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T B Harris

Publications and source records attributed to T B Harris.

At least 73 records · Page 4Linked to original sources
PubMed1995

Occult caffeine as a source of sleep problems in an older population.

OBJECTIVE: To evaluate the impact of caffeine in medication on sleep complaints in a community population of persons aged 67 or older. DESIGN: Cross-sectional analysis. SETTING: Iowa 65+ Rural Health Study. PARTICIPANTS: Those who completed their own interview, including a section on the use of medications, during the third annual in-person follow-up in 1984-1985. MEASUREMENTS MAIN OUTCOMES: trouble falling asleep or other sleep complaints. Covariates: use of caffeine-containing medication, spasmolytic, or sympathomimetic drug; number of drugs used; depressive symptoms; self-perceived health; comorbidity, hip fracture, arthritis, ulcer of stomach or intestines; and consumption of caffeinated beverages. RESULTS: The prevalence of caffeinated medication use by participants was 5.4%. Those reporting the use of any caffeine-containing medication were at an increased risk of having trouble falling asleep (Odds Ratio [OR] = 1.79, 95% confidence interval [CI] = 1.19-2.68). There was no significant risk of other reported nighttime or daytime sleep problems associated with use of caffeine-containing drugs. Even after adjusting for other factors that could interfere with initiation of sleep, such as painful disease, depressive symptoms, polypharmacy, use of specific medications known to interfere with sleep, and coffee consumption, the use of caffeine-containing medication still presented a significantly increased risk of having trouble falling asleep (OR = 1.60, CI = 1.04-2.46). Although those participants using over-the-counter analgesic medication containing caffeine had an increased risk of trouble falling asleep (OR = 1.88, CI = 1.22-2.90), there was no significant risk of trouble falling asleep for those who took similar noncaffeinated OTC analgesic drugs (OR = 1.26, CI = 0.87-1.83). CONCLUSIONS: The use of caffeine-containing medication is associated with sleep problems. Healthcare providers should be aware of potential problems associated with over-the-counter medications containing caffeine and should counsel patients about the potential of sleep problems. Older patients should be encouraged to read the label on medications and to select drugs that are caffeine-free when that is possible.

Aged↗
PubMed1994

Low cholesterol concentrations and severe depressive symptoms in elderly people.

OBJECTIVE: To investigate the reported association between low serum cholesterol concentration and severe depressive symptoms in an elderly population. DESIGN: Cross sectional analysis of pooled data from three communities of the established populations for epidemiologic studies of the elderly. Participants who completed their interview, including the Centers for Epidemiologic Studies' depression scale and consented to measurement of their cholesterol concentration were included in the study. SUBJECTS: 3939 men and women aged > or = 71. METHODS: chi 2 analysis, t tests, and multivariate regression analysis of the association between low cholesterol concentration and severe depressive symptoms. All analyses were stratified by sex, and multivariate analyses were adjusted for age, self reported health, physical function, number of drugs used, and weight loss. MAIN OUTCOME MEASURE: Score of depressive symptoms on the Centers for Epidemiologic Studies' depression scale. RESULTS: Depressive symptoms, cholesterol concentration, weight, and use of drugs were all associated with age in men and women. The relative odds of severe depressive symptoms (score > or = 16) for those with low cholesterol concentrations (< 4.14 mmol/l) were 1.9 (95% confidence interval, 1.1 to 3.3) for the older group of men and 1.8 (1.1 to 2.9) for the older group of women. This association was also observed when depressive symptoms were analysed as a continuous rather than a categorical variable. In multivariate models that adjusted for age, self reported health, physical function, number of drugs used, and weight loss, the association was substantially weakened. CONCLUSIONS: After several factors relating to health had been controlled for, no significant association between low cholesterol concentration and severe depressive symptoms was found.

Aged↗
PubMed1994

The influence of weight on adolescent self-esteem.

Overweight children have traditionally been thought to have lower self-esteem than other children. Prospective data from the California Child Health and Development Studies were used to test this hypothesis by examination of the relationship between body mass index, self-esteem and locus of control while controlling for demographic and baseline psychosocial traits. Principle components and confirmatory factor analysis were used to derive latent constructs for self-esteem, locus of control and other psychosocial factors. A covariance structure model was developed using the results of the confirmatory factor analysis. In this model, adolescent self-esteem, locus of control and body mass index were not related. These findings from prospective data in a non-clinical population suggest that although some subgroups of obese children may be vulnerable for decreased self-esteem, this does not appear to be a significant problem in the general population.

Adolescent↗
PubMed1994

The association between weight change and psychological well-being in women.

Previous studies on the effects of weight change on psychological well-being in clinical samples have yielded inconsistent results. We examined the relationship between weight change and psychological well-being as measured by the General Well-Being (GWB) scale in 3747 women aged 50 years or less at baseline using data from the NHANES I Epidemiologic Follow-up Study. Multiple logistic regression was used to estimate odds ratios while adjusting for potential confounders. Recent weight gain was associated with poorer well-being in both overweight and non-overweight women and recent weight loss with poorer well-being in non-overweight women. These findings were unchanged by controlling for age, race, marital status, employment status, education, physical activity level, number of medical conditions, alcohol use and extroversion. Thus, maintenance of stable weight may contribute to psychological well-being in women.

Adult↗
PubMed1993

Overweight, weight loss, and risk of coronary heart disease in older women. The NHANES I Epidemiologic Follow-up Study.

Little is known about the relation of overweight to risk of coronary heart disease in older women. In this paper, the authors used measured weight for 1,259 white women aged 65-74 years from the Epidemiologic Follow-up Study of the First National Health and Nutrition Examination Survey to examine the effect of overweight on coronary heart disease incidence (mean length of follow-up, 14 years). They also used reported lifetime maximum weight to examine the effect of weight loss on this association. Women with a Quetelet index (weight (kg)/height (m)2) of 29 or more showed an increased risk of coronary heart disease (relative risk (RR) = 1.5, 95% confidence interval (CI) 1.1-2.1) after adjustment for age and smoking in comparison with those with a Quetelet index of less than 21, while women with a Quetelet index of 23-24 had a lower risk of coronary heart disease (RR = 0.6, 95% CI 0.4-0.9). However, the pattern of risk associated with measured weight was modified by weight loss. Among heavier women whose weight was relatively stable, those with a Quetelet index of 29 or more had an increased risk of heart disease (RR = 2.7, 95% CI 1.7-4.4). Among those with greater weight loss, the relation between Quetelet index and risk of coronary heart disease was J-shaped. Overweight is an independent risk factor for coronary heart disease in older women, a finding strengthened after previous weight loss is accounted for. Reasons for the unexpected increase in risk of coronary heart disease in thinner women who lost weight are unclear, and further investigation is warranted.

Aged↗
PubMed1993

Dietary calcium and hip fracture risk: the NHANES I Epidemiologic Follow-Up Study.

The effect of dietary calcium on hip fracture risk was examined prospectively using the NHANES I Epidemiologic Follow-Up Study cohort, which is derived from a nationally representative sample of the United States population. A cohort of 4342 white men and postmenopausal women ages 50-74 years at baseline (1971-1975) were observed through 1987 for up to 16 years of follow-up. Quantitative estimates of calcium intake were obtained at baseline from a 24-h recall, while weekly frequency of dairy food consumption was obtained from a qualitative food frequency. By 1987, 44 men and 122 women had experienced a hip fracture according to hospital records or death certificates. In the total sample of women the risk of hip fracture was only slightly lower for the highest quartile compared with the lowest. However, although not statistically significant, the age-adjusted risk of hip fracture was approximately 50% lower in the highest quartile of calcium intake compared with the lowest quartile in the subgroup of women who were at least 6 years postmenopausal and not taking postmenopausal hormone. The low relative risk observed among men, although interesting, must be interpreted cautiously due to small sample size. Adjusting for other risk factors did not appreciably change the results for either sex. The pattern of relative risks for calcium quartiles and by selected cutpoints was not consistent with a dose-response effect of calcium. Our results suggest that calcium may lower hip fracture risk in late menopausal women.

Age Factors↗
PubMed1993

Modification of the relationship between the Quetelet index and mortality by weight-loss history among older women.

The effect of weight on mortality was examined using data from the first National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study for white women aged 65 to 74 years at baseline. There was a U-shaped curve relating the Quetelet index categories to total mortality, with increased risk for both lean and heavy women. However, the increased risk to lean subjects occurred only among those who had lost more than 8.55% from their reported lifetime maximum weight. Controlling for baseline medical conditions, excluding early years of follow-up, and limiting the analysis to never-smokers did not greatly change the results. Lean women with stable weight have the lowest risk of mortality, while those who have lost weight have a high risk. Heavy women have a high risk of mortality regardless of weight-loss history. Thus, the effect of weight on mortality is modified by history of weight loss in older women, even when accounting for factors associated with weight loss and increased mortality risk.

Aged↗
PubMed1993

Dietary diversity and subsequent mortality in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study.

We examined the relation of dietary diversity to subsequent all-cause mortality by using data from the First National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study, 1982-1987. The analytic cohort consisted of 4160 men and 6264 women (including 2556 deaths), 25-74 y at baseline (1971-1975). Twenty-four-hour dietary recalls were evaluated for variety among the five major food groups: dairy, meat, grain, fruit, and vegetable, with a dietary diversity score (DDS); consumption of each food group contributed 1 point to a maximum possible DDS of 5. Age-adjusted risk of mortality was inversely related to DDS (P < or = 0.0009) in men and women. The inverse diversity-mortality association was adjusted for potential confounders: education, race, smoking status, and dietary fiber intake; the relative risk of mortality in men and women consuming two or fewer food groups was 1.5 (95% CI 1.2-1.8) and 1.4 (95% CI 1.1-1.9), respectively. In conclusion, diets that omitted several food groups were associated with an increased risk of mortality.

Adult↗
PubMed1992

Does cancer survival differ for older patients?

The relation of age to 5-year relative survival rates was examined for leading sites of cancer resulting in death among 127,554 patients; data from 1978 to 1982 were studied for four areas of the Surveillance, Epidemiology and End Results program of the National Cancer Institute. Overall and stage-stratified relative survival rates declined with advancing patient age for cancer of the lung, prostate, pancreas, bladder, oral cavity, uterus, cervix, ovary, and large bowel (women only). In men, this trend was not explained by age differences in stage of diagnosis, whereas, among women, age was associated with more advanced disease for most sites examined. Although overall survival rates were lower in black patients compared with white patients, the age-survival and age-stage trends were similar in the two racial groups.

Black or African American↗
PubMed1992

Assessing hip fracture risk in a population-based health survey: the NHANES III osteoporosis component.

A unique study of osteoporotic hip fracture risk, currently being conducted as part of a national health survey of the United States population, is described. The osteoporosis component of the third National Health and Nutrition Examination Survey (NHANES III) will provide data on multiple risk factors for hip fracture, including bone density of the proximal femur, from a nationally representative sample of adults that includes the very old. The minimum age for inclusion in the component is 20 years, so risk factors can be examined across the adult age range. The component includes men as well as women, and blacks and Mexican Americans as well as non-Hispanic whites. Finally, a longitudinal follow-up of the cohort will allow risk factor data to be related to subsequent hip fracture occurrence.

Adult↗
PubMed1991

An overview of body weight of older persons, including the impact on mortality. The National Health and Nutrition Examination Survey I--Epidemiologic Follow-up Study.

The authors studied distributions of body weight for height, change in body weight with age, and the relationship between body mass index and mortality among participants in the Epidemiologic Follow-up Study of the first National Health and Nutrition Examination Survey (NHEFS) (n = 14,407), a cohort study based on an representative sample of the U.S. population. Percentiles of body weight for height according to age and sex are presented. Cross-sectional analyses of body weight suggest that mean body weight increases with age until late middle age, then plateaus and decreases for older aged persons. However, longitudinal analysis of change in weight with age shows that younger persons in the lower quintile at baseline tend to gain more than those in the higher quintile. Older persons in the higher quintile at baseline have the greatest average loss in weight. The relationship of body mass index to mortality is a U-shaped curve, with increased risks in the lowest and highest 15% of the distribution. Increased risk of mortality associated with the highest 15th percentile of the body mass index distribution, as well as the highest 15% of the joint distribution of body mass index and skinfold thickness, is statistically significant for white women. However, the risk diminishes when adjusted for the presence of disease and factors related to disease. More noteworthy is the fact that there is a statistically significant excess risk of mortality for both race and sex groups in the lowest 15% of the body mass index distribution after adjusting for smoking history, and presence of disease. Those in the lowest 15% of the joint body mass index and skinfold thickness distribution, were also at increased risk. Risk of mortality for both men and women who have lost 10% or more of their maximum lifetime weight within the last 10 years is statistically significant, even when controlling for current weight. This study has replicated previously reported relationships, while correcting for several methodological issues.

Aged↗
PubMed1991

Is the serum cholesterol-coronary heart disease relationship modified by activity level in older persons?

Although coronary heart disease remains a leading cause of death and disability in old age, the relationship of serum cholesterol level to risk of coronary heart disease in old age is controversial. Data for 2,388 white persons aged 65-74 who participated in the National Health and Nutrition Examination Survey (NHANES) I Epidemiologic Follow-up Study (NHEFS) were examined to determine the relationship of serum cholesterol level to coronary heart disease incidence and whether activity level would modify this relationship. While there was no overall relationship between serum cholesterol level and coronary heart disease risk in either men or women, the relationship between serum cholesterol level and coronary heart disease differed within activity groups. For persons who were more active, serum cholesterol level was associated with a graded increase in risk of coronary heart disease, from 1.3 (95% CI 0.7, 2.3) in those with serum cholesterol level of 4.7-5.1 to 1.7 in those with serum cholesterol level of 6.2 mmol/L or more (95% CI 1.0, 2.7), when compared with those with serum cholesterol level below 4.7. For the least active persons, all levels of cholesterol were associated with a significant inverse relative risk, including cholesterol of 6.2 mmol/L or more (Relative risk = 0.4 (95% CI 0.2, 0.7]. These data suggest that factors such as activity level may modify the serum cholesterol-coronary heart disease association in old age. The serum cholesterol-coronary heart disease association in more active older persons resembles that seen in younger populations, whereas the association in less active persons is that of serum cholesterol level and risk of cancer or death. The modification of the serum cholesterol-coronary heart disease association by activity level may have implications for appropriate clinical management as well as appropriate design of research studies of this association.

Aged↗
PubMed1991

Implications of health status in analysis of risk in older persons.

This article explores the hypothesis that health status in old age acts as a summary measure of health exposures over time and, as such, plays a central role as a determinant of survival and morbidity trajectories in old age. Evidence is presented for the utility of health status as a modifier of risk in other areas of gerontologic research, and an example of modification pertinent to the cholesterol-heart disease controversy in old age is presented. The potential of differential health status in old age to affect both risk factors and risk estimates in epidemiologic analyses may be an important principle as epidemiologists continue to development research to preserve and augment the quality of life in old age.

Activities of Daily Living↗
PubMed1988

Occurrence and predictors of pressure sores in the National Health and Nutrition Examination survey follow-up.

The occurrence of pressure sores during a follow-up period of approximately 10 years is documented for a US nationwide cohort aged 55 to 75 years at baseline. Using data from the first National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study, those who developed pressure sores were identified through death certificates, hospital discharge summaries and self-report or proxy-report. During the follow-up period, pressure sores were identified in 113 of the 5,193 respondents (2.2%) for whom follow-up information was available. Incidence over the follow-up period was 1.7% for those aged 55 to 69 at baseline and rose to 3.3% for those 70 to 75 years old. Risk factors for pressure sore development were evaluated using data collected in NHANES I at baseline. Those with identified pressure sores were compared with the remainder of their cohort and also with a control group matched on age and length of longest hospitalization or nursing home admission. Significantly increased risk for pressure sore development was found for those who at baseline were current smokers, reported being relatively inactive, had poor self-assessed health status and who were found on physician's exam to have dry or scaling skin. Neurologic abnormality on the physician's exam and anemia at baseline were also associated with increased risk of pressure sores, although these associations were of borderline statistical significance.

Age Factors↗
PubMedDate not supplied

Muscle mass and fat mass in relation to bone mineral density in very old men and women: the Framingham Heart Study.

Aim of the study was investigate the cross-sectional relationship between body composition and bone mineral density (BMD) in very old men and women. The study sample consisted of 504 women and 285 men, aged 72-93 yr, participating in examination 22 (1992-1993) of the Framingham Heart Study. Total body BMD, regional BMD, and soft-tissue body composition was measured by dual-energy X-ray absorptiometry. Both muscle mass and percentage body fat were positively associated with total body BMD in women. After adjustment for age, physical activity, smoking status, estrogen use, and thiazide use, BMD increased with increasing tertile of muscle mass (p = 0.007) and with increasing tertile of percentage body fat (p = 0.0001) in women. In men muscle mass, not percentage body fat, was positively associated with BMD. After adjustment for potential confounders, BMD remained associated with muscle mass only (p = 0.02). These results were similar for leg BMD and arm BMD. The study suggests that the influence of muscle and fat mass on bone mineral density is different between very old men and women.

Absorptiometry, Photon↗
PubMedDate not supplied

Sex- and race-related differences in cross-sectional geometry and bone density of the femoral mid-shaft in older adults.

BACKGROUND: Femoral shaft fracture incidence increases in older adults and is associated with low-energy trauma. Apart from bone density, the distribution and size of bone contributes to its strength. AIM: To examine if bone geometry and density of the femoral mid-shaft in older adults differs by sex and race, we studied 197 White women, 225 Black women, 242 White men, and 148 Black men aged 70-79 years participating in the Health, Aging, and Body Composition study; a prospective cohort study in the USA. A secondary purpose of the study was to examine the association of site-specific muscle and fat to bone geometry and density. SUBJECTS AND METHODS: Subjects were community-dwelling and reported no difficulty walking one-quarter of a mile or climbing stairs. Mid-femoral volumetric bone mineral density (vBMD, mg cm(-3)), total area (TA), cortical area (CA), medullary area (MA), cross-sectional moments of inertia (CSMI: I(x), I(y), J), and muscle and fat areas (cm(2)) were determined by computed tomography (CT; GE CT-9800, 10 mm slice thickness). RESULTS: vBMD was greater in men than women with no difference by race (p < 0.001). Bone areas and area moments of inertia were also greater in men than women (p < 0.001), with Black women having higher values than White women for TA and CA. Standardizing geometric parameters for body size differences by dividing by powers of femur length did not negate the sex difference for TA and MA. Significant differences (p < 0.05) among the four groups also remained for I(x) and J. Mid-thigh muscle area was an independent contributor to TA in all groups (Std beta = 0.181-0.351, p < 0.05) as well as CA in women (Std beta = 0.246-0.254, p < 0.01) and CSMI in White women (Std beta = 0.175-0.185, p < 0.05). Further, muscle area was a significant contributor to vBMD in Black women. CONCLUSION: These results indicate that bone geometry and density of the femoral diaphysis differs primarily by sex, rather than race, in older well-functioning adults. In addition, site-specific muscle area appears to have a potential contributory role to bone geometry parameters, especially in women.

Aged↗
PubMedDate not supplied

Glycemia and cognitive function in older adults using glucose-lowering drugs.

OBJECTIVES: In experimental studies, both high and low levels of plasma glucose are associated with cognitive impairment. In populations, less is known about the relationship between glycemia and cognitive function, especially in persons using glucose-lowering drugs. DESIGN: A cross-sectional study of 378 high-functioning black and white men and women aged 70 to 79 participating in the Health, Aging, and Body Composition Study (Health ABC) who used glucose-lowering medications. Glycemic measures included fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c). Cognitive function was assessed using the Modified Mini-Mental State Examination (3MS) and the Digit Symbol Substitution Test (DSS) at the same examination visit in which the glycemic measures were determined. SETTING: Memphis, Tennessee and Pittsburgh, Pennsylvania. RESULTS: We observed an "inverted-U" relationship (p =.0025 for 3MS, p=.0277 for DSS) between FPG (range 47 - 366 mg/dl) and performance on these two tests. The fasting plasma glucose levels associated with the highest score on the 3MS was 180 mg/dl and 135 mg/dl for the DSS. There was a monotonic inverse relationship between HbA1c and performance on 3MS and DSS without evidence of a threshold effect. CONCLUSION: Our findings suggest that older adults who are treated for diabetes may experience a small degree of cognitive impairment within the recommended fasting glucose levels, yet measures of long-term glycemic control support tight glycemic control. Given the high prevalence of diabetes and the common use of glucose-lowering drugs in older adults, further studies are needed to elucidate these relationships.

Aged↗