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Biomedical subjects

T E Seeman

Publications and source records attributed to T E Seeman.

64 records · Page 4Linked to original sources
PubMed1980

Monitoring health status, access to health care, and compliance behavior in a large urban community: a report from the Los Angeles health survey.

This article summarizes results from 2 health surveys conducted in Los Angeles County in 1974 and 1977. The original objective of this analysis was to identify aggregate changes in the health status of this population, in access as measured by the use/disability ratio, and in self-reported compliance with medical regimens. Additionally, we have suggested that this study illustrates the value of local population surveys for health policy--particularly in regard to recent Health Systems Agencies legislation. Substantial correspondence was found between the health status characteristics of both samples and national estimates, particularly for the prevalence of chronic illness. We also found a 3-year trend of increasing disability that is consisted with national data. However, unlike the national estimates, we found evidence of improved access relative to disability, and a corresponding reduction in the traditional income differential. Analysis of self-reported compliance showed little change over time, with Anglos and the middle and upper socioeconomic groups reporting less compliance with their doctors' recommendations.

Adolescent↗
PubMedDate not supplied

Evidence for an interaction between apolipoprotein E genotype, gender, and Alzheimer disease.

Carriers of the apolipoprotein E (APOE) epsilon4 allele show significantly higher risk of Alzheimer disease (AD). The aim of this present study was to test the hypothesis that a significant interaction exists between APOE genotype and gender on AD. Interactions of epsilon4 by gender, although indicated in the literature, require further verification. A total of 195 past or current control or AD participants in an ongoing longitudinal study of aging and dementia were genotyped. All subjects were at least 60 years old; demented subjects met clinical or pathologic criteria for late-onset AD. Logistic regression analysis and proportional hazard models were used to evaluate joint effects of APOE and gender. A significant statistical interaction between APOE and gender was shown (p = 0.04) in logistic regression analysis. Women carrying one or more APOE-epsilon4 allele were more likely to develop AD [odds ratio (OR) = 7.8, 95% confidence interval (CI) = 3.2-19. 1]. For men, the presence of the APOE-epsilon4 allele was not associated with a statistically significant increased risk (OR = 1.6, 95% CI = 0.5-5.3). The interaction term in the proportional hazards model neared (p = 0.07) statistical significance, and a similar but reduced gender effect was shown. The analysis suggests that the presence of one or more APOE-epsilon4 allele confers a substantially greater risk of AD to women than to men. These findings in part may account for reports of increased risk of AD faced by women.

Aged↗
PubMedDate not supplied

Social networks and coronary artery disease: a comparison of the structure and function of social relations as predictors of disease.

This study provides the first direct comparison of the relative importance of structural versus functional aspects of social network ties as they relate to susceptibility to coronary artery disease. Data from 119 men and 40 women undergoing coronary angiography provide an opportunity to compare these associations in relation to a direct and continuous measure of atherosclerosis while controlling for age, sex, income, hypertension, serum cholesterol, smoking, angina, diabetes, family history of heart disease, Type A behavior pattern, and hostility. Regression analyses indicate that network instrumental support and feelings of being loved are more important in predicting coronary atherosclerosis than is network size, independent of all covariables (relative extent of atherosclerosis, low/high support = 1.74 and 1.5, respectively). More "problem-oriented" emotional support did not show a similarly strong association (relative extent of atherosclerosis = 1.01). These findings suggest that certain functional aspects of social network ties are more strongly associated with host resistance to coronary atherosclerosis than are structural characteristics like network size.

Adult↗
PubMedDate not supplied

Impact of social environment characteristics on neuroendocrine regulation.

OBJECTIVE: This article reviews evidence relating social environment characteristics to patterns of neuroendocrine regulation. To date, although there has been considerable interest in the effects of social ties and support on health and longevity, less attention has been given to the effects of such social environment characteristics on actual physiologic parameters. METHOD: Animal and human studies from 1960s to the present are reviewed for evidence linking social environment characteristics to patterns of hypothalamic-pituitary-adrenal (HPA) axis, sympathetic nervous system (SNS), and cardiovascular activity. RESULTS: Community and laboratory-based studies document that characteristics of the social environment influence patterns of neuroendocrine reactivity. These effects seem to be highly sensitive to aspects of the social environment such as relative social status, the relative stability of the social ordering and, importantly, the quality of social relationships. Although supportive social relationships are often associated with attenuated patterns of HPA and SNS activation, the converse also seems to be true as nonsupportive social interactions are frequently associated with enhanced reactivity. CONCLUSION: Available evidence regarding links between social environment characteristics and neuroendocrine regulation documents a link between the social and biological realms that may have important consequences for health and longevity. The data provide support for the hypothesis that observed associations between social ties and health and longevity result, at least partially, from the positive influence of such social environment characteristics in reducing neuroendocrine reactivity. The evidence regarding nonsupportive or hostile social relationships highlights the importance of taking a broader view of the potential health effects of the social environment, one that encompasses the potential for both positive and negative effects.

Adult↗
PubMedDate not supplied

Is educational attainment associated with shared determinants of health in the elderly? Findings from the MacArthur Studies of Successful Aging.

OBJECTIVE: To investigate the association of educational attainment with an array of risk factors for poor health among high-functioning older men and women. METHODS: Cross-sectional analyses of psychosocial, behavioral, and biological factors and educational attainment were conducted using data from a population-based cohort study of older men and women. Participants consisted of 70- to 79-year-old residents of communities of East Boston, MA; New Haven, CT; and Durham County, NC (N = 1192) participating in the Established Populations for Epidemiologic Studies of the Elderly programs, a three-site longitudinal study of community-dwelling men and women. Participants were selected on the basis of high physical and cognitive function, representing approximately the top third of their peers in terms of functional ability in 1988. In-home interviews were conducted. Associations among education and behavioral (e.g., cigarette smoking and physical activity), biological (e.g., pulmonary function, serum cholesterol), psychological (e.g., self-efficacy, anxiety), and social (e.g., networks and support) factors were examined. RESULTS: Low levels of education were associated with poorer psychological function (less mastery, efficacy, happiness), less optimal health behaviors (increased tobacco consumption and decreased levels of physical activity), poorer biological conditions (decreased pulmonary function, increased body mass index and waist-to-hip ratio), and larger social networks (increased number of contacts, decreased negative support). Several factors (alcohol consumption, high-density lipoprotein cholesterol) were nonlinearly related to educational attainment. CONCLUSIONS: Educational attainment is associated with a broad array of psychosocial and biological conditions among the elderly. That an education gradient functions over an array of factors that structure daily life, even in later life in a healthy population, may suggest how socioeconomic status influences health.

Aged↗
PubMedDate not supplied

Health promoting effects of friends and family on health outcomes in older adults.

OBJECTIVE: To highlight the significant impact of social relationships on health and illness and suggest implications of these effects for health promotion efforts among older adults. DATA SOURCES: Published studies on social relationships and health (or health behaviors) for the period 1970-1998 were identified through MEDLINE by using the key words social relationships, social support, and health, as well as review of health-related journals such as the American Journal of Epidemiology, Annals of Epidemiology, American Journal of Public Health, Journal of Health and Social Behavior, Social Science and Medicine, and the Journals of Gerontology. STUDY SELECTION: Major published original research was considered. Where published research was too extensive for full discussion of all studies, preference was given to studies focusing on older adults and those using stronger methodology (i.e., representative samples, longitudinal data, or multivariate analyses controlling for potential confounders). DATA EXTRACTION: Reported findings were organized in terms of three major categories: (1) results related to major health outcomes such as mortality, CHD, and depression; (2) findings related to health behaviors; and (3) findings related to potential biological pathways for observed health effects of social relationships. DATA SYNTHESIS: Protective effects of social integration with respect to mortality risk among older adults are the most thoroughly documented, although protective effects have also been documented with respect to risks for mental and physical health outcomes and for better recovery after disease onset. There is also now a growing awareness of the potential for negative health effects from social relationships that are characterized by more negative patterns of critical and/or demanding interactions, including increased risks for depression and angina. Biological pathways are suggested by evidence that more negative social interactions are associated with physiological profiles characterized by elevated stress hormones, increased cardiovascular activity, and depressed immune function, whereas more positive, supportive social interactions are associated with the opposite profile. CONCLUSIONS: Available data clearly indicate that social relationships have the potential for both health promoting and health damaging effects in older adults, and that there are biologically plausible pathways for these effects. Such evidence suggests that aspects of the social environment could play an important role in future health promotion efforts for older adults, although careful consideration of both potentially positive as well as negative social influences is needed.

Aged↗
PubMedDate not supplied

Health indices as predictors of cognition among older African Americans: MacArthur studies of successful aging.

Using cross-sectional and longitudinal data from the MacArthur Successful Aging Study, this paper examines associations between cognition and indices of health in 224 elderly African Americans 70 to 79 years of age at initial interview. The results indicated that greater average peak expiratory flow was predictive of better cognitive performance at the first interview. One longitudinal analysis showed that gender was the only significant predictor of change (change as a continuous variable) with women tending to slightly improve their cognitive performance over time. When change was treated as a dichotomous variable (e.g., a decline of 6 or more points), lower levels of average peak expiratory flow and education were predictive of decline, and positive self-ratings of current health and changes in health in the past year were important factors in the improvement of cognitive performance. The results indicate that, in addition to education, health is an important predictor of the status and course of cognitive functioning in older African Americans.

Black or African American↗