Search PubMed⌕ Search

Biomedical subjects

T E Seeman

Publications and source records attributed to T E Seeman.

At least 55 records · Page 3Linked to original sources
PubMed1994

Plasma homovanillic acid and performance on motor and cognitive tasks in community-dwelling elderly: MacArthur studies of successful aging.

To investigate the dopaminergic correlates of the aging-related motor and cognitive deficits, the dopamine metabolite homovanillic acid (HVA) in plasma was studied in a community-dwelling elderly cohort (n = 141). The results showed that hand-signature time (HST), a measure of bradykinesia, correlated negatively with plasma HVA (r = -0.24, p < .007). Similarities task performance showed a trend-level positive correlation with plasma HVA (r = 0.15, p = .08). Because plasma HVA is derived from several sources including central dopaminergic neurons and both central and peripheral noradrenergic neurons, the noradrenergic metabolite 3-methoxy-4-hydroxyphenylglycol (MHPG) in plasma was also measured to indirectly estimate the relationships, with HVA originating from noradrenergic metabolism. Plasma MHPG significantly correlated with similarities scores (r = 0.34, p < .001) but not with HST. The results suggested that the association of HVA with prolonged HST may be related to central dopamine metabolism, but its association with similarities scores may be due to noradrenergic metabolism. The results raise the possibility that prolonged HST may be an indicator of preclinical brain dopamine loss in the elderly.

Aged↗
PubMed1994

Self-rated health and mortality in the high-functioning elderly--a closer look at healthy individuals: MacArthur field study of successful aging.

BACKGROUND: This study tested the predictive value of self-rated health on 3-year mortality, with attention focused on healthy, high-functioning elders. METHODS: Data from the MacArthur Field Study of Successful Aging were utilized. Subjects were 70-79-year-old (at baseline) residents of the communities of East Boston, MA, New Haven, CT, and a five-county area in and around Durham County, NC (N = 1192) which comprise three sites of the Established Populations for Epidemiologic Studies of the Elderly (EPESE). In-home interviews were conducted in 1988 and 1991. Logistic regression was performed to create odds ratios adjusted for age, sex, race, marital status, education, alcohol consumption, cigarette smoking, chronic diseases, past hospitalizations, and cognitive function. The sample was then divided into healthy and less healthy cohorts based on number of chronic diseases, and the analyses were repeated. RESULTS: The adjusted odds ratios for self-rated health (poor/bad ratings compared to excellent ratings) in relation to mortality were 19.56 in the general sample, 93.51 in the healthy cohort, and 2.75 in the less healthy cohort. CONCLUSION: Self-rated health is predictive of mortality in controlled analyses, with the greatest impact seen in healthy individuals. Health care professionals should be sensitive to the significance of poor self-rated health in apparently healthy patients.

Aged↗
PubMed1994

Predicting changes in physical performance in a high-functioning elderly cohort: MacArthur studies of successful aging.

BACKGROUND: Performance-based measures of physical performance were examined for an older cohort of relatively high-functioning men and women. Relationships between baseline physical performance and sociodemographic and health status characteristics were also examined. Three-year pattern changes in performance are described, and sociodemographic and health status predictors of change are investigated. METHODS: A cohort of relatively high-functioning men and women, aged 70-79, was identified in 1988 by subsampling from three community-based studies on the basis of physical and cognitive function. Baseline in-home assessments included tests of physical performance and measurement of sociodemographic characteristics and health status. A summary measure of physical performance was developed from tests of balance, gait, lower body strength and coordination, and manual dexterity. In-home assessments were repeated at follow-up in 1991. RESULTS: Better physical performance at baseline was more common among males, Whites, those reporting higher income and education, and those with fewer chronic conditions. In linear regression models, declines in performance were predicted by older age, lower income, higher education, relative weight and blood pressure, lower peak expiratory flow, prevalent diabetes and incident health conditions and hospitalizations during follow-up. Improvements in performance were also observed; the only significant association was with race (i.e., being Black). CONCLUSIONS: Declines in physical performance within a high-functioning cohort are predictable from sociodemographic and health status characteristics. The patterns of both decline and improvement in performance observed in this cohort suggest that older age is not uniformly associated with declines, indicating the potential for effective interventions to promote more successful aging.

Activities of Daily Living↗
PubMed1994

The impact of depressive symptomatology on physical disability: MacArthur Studies of Successful Aging.

OBJECTIVES: The purpose of these analyses was to test the hypothesis that depressive symptomatology affects the risk of onset of physical disability in high-functioning elderly adults. METHODS: The data come from the MacArthur Study of Successful Aging, a community-based cohort of high-functioning adults aged 70 through 79 years who were assessed twice at a 2.5-year interval. Physical and cognitive status was assessed by performance as well as by self-report measures. RESULTS: In gender-stratified logistic regression models, high depressive symptoms as measured by the depression subscale of the Hopkins Symptom Checklist were associated with an increased risk of onset of disability in activities of daily living for both men and women, adjusting for baseline sociodemographic factors, physical health status, and cognitive functioning. CONCLUSIONS: Joined with evidence that physical disability is a potential risk factor for depression, these findings suggest that both depressive symptoms and physical disability can initiate a spiralling decline in physical and psychological health. Given the important impact of activities-of-daily-living functioning on utilization of medical services and quality of life, prevention or reduction of depressive symptoms should be considered an important point of intervention.

Activities of Daily Living↗
PubMed1993

High, usual and impaired functioning in community-dwelling older men and women: findings from the MacArthur Foundation Research Network on Successful Aging.

The objective of this study is to determine the range of complex physical and cognitive abilities of older men and women functioning at high, medium and impaired ranges and to determine the psychosocial and physiological conditions that discriminate those in the high functioning group from those functioning at middle or impaired ranges. The subjects for this study were drawn from men and women aged 70-79 from 3 Established Populations for the Epidemiologic Study of the Elderly (EPESE) programs in East Boston MA, New Haven CT, and Durham County NC screened on the basis of criteria of physical and cognitive function. In 1988, 4030 men and women were screened as part of their annual EPESE interview. 1192 men and women met criteria for "high functioning". Age and sex-matched subjects were selected to represent the medium (n = 80) and low (n = 82) functioning groups. Physical and cognitive functioning was assessed from performance-based examinations and self-reported abilities. Physical function measures focused on balance, gait, and upper body strength. Cognitive exams assessed memory, language, abstraction, and praxis. Significant differences for every performance-based examination of physical and cognitive function were observed across functioning groups. Low functioning subjects were almost 3 times as likely to have an income of < or = $5000 compared to the high functioning group. They were less likely to have completed high school. High functioning subjects smoked cigarettes less and exercised more than others. They had higher levels of DHEA-S and peak expiratory flow rate. High functioning elders were more likely to engage in volunteer activities and score higher on scales of self-efficacy, mastery and report fewer psychiatric symptoms.

Activities of Daily Living↗
PubMed1993

Intercommunity variations in the association between social ties and mortality in the elderly. A comparative analysis of three communities.

Identical measures of social ties obtained from three community-based cohorts aged 65 and over from East Boston, MA; New Haven, CT; and two rural counties in Iowa permit the first direct cross-community comparison of the hypothesis that social isolation increases 5-year mortality risks (1982 to 1987) for older men and women. In sex-specific proportional hazards analyses, social ties were significantly and inversely related to mortality independently of age in all three cohorts (e.g., relative hazard (RH) = 1.97 to 3.06 for men and women, comparing those with no ties to those with four types of ties). After controlling for age, pack-years of smoking, body mass, chronic conditions, angina, and physical and cognitive disability, social ties remain significant predictors of mortality risk for the men and women in New Haven (RH = 2.4 and 1.8) and for women in Iowa (RH = 1.9). For the men in Iowa (RH = 1.4) and the men and women in East Boston (RH = 1.0 and 1.3), the associations are weaker and nonsignificant.

Aged↗
PubMed1993

Measured versus estimated creatinine clearance in a high-functioning elderly sample: MacArthur Foundation Study of Successful Aging.

OBJECTIVE: To assess the validity of several equations for estimating creatinine clearance in a large sample of high-functioning, community-dwelling elderly. DESIGN: Serum and 12-hour urine samples were collected and assayed for creatinine using the Jaffe total chromagen method. Fifteen clearance-estimating equations were evaluated for bias, accuracy, correlation with measured clearance values, and frequency of erroneous placement into renal function categories. Stepwise regression modeling and reliability testing were performed on a split sample to construct and assess a novel creatinine-clearance-estimating equation. SETTING: New Haven, Connecticut, East Boston, Massachusetts, and a five-county region in and around Durham, North Carolina. PARTICIPANTS: A subsample of community-dwelling men and women (age range 70-79 years) from the Established Populations for Epidemiological Studies of the Elderly was screened for physical and cognitive functioning and placed into high-, medium-, and low-functioning groups (n = 1354). High-functioning respondents who provided blood and complete urine samples (n = 762) were included in the present study. RESULTS: In general, estimated creatinine clearance was more closely correlated to measured values in males than in females. Most equations underestimated creatinine clearance, with average bias ranging from -33.1 mL/min to +19.6 mL/min. Predictive accuracy ranged from 18.2 mL/min to 38.0 mL/min. Equations were variable in their erroneous placement of individuals into renal function categories. Regression modeling yielded an equation which contained novel components but failed to provide better estimates of creatinine clearance than those already available. CONCLUSIONS: The equations evaluated here provide unacceptable predictions of creatinine clearance in normally aging individuals. We advocate the use of serum drug concentration measurements when available and encourage investigation into timed urine collections of short duration as alternatives to clearance-estimating equations in the elderly.

Activities of Daily Living↗
PubMed1993

Risk due to inactivity in physically capable older adults.

OBJECTIVES: This study examined the association between recreational physical activity among physically capable older adults and functional status, incidence of selected chronic conditions, and mortality over 3 and 6 years. METHODS: Data are from three sites of the Established Populations for Epidemiologic Studies of the Elderly. RESULTS: A high level of recreational physical activity reduced the likelihood of mortality over both 3 and 6 years. Moderate to high activity reduced the risk of physical impairments over 3 years; this effect diminishes after 6 years. A consistent relationship between activity and new myocardial infarction or stroke or the incidence of diabetes or angina was not found after 3 or 6 years. CONCLUSIONS: Findings suggest that physical activity offers benefits to physically capable older adults, primarily in reducing the risk of functional decline and mortality. Future work must use more objective and quantifiable measures of activity and assess changes in activity levels over time.

Activities of Daily Living↗
PubMed1991

Patient selection factors in angiographic studies: a conceptual formulation and empirical test.

Studies using coronary angiography patients as the study population to assess etiologic relationships are vulnerable to bias produced by patient selection factors, but the direction and magnitude of the bias in any particular study are uncertain. Partly for this reason, some authors have questioned the use of angiography data for studies of etiology. Nevertheless, this type of data continues to be used in etiologic studies. Therefore, in this paper a conceptual framework is described to quantify the degree of bias under different assumptions about the process whereby patients are selected for angiography. The direction and degree of bias depend on the pattern of patient selection, as well as the measure of association used (e.g., the risk ratio or odds ratio). One method is then described, based on assessing how physicians refer patients to angiography, which estimates the degree of bias produced by selection factors. This study is limited to the situation of a two-level risk factor (e.g., type A/B behavior) in relation to a two-level outcome measure (e.g., significant coronary artery occlusion versus no significant coronary artery occlusion). While type A/B behavior is used as an example in this paper, the concepts apply to any behavioral or nonbehavioral predictor variable.

Bias↗
PubMed1991

Personal control and coronary artery disease: how generalized expectancies about control may influence disease risk.

Generalized expectancies about control are examined as a possible independent risk factor for coronary artery disease in a sample of subjects undergoing coronary angiography. This characteristic is also examined as a possible underlying component of the Type A behavior pattern which may contribute to the latter's association with heart disease. Regression analyses adjusting for age, sex, income and known risk factors for heart disease (hypertension, serum cholesterol, smoking, diabetes, angina, family history of CHD, hostility and Type A behavior pattern) indicate that having a stronger belief in personal mastery or control is an independent predictor of more severe coronary atherosclerosis. This characteristic, however, is not significantly related to the Type A behavior pattern.

Adult↗
PubMed1989

The health consequences of multiple morbidity in the elderly. The Alameda County study.

Longitudinal data from the Alameda County Study are used to examine three health consequences of multiple or co-morbidity, defined as the coexistence of two or more chronic conditions and/or symptoms. Age-adjusted analyses of the consequences of baseline co-morbidity show significant associations in both age groups with 17-year mortality, and with the development of multiple new conditions and the occurrence of depression over a 9-year follow-up. After adjustments for sociodemographic characteristics and health behaviors, all associations with multiple new conditions remain significant. The association with depressive symptoms, however, remains significant for the younger age group only and the association with mortality become nonsignificant in both age groups.

Adult↗
PubMed1988

Structural characteristics of social networks and their relationship with social support in the elderly: who provides support.

The analyses presented here examine relationships between structural characteristics of social networks and two types of support (instrumental and emotional support) in a sample of community-dwelling individuals aged 65 and older. For each type of support, two dimensions are examined (1) the availability of such support and (2) the perceived adequacy of that support. Regression models, adjusting for age, sex, race and income show that structural characteristics such as total network size, number of face-to-face contacts and number of proximal ties are associated with greater availability of both instrumental and emotional support. The perceived adequacy of both types of support is most strongly related to the number of monthly face-to-face contacts. Comparisons of specific types of ties show that neither ones' spouse nor ones' children are primary sources of support. Rather the presence of a confidant is strongly associated with both dimensions of instrumental and emotional support; the presence of a spouse is not. And, while ties with children are most strongly related to aspects of instrumental support, ties with close friends and relatives are more strongly related to aspects of emotional support. Analyses of possible interactions show that for those without a spouse, confidants assume greater importance in providing emotional support. For those without children, ties with close friends and relatives assume a larger role relative to the perceived adequacy of both emotional and instrumental support.

Aged↗
PubMed1987

Social network ties and mortality among the elderly in the Alameda County Study.

Seventeen-year mortality data from the Alameda County Study are used to examine the relative importance of social ties as predictors of survival at different ages, ranging from 38-94 years at baseline. Previous analyses of Alameda County data by Berkman and Syme (Am J Epidemiol 1979;109:186-204) have shown that such ties are significant predictors of lower nine-year mortality risk for persons aged less than 70 years at baseline. Proportional hazard analyses indicate that social ties are also significant predictors of lower 17-year mortality risks for those aged 70 and older after adjusting for age, sex, race, baseline health status, perceived health, depression, and health practices (relative hazard = 1.49 for Berkman-Syme Social Network Index; 95% confidence interval (CI) = 1.09-2.05). Comparisons of the relative importance of four types of social ties reveal an interesting shift across the age groups. Marital status assumes primary importance for those aged less than 60 years at baseline (relative hazard = 1.6 and 1.4 for those aged 38-49 and 50-59, respectively; 95% CI = 1.12-2.29 and 1.02-1.91, respectively). However, ties with close friends and/or relatives assume greater importance for those aged 60 and older (relative hazard = 1.17 comparing those reporting five or more contacts per month to the more socially isolated who report less than five such contacts per month; 95% CI = 0.98-1.89).

Adult↗
PubMed1987

Mortality among the elderly in the Alameda County Study: behavioral and demographic risk factors.

We studied the association between behavioral and demographic risk factors and 17-year mortality in members of the Alameda County (California) Study who were 60-94 years of age at baseline. In this age group, increased risk of death is associated with being male, smoking, having little leisure-time physical activity, deviating from moderate weight relative to height, and not regularly eating breakfast. These increased risks were independent of age, race, socioeconomic position (SEP), other behavioral risk factors, and baseline physical health status. Further examination of the group aged 70 or more revealed the same patterns of heightened risk.

Aged↗
PubMed1983

Sex differences in reports of illness and disability: a further test of the fixed role hypothesis.

Data from a longitudinal study of adult health behavior (N = 1088) were used to test the 'fixed role' hypothesis as an explanation for sex differences in reports of illness and disability. According to this hypothesis, the traditional female excess in reported morbidity is due to females having more flexible role obligations than men--thus making it easier for women to adopt the sick role. In this analysis, regression techniques were used to examine sex differentials in reports of both 'symptom episodes' and bed days, while controlling statistically for fixed roles such as employment status, head of household and % contribution to the total family income. Our findings showed that the three fixed role measures did not explain sex differences in reports of symptom episodes or total bed days (N = 1088). However, among people reporting at least one bed day (N = 503), such obligations did explain the female excess in reported bed days. These findings suggest that fixed role obligations may play a larger role in determining when to relinquish the sick role as opposed to its adoption. These analyses also suggest that role obligations associated with employment status have the major influence on such sick role behavior.

Adult↗