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Biomedical subjects

S Meeks

Publications and source records attributed to S Meeks.

11 recordsLinked to original sources

Contribution of education to health and life satisfaction in older adults mediated by negative affect.

OBJECTIVES: The authors developed a model of relationships between two enduring attributes (educational attainment and negative affect) and two indicators of successful aging (health and life satisfaction). METHODS: A probability sample of 1,177 participants (age 55 and older) were interviewed four times at 6-month intervals. Structural equation models were developed based on the authors' hypothetical model proposing a mediating effect of negative affect between health and successful aging. RESULTS: As predicted, education and negative affect both were directly related to health and life satisfaction. Also, as predicted, negative affect mediated the relationship between education and successful aging indicators. DISCUSSION: Education appears to confer a lifelong advantage for healthy aging. Part of this advantage is accounted for by the relationship between education and trait negative affect. Higher educational attainment is related to lower levels of trait negative affect; lower negative affect results in better health and life satisfaction.

Aged↗

Longitudinal relationships between depressive symptoms and health in normal older and middle-aged adults.

Comorbidity between health and depression is salient in late life, when risk for physical illness rises. Other community studies have not distinguished between the effects of brief and long-standing depressive symptoms on excess morbidity and mortality. S. Cohen and M. S. Rodriguez's (1995) differential hypothesis of pathways between depression and health was used to examine the relationships between health and depression in a prospective probability sample of 1,479 community-resident middle-aged and older adults. Findings suggest that different durations of depressive symptoms have different relationships to health. Health had an impact on short-term increases in depressive symptoms but depressive symptoms had a weaker impact on health. The reciprocal impact was indistinguishable from the health influence on depression. In contrast, longer term depressive symptoms had a clear impact on health. The results imply that physical illness can affect depressive states; depressive traits but not states can affect illness.

Age Factors↗

Inverse radiosurgery treatment planning through deconvolution and constrained optimization.

An inverse radiosurgery treatment planning approach is presented which calculates conformal dose distributions for small, irregularly shaped targets. Two general approaches have been suggested for solution of the inverse radiotherapy problem: explicit and implicit. Explicit methods are typically fast, but generally require geometric and/or dosimetric simplifications. Implicit methods have also been used, but are computationally expensive because they require iterative manipulation of each beam's individual elements. The method presented here incorporates an integrated approach in order to efficiently solve the inverse problem without requiring simplifications which may affect the accuracy of the final result. A deconvolution algorithm (explicit approach) is utilized to determine the intensity modulation function for multiple user-selected beam's eye views of the desired dose distribution. A simulated annealing algorithm (implicit approach) then optimizes each beam's macroscopic weight. Additionally, this method is fully three-dimensional and accurately models phantom scatter by incorporating Monte Carlo generated energy deposition kernels into the dosimetry process. Several small target structure examples are presented and applicability of this methodology to larger targets for general radiotherapy cases is addressed.

Algorithms↗

Short-term course of mental illness in middle age and late life.

The heterogeneity in severe mental illnesses means that although some persons exhibit a chronic course in later life, others may recover for long periods or have episodes throughout the lifespan. The challenge to mental health providers is to identify those people most at risk for a chronic or relapsing course in later life. Data described here come from a prospective study of course and adjustment in severe mental illness for persons over age 40. The sample of 313 people, residing in the community and both in treatment and not in treatment, is unique. Six 8-month course patterns were identified; nearly one third of the participants had course patterns that were unstable, and one third were well across the 8 months. Older participants were more stable and less depressed, but otherwise were very similar to those in middle age. Demographic and history variables that predict long-term outcomes were not useful for predicting short-term recovery or relapse.

Adult↗

Mental illness in late life: socioeconomic conditions, psychiatric symptoms, and adjustment of long-term sufferers.

The relationships between social and economic conditions and psychiatric disorder among 346 older adults with severe mental illness living in the community are examined in this article. Measures included socioeconomic indexes, symptoms, diagnoses, and adjustment. As expected, socioeconomic and illness factors were interrelated in this sample. Diagnosis was related to both functioning and socioeconomic factors. As a rule, participants were financially impoverished but socially integrated into social networks consisting largely of kin. In spite of impoverishment and presence of significant symptoms, most were maintaining themselves in the community with at least marginal functioning, though they received very little support from the mental health system beyond medication. Compared with the younger cohort, the older cohort was functioning better, had fewer symptoms, and had better global adjustment. Those with coexisting psychotic and affective syndromes were most at risk. Future analyses with this data set will need to develop complex multivariate models to predict the primary influences on functioning and short-term stability.

Adult↗

Service providers in the social networks of clients with severe mental illness.

The social networks of 27 severely mentally ill (SMI) clients of two community mental health centers were compared with those of 19 clients who had less severe disorders. The networks of the SMI clients were smaller and less reciprocal and contained fewer family members. SMI clients' networks were also more likely to include social service providers, such as group home staff and caseworkers. These social service providers gave direct advice and medical, food, and financial assistance in addition to emotional support, but the relationships were nonreciprocal. Clients with the fewest indigenous supports had the most social service links. These findings suggest that mental health services for SMI persons may provide substitute social supports that serve a broader function than more traditional emotional therapy.

Adult↗

Protective functions of health and self-esteem against depression in older adults facing illness or bereavement.

Four functions were examined by which health and self-esteem could ward off depression over time in older adults. Adults (N = 1,074)--55 years and older--were interviewed 5 times at 6-month intervals. Demographic and prevent depression controls were included. Neither health nor self-esteem served as an interactive buffer. Both had direct negative effects on depression, independent of events, over 2 years. Neither illnesses nor bereavements had direct effects on depression; both had indirect effects through other events; illness also had indirect effects by weakening health. Health had stronger preventive effect on illnesses but was more vulnerable to undesirable events than was self-esteem. There was little support for the specificity hypothesis that a close match between event and resource would increase resource effects.

Adaptation, Psychological↗

Mental health needs of the chronically mentally ill elderly.

The treatment histories and current social, financial, and clinical status of 111 chronically mentally ill (CMI) persons over the age of 60 were examined. Information was obtained from Ss, family, mental health records, and mental health professionals familiar with Ss. Psychiatric symptoms were observed in 74% of Ss. Many Ss experienced long periods without acute episodes of illness. Recurring episodes eventually appeared in most Ss, however, and ongoing deficits in daily functioning and social contacts were prototypical. Two thirds of the Ss were living in the community, relying heavily on family contacts; the rest lived primarily in nursing homes (23.4%) or psychiatric hospitals (7.2%). Social support was the best predictor of level of functioning. Findings suggest that failure of CMI elderly to use mental health services is not due to lack of need. Mental health services currently do not appear to be meeting the needs of this population.

Activities of Daily Living↗

Age differences in coping: does less mean worse.

Previous research suggests that elderly people utilize fewer coping strategies than younger people. Some researchers suggest that these quantitative changes reflect decreases in the use of maladaptive strategies; others contend that they reflect decreases in the use of adaptive strategies by older adults. The present article reports the findings of three studies of coping in older people, two addressing coping with health problems, and the other addressing coping with moving. In all three studies, the number of self-reported coping strategies decreases with age. Results do not support the idea that decreases in the number of strategies imply decrements in the quality of coping, however: in two studies, age was unrelated to the effectiveness of strategies, in the third, effectiveness ratings were higher for older subjects. The need for evaluation of specific outcomes of coping strategies is discussed, along with the need for task-specific measurement of coping. It is proposed that decreases in the number of coping strategies reflect improved coping efficiency, rather than a deterioration of adaptational skills.

Adaptation, Psychological↗

Bipolar disorder in the latter half of life: symptom presentation, global functioning and age of onset.

BACKGROUND: Little is known about bipolar disorder in late life. Recent research has been in acute, in-patient, settings, and has focused on late-onset mania, or has produced samples with surprisingly late mean ages of onset. No recent study has used a larger out-patient sample to address late-life outcomes of bipolar disorder. METHODS: 86 community-residing, middle-aged and older adults who met RDC for bipolar I or II were interviewed using the Schedule for Affective Disorders and Schizophrenia, three times over 8 months. RESULTS: Participants were primarily unmarried and impoverished. Most were living alone or with immediate family members. The majority were in depressive episodes. Depressive symptoms were more common and more predictive of functioning than manic symptoms. Age of onset was related to global functioning. The effect of age of onset was mediated by number of depressive episodes. CONCLUSION: Most adults in this sample had supports to maintain them in the community in spite of chronic or intermittently cycling manifestations of affective disorder and limited medication. Consistent with prior research, early age of onset was related to poorer functioning, apparently by increasing the number and severity of depressive episodes. LIMITATIONS: Limitations stem from possible exclusion of those people with the worst and best outcomes. It also is a relatively young sample for a gerontological study. CLINICAL RELEVANCE: The study suggests that more attention needs to be paid to diagnosing and treating depressive episodes in later life.

Adult↗