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PubMed1991

Visual impairment and retinopathy in people with normal glucose tolerance, impaired glucose tolerance, and newly diagnosed NIDDM.

OBJECTIVE: Prevalence rates of visual impairment and retinopathy were compared in 1992 people with normal glucose tolerance, impaired glucose tolerance (IGT), or newly diagnosed non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS: Glucose tolerance status was based on an oral glucose tolerance test after exclusion of those with a history of diabetes and/or diabetes medication use in an upper middle-class community of older white adults in southern California between 1984 and 1987. RESULTS: Although many sex-specific comparisons were made between glucose tolerance groups, only a few emerged as statistically significant. Among those, women with IGT had significantly higher age-adjusted rates of visual impairment (10.8%) than women with normal glucose tolerance (4.4%). Among men, those with IGT had significantly higher age-adjusted rates of visual impairment (7.9%) than men with newly diagnosed NIDDM (4.0%). CONCLUSIONS: Low frequencies of retinopathy were found in all three glucose tolerance groups.

Age Factors↗
PubMed2004

Oral tolerance to nickel requires CD4+ invariant NKT cells for the infectious spread of tolerance and the induction of specific regulatory T cells.

Previously, oral administration of nickel to C57BL/6 wild-type (WT) mice was shown to render both their splenic T cells and APCs (i.e., T cell-depleted spleen cells) capable of transferring nickel tolerance to naive syngeneic recipients. Moreover, sequential adoptive transfer experiments revealed that on transfer of tolerogenic APCs and immunization, the naive T cells of the recipients differentiated into regulatory T (Treg) cells. Here, we demonstrate that after oral nickel treatment Jalpha18(-/-) mice, which lack invariant NKT (iNKT) cells, were not tolerized and failed to generate Treg cells. However, transfer of APCs from those Jalpha18(-/-) mice did tolerize WT recipients. Hence, during oral nickel administration, tolerogenic APCs are generated that require iNKT cell help for the induction of Treg cells. To obtain this help, the tolerogenic APCs must address the iNKT cells in a CD1-restricted manner. When Jalpha18(-/-) mice were used as recipients of cells from orally tolerized WT donors, the WT Treg cells transferred the tolerance, whereas WT APCs failed to do so, although they proved tolerogenic on transfer to WT recipients. However, Jalpha18(-/-) recipients did become susceptible to the tolerogenicity of transferred WT APCs when they were reconstituted with IL-4- and IL-10-producing CD4(+) iNKT cells. We conclude that CD4(+) iNKT cells are required for the induction of oral nickel tolerance and, in particular, for the infectious spread of tolerance from APCs to T cells. Once induced, these Treg cells, however, can act independently of iNKT cells.

Adoptive Transfer↗
PubMed2001

Acute antinociceptive tolerance and asymmetric cross-tolerance between endomorphin-1 and endomorphin-2 given intracerebroventricularly in the mouse.

Development of tolerance in mice pretreated intracerebroventricularly with mu-opioid receptor agonist endomorphin-1, endomorphin-2, or [D-Ala(2),N-Me-Phe(4),Gly-ol(5)]-enkephalin (DAMGO) was compared between endomorphin-1- and endomorphin-2-induced antinociception with the tail-flick test. A 2-h pretreatment with endomorphin-1 (30 nmol) produced a 3-fold shift to the right in the dose-response curve for endomorphin-1. Similarly, a 1-h pretreatment with endomorphin-2 (70 nmol) caused a 3.9-fold shift to the right for endomorphin-2. In cross-tolerance experiments, pretreatment with endomorphin-2 (70 nmol) caused a 2.3-fold shift of the dose-response curve for endomorphin-1, whereas pretreatment with endomorphin-1 (30 nmol) caused no change of the endomorphin-2 dose-response curve. Thus, mice acutely tolerant to endomorphin-1 were not cross-tolerant to endomorphin-2, although mice made tolerant to endomorphin-2 were partially cross-tolerant to endomorphin-1; an asymmetric cross-tolerance occurred. Pretreatment with DAMGO 3 h before intracerebroventricular injection of endomorphin-1, endomorphin-2, or DAMGO attenuated markedly the antinociception induced by endomorphin-1 and DAMGO but not endomorphin-2. It is proposed that two separate subtypes of mu-opioid receptors are involved in antinociceptive effects induced by endomorphin-1 and endomorphin-2. One subtype of opioid mu-receptors is stimulated by DAMGO, endomorphin-1, and endomorphin-2, and another subtype of mu-opioid receptors is stimulated solely by endomorphin-2.

Analgesics, Opioid↗
PubMed1977

Single-dose tolerance to morphine hypothermia in the rat: differentiation of acute from long-term tolerance.

The time course for the development and disappearance fo tolerance to the hypothermic effects of morphine was determined after a single subcutaneous injection (10 mg/kg) in rats. Body temperature responses to second injections, given at varying times after the first, were compared with those produced by the initial injections. Tolerance (attenuation of the hypothermic response) induced by a single dose of morphine was found to be biphasic. Acute tolerance was apparent by 4.5 hours and lasted at least 20 hours after morphine administration. Development of long-term tolerance occurred within 24 hours, was maximal at 3 days and persisted up to 11 days. Both acute and long-term tolerance were drug specific since hypothermic responses to pentobarbital were not altered either 4.5 or 72 hours after morphine. Long-term tolerance was attenuated by co-administration of naloxone with initial dose of morphine. Long-term tolerance induced by multiple doses of morphine (300 mg/kg/day) differed from that induced by a single dose in persistence (3-4 weeks) rather than in quality or magnitude. The thermoregulatory response of the rat provides a sensitive measurement system which allows discrimination between acute and long-term opiate effects.

Animals↗
PubMed1977

Cellular events in tolerance. VI. Neonatal vs adult B cell tolerance: differences in antigen-binding cell patterns and lipopolysaccharide stimulation.

The numbers and fate of antigen-binding cells (ABC) in neonatal and adult mice rendered tolerant to fluorescein (FL)-labeled heterologous gamma-globulins were studied. Similar numbers of FL-ABC were observed 1 day after tolerogen in both adult and neonatal mouse spleens: by 7 days after tolerization, no FL-ABC were observed in either case. Reinjection with FL-tolerogen at 7 days led to the detection of normal numbers of ABC in adult mice but significantly reduced numbers in neonates. This suggests that neonatal ABC either have been deleted or have failed to resynthesize surface receptors. Two weeks after tolerance induction, spleen cells from these tolerant mice were cultured with Escherichia coli lipopolysaccharide (LPS), a polyclonal B cell mitogen, or with specific antigen. Tolerant adult spleen cells made an equivalent anti-FL response to that of the uninjected controls when stimulated with LPS, but were unresponsive to specific antigenic triggering. In contrast, spleen cells from neonatally tolerized mice were unresponsive to either specific or nonspecific (LPS) stimulation. Thus, these neonatally tolerized spleen cells lose sensitivity to polyclonal-stimulating agents (along with their receptors), or more simply, are deleted.

Aging↗
PubMed1988

Tolerance to intrathecal oxymetazoline-induced analgesia, with paradigm-dependent cross-tolerance to intrathecal morphine.

Male, Sprague-Dawley rats, implanted with intrathecal (i.t.) catheters, were given repeated i.t. injections of morphine (40 nmol), oxymetazoline (100 nmol) or saline (10 microliter) at 12-h intervals for 3 days. Antinociception was determined 1 or 1.5 hr after each injection using the tail-flick and paw-pressure tests. Complete tolerance to i.t. morphine and oxymetazoline developed within 72 and 24 hr, respectively. Antinociception after i.t. oxymetazoline (100 nmol) in morphine-tolerant rats, and after i.t. morphine (20 nmol) in oxymetazoline-tolerant rats, was not significantly different from their respective effects in saline-pretreated rats. These data suggest an absence of cross-tolerance between morphine and oxymetazoline in the rat spinal cord. In a separate group of rats, the continuous i.t. infusion of morphine (26 nmol/hr) produced significant antinociception; tolerance to morphine developed within 36 hr. The antinociceptive effect of i.t. oxymetazoline (100 nmol) was significantly attenuated in rats pretreated with continuous i.t. morphine as compared to saline-pretreated rats. In rats pretreated with continuous i.t. oxymetazoline, cross-tolerance to morphine could not be determined due to severe adverse effects during oxymetazoline infusion. The results of this study suggest that functional cross-tolerance between morphine and alpha adrenoceptor agonists in the spinal cord cannot be excluded on the basis of repeated i.t. injection experiments alone.

Analgesia↗
PubMed1978

Tolerance and cross tolerance to the anorexigenic effect of appetite suppressants in rats.

Rats were treated chronically with various anorexigenic substances which were administered orally once (or twice) daily or bidaily. Complete tolerance to the anorectic effect of d-amphetamine, fenfluramine, benfluorex (780 SE), chlorphentermine, and mazindol developed in 11-17 days. Test doses were given at different points of time after withdrawal in order to recognize the presence or absence of direct or cross tolerance. Direct tolerance to fenfluramine and benfluorex persisted for 46 days, whereas tolerance to mazindol was no longer present at day 20. There was lasting bidirectional cross tolerance between chlorphentermine and fenfluramine, transient bidirectional cross tolerance between mazindol and amphetamine, but only unidirectional cross tolerance between amphetamine and fenfluramine.

Animals↗
PubMed1981

Opioid and non-opioid stress analgesia: assessment of tolerance and cross-tolerance with morphine.

Opioid and non-opioid mechanisms of analgesia elicited by two kinds of footshock stress that differ only in temporal characteristics previously have been inferred on the basis of susceptibility to naloxone blockade. The present study sought further evidence on this point by comparing these two kinds of footshock analgesia for possible tolerance development and cross-tolerance with morphine. It was found that, with repeated exposure to stress, tolerance developed to naloxone-sensitive, but not naloxone-insensitive, stress analgesia. Furthermore, morphine-tolerant rats displayed cross-tolerance to only the naloxone-sensitive form of footshock analgesia. Although prior exposure to both footshock paradigms potentiated morphine analgesia, less potentiation occurred in rats tolerant to the naloxone-sensitive footshock stress. Thus, cross-tolerance between morphine and this type of stress analgesia appears to occur in both directions. These findings are consistent with those using naloxone antagonism as a criterion for opioid mediation and support the conclusion that separate opioid and non-opioid mechanisms of stress analgesia exist.

Analgesia↗
PubMed1998

Reference values for glucose tolerance and glucose tolerance status in cats.

OBJECTIVE: To determine the reference range for glucose tolerance, using a simplified glucose tolerance test (GTT), and to evaluate glucose tolerance status in cats. DESIGN: Prospective study. ANIMALS: 57 clinically normal cats. PROCEDURE: 2 catheters were placed in the cephalic veins of nonsedated cats at least 3 hours before the test. Blood samples were obtained before (0 minutes) and 2, 5, 10, 15, 30, 45, 60, 90, and 120 minutes after glucose (0.5 g/kg [0.23 g/lb] of body weight) was injected i.v. Blood glucose concentration was measured by a glucose meter. Glucose half-life (t1/2) and disappearance of glucose (Kglucose) were calculated. RESULTS: Glucose tolerance in cats was considered normal when upper limits for glucose concentration were < or = 159 mg/dl at 0 minutes, < or = 322 mg/dl at 60 minutes, < or = 238 mg/dl at 90 minutes, or < or = 171 mg/dl at 120 minutes and glucose t1/2 was < or = 94.7 minutes or Kglucose was > or = 0.41%/min. Impaired glucose tolerance in cats was defined as a glucose concentration > or = 160 mg/dl at 0 minutes, > or = 323 mg/dl at 60 minutes, > or = 239 mg/dl at 90 minutes, or > or = 172 mg/dl at 120 minutes. The frequency of impaired glucose tolerance was 2%. Five cats had stress-affected GTT. Significant differences in glucose t1/2 or Kglucose between cats < 7 and > or = 7 years old were not found. CLINICAL IMPLICATIONS: The simplified GTT and measurement of glucose concentration by a glucose meter provides a simple and low-cost method of assessing glucose tolerance status in cats that are normoglycemic after food is withheld. Use of absolute glucose concentrations overcomes the need to calculate glucose t1/2 values. The high glucose concentration at 0 minutes found in this study may reflect a more realistic concentration to use in assessing client-owned cats in a hospital environment.

Aging↗
PubMed2004

Cold tolerance of Littorinidae from southern Africa: intertidal snails are not constrained to freeze tolerance.

All intertidal gastropods for which cold tolerance strategies have been assessed have been shown to be freeze tolerant. Thus, freeze tolerance is considered an adaptation to the intertidal environment. We investigated the cold tolerance strategies of three species of subtropical and temperate snails (Gastropoda: Littorinidae) to determine whether this group is phylogenetically constrained to freeze tolerance. We exposed 'dry' acclimated and 'wet' rehydrated snails to low temperatures to determine temperature of crystallisation (Tc), lower lethal temperature and LT(50) and to examine the relationship between ice formation and mortality. Tc was lowest in dry Afrolittorina knysnaensis (-13.6+/-0.4 degrees C), followed by dry Echinolittorina natalensis (-10.9+/-0.2 degrees C) and wet A. knysnaensis (-10.2+/-0.2 degrees C) . The Tc of both A. knysnaensis and E. natalensis increased with rehydration, whereas Tc of dry and wet Afrolittorina africana did not differ (-9.6+/-0.2 and -9.0+/-0.2 degrees C respectively). Wet snails of all species exhibited no or low survival of inoculative freezing, whereas dry individuals of A. knysnaensis could survive subzero temperatures above -8 degrees C when freezing was inoculated with ice . In the absence of external ice, Afrolittorina knysnaensis employs a freeze-avoidance strategy of cold tolerance, the first time this has been reported for an intertidal snail, indicating that there is no family-level phylogenetic constraint to freeze tolerance. Echinolittorina natalensis and A. africana both showed pre-freeze mortality and survival of some internal ice formation, but were not cold hardy in any strict sense.

Adaptation, Physiological↗
PubMed2005

Anoxia tolerance and freeze tolerance in hatchling turtles.

Freezing survival in hatchling turtles may be limited by ischemic anoxia in frozen tissues and the associated accumulation of lactate and reactive oxygen species (ROS). To determine whether mechanisms for coping with anoxia are also important in freeze tolerance, we examined the association between capacities for freezing survival and anoxia tolerance in hatchlings of seven species of turtles. Tolerance to freezing (-2.5 degrees C) was high in Emydoidea blandingii, Chrysemys picta, Terrapene ornata, and Malaclemys terrapin and low in Graptemys geographica, Chelydra serpentina, and Trachemys scripta. Hatchlings survived in a N(2) atmosphere at 4 degrees C for periods ranging from 17 d (M. terrapin) to 50 d (G. geographica), but survival time was not associated with freeze tolerance. Lactate accumulated during both stresses, but plasma levels in frozen/thawed turtles were well below those found in anoxia-exposed animals. Activity of the antioxidant enzyme catalase in liver increased markedly with anoxia exposure in most species, but increased with freezing/thawing only in species with low freeze tolerance. Our results suggest that whereas oxygen deprivation occurs during somatic freezing, freeze tolerance is not limited by anoxia tolerance in hatchling turtles.

Acclimatization↗
PubMed1994

Effects of sulphur dioxide (SO2) on growth and flowering of SO2-tolerant and non-tolerant genotypes of Phleum pratense.

The objective of this study was to compare the growth and interaction of clipping and sulphur dioxide (SO(2)) exposure on SO(2)-tolerant and non-tolerant genotypes of Phleum pratense at two field sites along an SO(2)-concentration gradient. Sulphur-dioxide-tolerant and non-tolerant genotypes of Phleum pratense were identified from indigenous populations that had been collected along the same SO(2)-concentration gradient in southern Alberta, Canada. Physiological differences between the two genotypes were confirmed by supplying leaves with (14)CO(2) and examining the assimilate partitioning between the genotypes. For the field experiment, clones of each genotype and seedlings grown from commercial seed were planted at two different field sites along an SO(2)-emission gradient. There were no differences in growth between the genotypes at the two field sites after the first year except that the SO(2)-tolerant clones had a greater percentage of root length colonised by vesicular-arbuscular (VA) mycorrhizal fungi. After the second growing season, there was a significant decrease in the number of inflorescences produced by plants exposed to SO(2), particularly by the non-tolerant genotype. The added stress of defoliation appeared to increase the sensitivity of flowering to SO(2), again particularly in the non-tolerant genotype. The results of the field study showed that flowering as opposed to vegetative plant growth was more sensitive to long-term low-concentration SO(2) exposure and that this sensitivity was compounded by the stress interaction of defoliation.

Journal Article↗
PubMed2000

Evolution of ammonia and urea tolerance in Drosophila melanogaster: resistance and cross-tolerance.

We examined whether populations of Drosophila melanogaster could evolve a genetically based tolerance to high levels of toxic compounds (urea or ammonia) added to their larval food medium. We also examined whether tolerance to one compound may impart cross-tolerance to other compounds. Five populations selected for ammonia tolerance (AX), five populations selected for urea tolerance (UX), and five unselected controls (AUC) were assayed for developmental time, viability, and female fertility. These characteristics were measured on each of the 15 populations reared on one of three larval food conditions (plain banana-molasses, 0.35 M NH(4)Cl, or 0.266 M urea). On urea-supplemented media, the urea-selected populations developed fastest and expressed the highest viability; the ammonia-selected populations developed significantly faster and had a higher viability than the controls. Similarly, on ammonia-supplemented media, the ammonia-selected populations developed fastest and expressed the highest viability; the urea-selected populations developed significantly faster and had a higher viability than the controls. This suggests that a cross-tolerance exists for resisting different toxic compounds. Urea-selected females reared on urea-containing food media displayed superior fecundity, without any observable cross-tolerance effect. When all populations were reared on food containing 0.266 M urea, the urea-selected populations had the lowest levels of urea in their tissues. All populations reared on food containing 0.37 M ammonia or 0.266 M urea, contained more ammonia in their tissues than did populations reared on plain food.

Journal Article↗
PubMed1997

In vitro tolerance to anoxia and ischemia in isolated hearts from hypoxia sensitive and hypoxia tolerant turtles.

Although freshwater turtles as a group are highly anoxia tolerant, dramatic interspecific differences in the degree of anoxia tolerance have been demonstrated in vivo. Painted turtles (Chrysemys picta bellii) appear to be the most hypoxia-tolerant species thus far studied, while softshelled turtles (Trionyx spinifer) are the most hypoxia-sensitive. We have assumed that this dichotomy persists in vitro but have not, until now, directly tested this assumption. We therefore, directly compared the responses of isolated, perfused, working hearts from these two species to either 240 min of anoxia, 90 min of global ischemia, or 240 min of global ischemia followed by reoxygenation/reperfusion. Isolated hearts were perfused at 20 degrees C and monitored continuously for phosphocreatine (PCr), adenosine triphosphate (ATP), inorganic phosphate (Pi), and intracellular pH (pHi) by 31P-nuclear magnetic resonance spectroscopy as well as for ventricular developed pressure and heart rate. Contrary to our expectations, we observed few significant differences in any of these parameters between painted and softshelled turtle hearts. Hearts from both species tolerated 240 min of anoxia equally well and both restored PCr, pHi, and Pi contents to control levels during reoxygenation. We did observe some significant interspecific differences in the 90 min (pHi and Pi) and 240 min (PCr) ischemia protocols although these seemed to suggest that Trionyx hearts might be more tolerant to these stresses than Chrysemys hearts. We conclude that: (a) the observed in vivo differences in anoxia tolerance between painted and softshelled turtles must either be due to differences in organ metabolism in organs other than the heart (e.g., brain) or to some integrative physiologic differences between the species; and (b) isolated hearts from a species known to be relatively anoxia sensitive in vivo can exhibit an apparent high degree of anoxia and ischemia tolerance in vitro.

Adenosine Triphosphate↗
PubMed1998

Oxidative stress tolerance and longevity in Arabidopsis: the late-flowering mutant gigantea is tolerant to paraquat.

Recent genetic analyses of longevity in animals have revealed that long-lived strains are more tolerant to environmental stresses. To investigate whether extended longevity in Arabidopsis also correlates with an increase in stress tolerance, the response was tested of 11 late-flowering mutants to the superoxide radical-generating herbicide paraquat. A tight correlation between flowering time and paraquat tolerance was found when plants were exposed to low doses of herbicide. Furthermore, the mutant gigantea (gi-3) with the longest delay in flowering time had a high tolerance level to paraquat-induced oxidative stress. All the tested gi alleles had an increased tolerance to paraquat toxicity compared to wild-type, although the actual levels of tolerance differed. In addition, the gi-3 mutant was more tolerant to hydrogen peroxide. These results suggest that the link between longevity and oxidative stress resistance in plants is similar to that found in animals, implying that this phenomenon may be general for all aerobic organisms.

Alleles↗
PubMed2001

Alcohol tolerance and nicotine cross-tolerance in adolescent mice.

The present experiment was designed to evaluate the development of tolerance to alcohol and cross-tolerance to nicotine in adolescent mice. C57BL/6J mice (30-40 days old) were injected IP with alcohol (2.5 g/kg) for 4 consecutive days. A control group received four saline injections. On the test day, all subjects received an alcohol injection. Tolerance to alcohol's hypothermic effect was observed. Mice (male and female) exposed to alcohol for the 4 previous days showed less hypothermic response to an alcohol challenge than animals injected for 4 days with saline and then challenged with alcohol. Tolerance to alcohol's motor incoordinating effects and differences in blood alcohol concentrations were not observed. Thirty days following alcohol treatment, the same mice received a single nicotine injection (1 mg/kg) to assess cross-tolerance. Nicotine's effect on locomotor activity (open field test) and rectal temperature varied as a function of prior adolescent alcohol exposure and gender. Specifically, female mice who had been exposed to alcohol administrations were more resistant to nicotine's effect on locomotion and temperature than saline-treated animals. In summary, these data demonstrate that adolescent mice develop tolerance to some, but not all, alcohol-induced responses, and that female mice are cross-tolerant to nicotine's effects on temperature and activity.

Journal Article↗
PubMed1998

Molecular and physiological responses to water deficit in drought-tolerant and drought-sensitive lines of sunflower. Accumulation of dehydrin transcripts correlates with tolerance.

To investigate correlations between phenotypic adaptation to water limitation and drought-induced gene expression, we have studied a model system consisting of a drought-tolerant line (R1) and a drought-sensitive line (S1) of sunflowers (Helianthus annuus L.) subjected to progressive drought. R1 tolerance is characterized by the maintenance of shoot cellular turgor. Drought-induced genes (HaElip1, HaDhn1, and HaDhn2) were previously identified in the tolerant line. The accumulation of the corresponding transcripts was compared as a function of soil and leaf water status in R1 and S1 plants during progressive drought. In leaves of R1 plants the accumulation of HaDhn1 and HaDhn2 transcripts, but not HaElip1 transcripts, was correlated with the drought-adaptive response. Drought-induced abscisic acid (ABA) concentration was not associated with the varietal difference in drought tolerance. Stomata of both lines displayed similar sensitivity to ABA. ABA-induced accumulation of HaDhn2 transcripts was higher in the tolerant than in the sensitive genotype. HaDhn1 transcripts were similarly accumulated in the tolerant and in the sensitive plants in response to ABA, suggesting that additional factors involved in drought regulation of HaDhn1 expression might exist in tolerant plants.

Abscisic Acid↗
PubMed2001

A biethnic community survey of cognition in participants with type 2 diabetes, impaired glucose tolerance, and normal glucose tolerance: the New Mexico Elder Health Survey.

OBJECTIVE: To determine whether elderly individuals with type 2 diabetes or impaired glucose tolerance are at increased risk for cognitive impairment compared with individuals with normal glucose tolerance. RESEARCH DESIGN AND METHODS: Elderly Hispanic individuals (n = 414) and non-Hispanic white individuals (n = 469) aged > or =65 years, randomly selected from the Medicare rolls of Bernalillo County (Albuquerque), NM, were recruited for an interview/examination that included an evaluation of glucose tolerance. Information on nine tests of cognitive function and two measures of depression allowed comparisons between diabetic status and these functions. Comparisons also were made between glycosolated hemoglobin concentrations and these cognitive tests in the 188 participants with diabetes. RESULTS: None of the mean scores on the tests of cognitive function was significantly lower in the participants with diabetes compared with those participants with normal glucose tolerance after adjustments for ethnicity, sex, age, level of education, and presence of depression, with or without elimination of those with dementia (Mini-Mental State Exam <18). Interestingly, participants with impaired glucose tolerance tended to score higher than those with normal glucose tolerance. No significant associations were found between glycosolated hemoglobin concentrations and cognitive test scores in participants with diabetes. CONCLUSIONS: We could not show any increased risk for cognitive impairment in participants with diabetes compared with those with normal glucose tolerance after adjustments for ethnicity, sex, age, education, and presence of depression, before or after elimination of dementia in this random sample from a biethnic population of predominantly community-dwelling elders.

Aged↗