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Biomedical subjects

M F Elias

Publications and source records attributed to M F Elias.

At least 19 recordsLinked to original sources
PubMed1999

Alcohol consumption and cognitive performance in the Framingham Heart Study.

Recent studies have indicated that moderate alcohol intake may be beneficial to cognitive functioning in women, although not necessarily in men. Data from the Framingham Heart Study, a large, prospective study of cardiovascular disease in Framingham, Massachusetts, were used to examine the relation between alcohol consumption and cognitive ability. The major research question was whether a different alcohol-cognition relation would be found for male and female drinkers. Men (n = 733) and women (n = 1,053), aged 55-88 years, were queried as to their weekly intake of alcohol, and these data were used to construct groups of abstainers, very light, light, moderate, and heavy drinkers. Data from earlier reports of alcohol consumption were also examined. Participants were administered eight tests which reflect performance in the domains of verbal memory, learning, visual organization and memory, attention, abstract reasoning, and concept formation. Multivariate linear regression analyses were used with statistical adjustment for age, education, occupation, cardiovascular disease, and associated risk factors. Women who drank moderately (2-4 drinks/day) showed superior performance in many cognitive domains relative to abstainers. For men, superior performance was found within the range of 4-8 drinks/day, although fewer significant relations were observed. These results were confirmed by prospective analyses of 24-year drinking history.

Aged↗
PubMed1998

A longitudinal study of blood pressure in relation to performance on the Wechsler Adult Intelligence Scale.

A growth curve analysis was used to examine estimated longitudinal decline (over 19 years) on the Wechsler Adult Intelligence Scale (WAIS; D. Wechsler, 1955) in relation to arterial hypertension and blood pressure (BP) for 55 men and 85 women (40 to 70 years old) who were free from overt major coexisting diseases. BP was associated with longitudinal decline for Visualization-Performance (VP) ability and Speed. Hypertension was a weaker predictor of VP and was unrelated to Speed. Age effects on VP were overestimated when averaged BP level, particularly systolic BP, was not controlled statistically. It was concluded that initial BP level and hypertension predict age-related longitudinal decline in specific major abilities assessed by the WAIS but that BP averaged over examinations is a stronger predictor.

Adult↗
PubMed1998

Seizures in east-bound visitors to Hawaii.

Anecdotal observations by emergency physicians at Straub Clinic and Hospital suggest that first-time seizures are common in Japanese tourists visiting Hawaii. Because such patients seemed to present in the evening of their day of arrival, some physicians have attributed these seizures to sleep deprivation based primarily upon clinical impressions. However, there has been no previous review of these cases to confirm the impression that these seizures have a relatively benign cause. This retrospective study aims to identify the role of sleep deprivation as a potential factor in seizures within this population.

Adolescent↗
PubMed1998

Effects of chronic hypertension on cognitive functioning.

Arterial hypertension and blood pressure level are associated with modestly accelerated cognitive decline over the adult life span and with moderately increased risk of poor cognitive performance at all ages. Correlations between white matter lesions in brain and elevated blood pressure provide indirect evidence that structural and functional changes in brain over time may lead to lowered of cognitive functioning when blood pressure control is poor or lacking. Preventive methods designed to lower population blood pressure, early detection, and aggressive treatment of hypertension are important to prevent accelerated cognitive decline in the individual and to preserve cognitive ability in the population. Some evidence suggests that poorly controlled hypertension may predispose to the dementias, but more work is needed to ascertain this.

Chronic Disease↗
PubMed1997

NIDDM and blood pressure as risk factors for poor cognitive performance. The Framingham Study.

OBJECTIVE: To determine if NIDDM and blood pressure are risk factors for poor cognitive performance and if history and duration of NIDDM and blood pressure interact such that the risk of poor performance is greater for subjects with both NIDDM and hypertension. RESEARCH DESIGN AND METHODS: We used a large prospective cohort sample with 187 NIDDM subjects and 1,624 nondiabetic subjects who were followed for 28-30 years. Cognitive function was assessed using eight tests of learning, memory, visual organization, verbal fluency attention, concept formation, and abstract reasoning. A composite score was also calculated. Odds ratios were used to estimate the relative risk of performing below the lower 25th percentile of z scores on these tests. RESULTS: NIDDM and blood pressure interacted such that diagnosis and duration of NIDDM were associated with greater risk of poor performance on tests of visual memory and on the composite score for hypertensive subjects. Duration of NIDDM was associated with increased risk for poor performance on tests of verbal memory and concept formation. Insulin-treated NIDDM subjects were at higher risk for poor cognitive performance than those NIDDM subjects treated with oral agents or diet. Blood pressure level was associated independently with a measure of verbal fluency. CONCLUSIONS: History and duration of NIDDM and high blood pressure are significant risk factors for poor cognitive performance. Hypertensive people with NIDDM are at greatest risk for poor performance on tests measuring visual organization and memory.

Aged↗
PubMed1996

A 15-year longitudinal study of Halstead-Reitan neuropsychological test performance.

Using a two-stage growth curve analysis, change over time in performance on tests in the Halstead-Reitan Battery and Average Impairment Rating (AIR) was assessed for 53 individuals who varied in age and health status. In the first stage of the analysis, estimated slope and intercept values were calculated for each individual by regressing longitudinal data points on time. In the second stage, estimated slope and intercept values obtained in the first-stage analysis were regressed on age at entry into the study with statistical control for health status, education, occupation, and gender. Control for health status had an insignificant influence on magnitude of associations between age and test performance. Age-at-entry into the study was associated with statistically significant increasing change over time (poorer performance) for tests placing relatively heavy demands on speed of psychomotor performance and for AIR.

Adult↗
PubMed1994

Effects of antihypertensive medications on quality of life in elderly hypertensive women.

The impact of antihypertensive medications on the quality of life of elderly hypertensive women has rarely been systematically evaluated in large clinical trials using drugs from the new generations of pharmaceutic preparations. We carried out a multicenter, randomized double-blind clinical trial with 309 hypertensive women aged 60 to 80 years to assess effects of atenolol, enalapril, and isradipine on measures of quality of life over a 22-week period. The patients had mild to moderate hypertension. Hydrochlorothiazide was added to treatment if monotherapy was inadequate in lowering blood pressure. At the conclusion of the trial the three drug groups did not differ in degree of reduction of diastolic blood pressure or in supplementation with hydrochlorothiazide. Over the 22-week trial, linear trend analysis showed no differences between the treatment groups in change from baseline on quality of life measures of well-being, physical status, emotional status, cognitive functioning, and social role participation. Regarding each of 33 physical side effects over the 22 weeks, we found no general difference between atenolol, enalapril, and isradipine groups on measures of change in distress over symptoms except for enalapril patients who worsened in distress over cough (P = .001) and atenolol patients who worsened in distress over dry mouth (P = .014). Centering on three medications that are relatively new additions to the armamentarium for blood pressure control, the findings underline the increasing opportunities for the physician to select drugs that can control blood pressure while maintaining the quality of life of elderly hypertensive women.

Aged↗
PubMed1993

Untreated blood pressure level is inversely related to cognitive functioning: the Framingham Study.

It was hypothesized that blood pressure would be inversely related to cognitive functioning, if unconfounded with antihypertensive medication and measured over many occasions prior to neuropsychological testing. For stroke-free Framingham Study participants aged 55-88 years (n = 1,702), blood pressure levels were averaged over five biennial examinations (1956-1964) when few hypertensives were being treated, and examined in relation to neuropsychological tests administered between 1976 and 1978. With age, education, occupation, cigarette smoking, alcohol consumption, and gender controlled, blood pressure levels and chronicity of hypertension were inversely related to the composite score and measures of attention and memory. This was true for the full sample, for a subsample untreated during blood pressure measurement (n = 1,485), and for a subsample untreated throughout the entire study period (n = 1,038). For example, decline per 10 mmHg increment in blood pressure ranged from -0.04 to -0.07 standard score units (z) for the composite score. A negative finding previously was most likely due to blood pressure measurement concurrently with neuropsychological testing, or too few measurements. Hypertension-associated pathogenic processes may cause mild cognitive impairment, but other mechanisms need to be considered.

Aged↗
PubMed1993

Cognitive function and cardiovascular responsivity in subjects with a parental history of hypertension.

College-age subjects with and without a parental history of hypertension completed a battery of tests of cognitive function on two separate occasions. Pulse rate and blood pressure were measured during performance of each task. In one session, subjects were told that their performance was being evaluated and videotaped from behind an observation mirror (Evaluation Condition). In the other session, subjects were told that their performance was not being observed (Nonevaluation Condition). Regardless of Evaluation Condition, Parental History subjects exhibited slower search of short-term memory than Non-Family History subjects during the first but not the second testing session. Parental History subjects displayed greater elevations in pulse rate than Nonparental History subjects during task performance. The results were interpreted as providing evidence that pathophysiological mechanisms associated with essential hypertension are not the only viable explanations of lower levels of cognitive performance exhibited by hypertensive subjects.

Adolescent↗
PubMed1993

The influence of gender and age on Halstead-Reitan neuropsychological test performance.

Age-cohort differences for seven tests from the Halstead-Reitan Neuropsychological Battery, for overall performance on the Impairment Index, and for a multivariate composite of the seven scores, were examined for 427 subjects falling into six age groups (15-24, 25-34, 35-44, 45-54, 55-64, and 65 years and over). Univariate and multivariate-discriminant analyses were performed. Poorer performance was observed across age-cohorts (linear trend) for all tests and the Impairment Index. A very modest Age-Cohort (linear trend) x Gender interaction was observed only for the Category Test. Decline in Category Test performance across age-cohorts was more pronounced for women than for men. For women, the best discrimination among age groups was observed for the Category Test. For men, Tactile Performance Localization Test discriminated best. The poorest discrimination among age groups was seen for Finger-Tapping for men and Tactile Performance Test--Total (time score) for women. Results were consistent with a model of specific nested within general decline. Although linear-trend across age groups was observed for all tests, the strongest discriminations were associated with neuropsychological tests of abstraction and complex problem-solving performance.

Adolescent↗
PubMed1991

Statistical tools and status symbols.

This paper sets the stage for a series of edited papers which follow. It is argued that obvious statistical blunders (mortal sins) have not disappeared entirely from the aging literature, but that the most frequent error now is that of choosing a less powerful analytic solution when a more powerful (and equally applicable) one is at hand (a venial sin). Clearly, it is argued, power must be considered in relationship to the theoretical model, the condition of the data set, and the research question. Editors and reviewers, it is argued, must cut through the "glitter" of new fads and the security of tradition in order to objectively consider the merits of new statistical applications. More importantly, without knowledge of the issues, limitations, and advantages of contemporary and emerging analytic techniques, authors cannot make good analytic choices and defend them effectively. The time between presentation of innovative approaches in the quantitative journals and application in the aging literature contributes to traditionalism in data analysis. Overzealousness by advocates of new approaches often contributes to premature embracing of them. Thus the papers that follow were designed to bring new methods to the "working-researcher" with a frank appraisal of assumptions, proper and improper applications, and limitations. Authors of these papers were challenged to communicate in plain and understandable terms and to provide practical examples.

Humans↗
PubMed1991

Structural modeling of mixed longitudinal and cross-sectional data.

In this paper we describe some mathematical and statistical models for dealing with changes over age. We concentrate specifically on the use of a structural equation modeling (SEM) approach (using computer programs like LISREL) to deal with issues of: (1) group differences in regression parameters, (2) differences in longitudinal and cross-sectional results, (3) differences due to longitudinal attrition, and (4) mixtures of these problems. To illustrate these ideas we use data from a previous study of hypertension and intellectual abilities (from Schultz, Elias, Robbins, Streeten, and Blakeman, 1986).

Adult↗
PubMed1990

The effects of age, blood pressure, and knowledge of hypertensive diagnosis on anxiety and depression.

Recent studies have indicated that heightened anxiety and depression in hypertensives, relative to normotensives, is particular to hypertensives' knowledge of their diagnosis. We tested the hypothesis that knowledge of hypertensive diagnosis (KHD) has a stronger association with anxiety and depression for younger than for older individuals. Samples were 239 subjects referred to a hypertension clinic with KHD and 90 subjects, never diagnosed as hypertensive, recruited as a normotensive comparison group. Two age groups, 21-39 and 45-65, were employed. Regression analyses indicated that higher unmedicated blood pressure (BP) values were associated with higher state anxiety but not trait anxiety or depression, after age, education, and sex were entered into the equations. Knowledge of hypertension diagnosis was related to higher scores on all anxiety and depression measures. However, evidence that BP values and KHD had stronger associations with anxiety and depression for a younger than for an older cohort was not obtained. Regression analyses performed within the hypertension clinic referrals indicated that the severity of hypertension as reflected by unmedicated BP values was unrelated to anxiety and depression, and that a history of treatment with anti-hypertensive medications was related only to higher somatic depression.

Adult↗
PubMed1990

Determining neuropsychological cut scores for older, healthy adults.

Three age groups (20-31, 37-49, and 55-67 years) of healthy men and women were compared on tests from the Halstead-Reitan neuropsychological test battery. Age-cohort differences in performance were observed for every measure (except Finger Tapping) and for overall indices of cognitive functioning, the Average Impairment Rating (AIR) and the Halstead-Reitan Impairment Index (HR II). When traditional cut scores (developed with age-heterogeneous samples) were used, alarmingly high percentages of subjects in the oldest group were defined as brain damaged. These findings were not attributable to higher levels of psychometrically-assessed anxiety and depression in the older groups or for the impaired subjects. Slightly more conservative criteria (fewer diagnoses of brain impairment) were then employed. The first, AIR greater than or equal to 2.00, resulted in a low and more reasonable base rate of brain impairment for the oldest group. The second, AIR greater than 2.00, resulted in age-parity in incidence of brain impairment. The heuristic value of more conservative AIR scores was discussed as were possible uses in applied clinical research settings. The limitations of this approach were noted with regard to its exclusive focus on the problem of false positive diagnoses. It was emphasized that, from a neuropsychological diagnostic perspective, cut scores based on healthy aging samples must ultimately be tested in the context of traditional neuropsychological studies in which external validation with neurosurgical and neurological criteria is employed.

Adult↗
PubMed1990

Is blood pressure an important variable in research on aging and neuropsychological test performance?

Regression analyses using Blood Pressure, Age, and the multiplicative effect of Blood Pressure and Age as predictors of performance (on selected tests from the Halstead-Reitan neuropsychological test battery) were done. Three hypotheses were tested with subjects ranging in age from 20 to 72 years of age: (1) blood pressure values predict neuropsychological test performance over a wide range of hypertensive and normotensive blood pressure values; (2) blood pressure predicts performance within the narrower range of normal and borderline values; (3) blood pressure X age interactions, when observed over this age and education range, are such that negative blood pressure effects on performance are larger for younger than older subjects. Regression analyses confirmed each of these hypotheses and indicated that strength of prediction was not reduced when participants free from hypertension-related complications and medication were tested. Blood pressure X age interactions were seen for Trailmaking-B Test and the Tactile Performance Test-Localization for the primary sample. However, only Blood Pressure main effects were observed for the Average Impairment Rating, the Categories Test, TPT-Memory and TPT-Localization when age, sex, and education were controlled. Implications of these findings for the role of blood pressure in aging research and for longitudinal studies with subjects free from the need for treatment with antihypertensive medications are discussed.

Adult↗
PubMed1989

A longitudinal study of the performance of hypertensive and normotensive subjects on the Wechsler Adult Intelligence Scale.

Performance on the Wechsler Adult Intelligence Scale was followed over two 5- to 6-year intervals for essential hypertensive Ss (EH; n = 22) free from medical complications and for normotensive Ss (N; n = 20). EH were treated with adrenergic beta-blocking drugs, diuretics, or both. Mean age was 46 years (SD = 12.6 years), initially (Time 1). Results were unaltered by adjustment for initial age. N improved modestly on the Verbal scale, from Time 1 to Time 2 only. EH neither improved nor declined on the Verbal scale. Scores remained unchanged for both EH and N Ss for the Performance scale. Overall, and at Times 2 and 3, Verbal scores were lower for the EH group. It was concluded that neither decline nor improvement in cognitive function over time are necessary outcomes of modest, carefully treated, uncomplicated hypertension in the middle years.

Female↗
PubMed1989

A longitudinal study of neuropsychological performance by hypertensives and normotensives: a third measurement point.

The neuropsychological test performance of hypertensive and normotensive subjects was compared at three times of measurement over a 10-year period. The tests used were among those that are most sensitive to brain impairment in the Halstead-Reitan battery. In addition to individual test measures, a widely used clinical index of battery-wide performance--the Average Impairment Rating (AIR)--was used. Hypertensives exhibited lower mean levels of performance on the AIR at all times of measurement. However, the Blood Pressure Group x Time of Measurement interactions were not statistically significant, indicating that hypertensives and normotensives did not exhibit a differential rate of change (decline or improvement) over time. Hypertensives also performed more poorly for a measure of learning set formation (categories test) and two tests of memory for forms experienced by touch only (tactile perception memory and localization tests). However, Blood Pressure x Time of Measurement interactions were not observed for these measures.

Adult↗