all P < 0.05). During the preceding year, 32 individuals (15%) had experienced severe hypoglycaemia, with an estimated incidence for the entire group of 0.28 episodes/patient/year. Principal components analysis revealed two underlying symptom groups (autonomic and neuroglycopenic), similar to those reported previously by young adults with Type 1 diabetes, but the total symptom score declined with advancing age. Of the 157 with a history of hypoglycaemia, the 13 (8%) individuals who gave a history of impaired awareness of hypoglycaemia had experienced a ninefold higher incidence of severe hypoglycaemia than those with normal awareness, and reported experiencing mainly neuroglycopenic symptoms. CONCLUSIONS: While the overall frequencies of mild and severe hypoglycaemia were lower in insulin-treated Type 2 diabetes than have been reported previously in Type 1 diabetes, the risk of hypoglycaemia was greater with increasing duration of diabetes and of insulin therapy. Although impaired awareness of hypoglycaemia was uncommon, it was associated with a higher incidence of severe hypoglycaemia.

Adult↗

Increased blood-brain barrier permeability in type II diabetes demonstrated by gadolinium magnetic resonance imaging.

OBJECTIVES: Patients with type II diabetes are at increased risk of cognitive impairment. The retinal and renal complications of diabetes follow microvascular damage permitting small arterioles to leak, hence the cerebral damage might also follow loss of blood-brain barrier (BBB) integrity. Magnetic resonance (MR) brain imaging with intravenous gadolinium (Gd) diethylenetriamine pentaacetic acid (Gd-DTPA) was used to identify increased BBB permeability. METHODS: Ten well controlled type II diabetic patients aged 65-70 years and 10 controls underwent MR brain imaging with fluid attenuated inversion recovery (FLAIR); T1 weighted (T1W) volumetric imaging before; and T1W volumetric imaging at 5, 15, 30, 45, 60, and 90 minutes after intravenous Gd-DTPA. The T1W image before Gd-DTPA was subtracted from the images at each time point after Gd-DTPA. Net signal intensity was plotted against time for different brain regions. White matter hyperintensities were scored from the FLAIR image. RESULTS: The signal intensity/time curves showed that brain signal intensity increased more in the diabetic group than controls during the first 15 minutes after Gd-DTPA, particularly in the basal ganglia (p=0.018). Signal intensity in controls peaked at five minutes and diabetics at 15 minutes. Subjects with more white matter hyperintensities had greater signal increase after Gd-DTPA, whether diabetic or not (p=0.001). CONCLUSIONS: Increased BBB permeability with MR imaging was detected in patients with type II diabetes or white matter hyperintensities. Increased permeability of the BBB might account for some of the cerebral effects of type II diabetes, and so possibly also for the effect of other conditions that affect the microvasculature (like hypertension), on the brain.

Aged↗

Brain white matter lesions detected by magnetic resonance [correction of resosnance] imaging are associated with balance and gait speed.

OBJECTIVE: To investigate the relations between premorbid and current mental ability, mood, and white matter signal abnormalities detected by T2 weighted brain magnetic resonance imaging (MRI) and impairment of balance and mobility in older adults. METHODS: 97 subjects from the Aberdeen 1921 birth cohort underwent brain MRI, evaluation of balance, and measurement of gait speed. White matter hyperintensities detected on T2 weighted MRI scans were rated by three independent raters on three variables: white matter lesions; periventricular lesions; and brain stem lesions. RESULTS: Decreased gait speed was correlated with impaired visual acuity (p = 0.020), shorter stature (p = 0.008), a lower childhood IQ (p = 0.030), a lower current Raven's progressive matrices score (Raven score) (p < 0.001), a higher hospital anxiety and depression scale (HADS) score (p = 0.004), and an increased grade of brain stem lesions on MRI. Inability to balance was correlated with Raven score (p = 0.042), brain stem lesions (p = 0.003), white matter lesions (p = 0.003), and periventricular lesions (p = 0.038). Binary logistic regression identified brain stem lesions (odds ratio (OR) 0.22; 95% confidence interval 0.09 to 0.54) and HADS depression score (OR 0.75; 0.58 to 0.97) as the only significant associations with balance. Structural equation modelling detected an association between two latent traits representing white matter disease and an integrating function, respectively. CONCLUSIONS: In this cohort, white matter lesions, periventricular lesions, and brain stem lesions were associated with impaired balance. Current mental ability was strongly related to gait speed. There appears to be a concordance between motor skills and intellect in old age, which is degraded by white matter disease.

Aged↗

Effects of acute hypoglycaemia on auditory information processing in adults with Type I diabetes.

AIMS/HYPOTHESIS: Acute hypoglycaemia in humans causes general impairment of cognitive function, but information about its effects on more specific cognitive processes is limited. METHODS: Basic aspects of auditory function were studied in 15 adults with uncomplicated Type I (insulin-dependent) diabetes mellitus. Two separate hyperinsulinaemic glucose clamp procedures were done on different study days, in a counterbalanced fashion, either maintaining euglycaemia (blood glucose 5.0 mmol x l(-1)) or inducing hypoglycaemia (blood glucose 2.6 mmol x l(-1)). During each study, the subjects performed a battery of auditory and cognitive function tasks. RESULTS: Hypoglycaemia caused deterioration in mental efficiency as assessed by Digit Symbol (p<0.001) and Trail Making B (p=0.004) tasks. Acute hypoglycaemia also caused deterioration in one of three measures of simple auditory processing (single-tone loudness, p=0.001) and in auditory temporal processing (p=0.007). The amplitude and latency of auditory N100, P200 and P300 event-related potentials were not affected, but the amplitude of the N240 potential was reduced during acute hypoglycaemia. CONCLUSION/INTERPRETATION: Our findings are consistent with other recognised disruptive effects of acute hypoglycaemia on sensory information processing in non-diabetic and diabetic adults, including adverse effects on auditory information processing in non-diabetic subjects. These derangements have implications for the everyday activities of people with Type I diabetes who are frequently exposed to acute hypoglycaemia.

Acute Disease↗