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PubMed2001

Low levels of prostate-specific antigen predict long-term risk of prostate cancer: results from the Baltimore Longitudinal Study of Aging.

OBJECTIVES: To evaluate the relationship between low prostate-specific antigen (PSA) levels that are considered normal and the long-term risk of prostate cancer. METHODS: The relative risk of, and cumulative probability of freedom from, prostate cancer by PSA level and age decade was evaluated in male participants of a longitudinal aging study, the Baltimore Longitudinal Study of Aging (National Institute on Aging). The relative risk was estimated from a Cox proportional hazards regression model for men aged 40 to 49.9 (n = 351) and 50 to 59.9 (n = 445). The disease-free probability was determined by Kaplan-Meier survival analysis. RESULTS: The relative risk of prostate cancer for men aged 40 to 49.9 was 3.75 (range 1.6 to 8.6) when the PSA level was at or greater than the median (0.60 ng/mL) compared with men with PSA levels less than the median. This risk was similar for men aged 50 to 59.9 when comparing those with PSA levels greater than and less than the median (0.71 ng/mL). At 25 years, the cumulative probability of freedom from prostate cancer for men aged 40 to 49.9 was 89.6% (range 81% to 97%) and 71.6% (range 60% to 83%) when the PSA level was less than and greater than the median, respectively. The 25-year disease-free probability for men aged 50 to 59.9 was 83.6% (range 76% to 91%) and 58.9% (range 48% to 70%) when the PSA level was less than and greater than the median, respectively. CONCLUSIONS: The association between the baseline serum PSA level and the subsequent risk of prostate cancer suggests that the biologic events that predispose to prostate cancer begin early in middle age. Men who have baseline PSA levels that are "normal" but reflect a higher risk of prostate cancer may be the most appropriate candidates for future prevention trials. Those men with the lowest risk of prostate cancer on the basis of the baseline PSA measurements are unlikely to benefit from frequent PSA surveillance in an effort to detect prostate cancer early.

Adult↗
PubMedDate not supplied

Reliability of the manual dynamic mode of the Baltimore Therapeutic Equipment Work Simulator.

Twelve Baltimore Therapeutic Equipment Work Simulators (BTEWS) were tested for consistency of resistance in the manual dynamic mode using a previously described timed weight-drop test. Fifty weight-drop measurements were made at five different weight levels: 5, 10, 20, 30, and 40 lb. Alterations in weight-drop times indicate changes in exercise-head resistance. Substantial resistance variation was found in the manual dynamic mode. With console resistance set consistently at 92% of applied weight, weight-drop times varied from failures of the weight to drop to times that were not recognized by the electronic timing system. Measurable weight-drop times ranged from 0.75 to 16.97 seconds. Ten Simulators had weight-drop times greater than +/-3 standard deviations (SD) from the mean; eight Simulators had times +/-4 SD from the mean; and four had times +/-5 SD from the mean. Console printout data did not accurately reflect resistance produced by the exercise head. While intermachine correlations based on Simulator printout data ranged from +1.0 to +0.9906, correlations derived from resistance-based weight-drop times ranged from +0.9866 to -0.9956. For a constant externally applied torque, the weight-drop times should have been constant but were not. Resistance produced in the manual dynamic mode is inconsistent, both within and between machines (p = 0.0001).

Evaluation Studies as Topic↗
PubMed1992

The epidemiology of psychiatrist-ascertained depression and DSM-III depressive disorders. Results from the Eastern Baltimore Mental Health Survey Clinical Reappraisal.

Psychiatrists used a semi-structured Standardized Psychiatric Examination method to examine 810 adults drawn from a probability sample of eastern Baltimore residents in 1981. Of the population, 5.9% was found to be significantly depressed. DSM-III major depression (MD) had a prevalence of 1.1% and 'non-major depression' (nMD), our collective term for the other depressive disorder categories in DSM-III, had a prevalence of 3.4%. The two types of depression differed by sex ratio, age-specific prevalence, symptom severity, symptom profiles, and family history of suicide. Analyses using a multiple logistic regression model discerned that both types of depression were influenced by adverse life events, and that nMD was influenced strongly by gender, marital status, and lack of employment outside the home. Neither type of depression was influenced by income, education, or race. This study validates the concept of major depression as a clinical entity. Future studies of the aetiology, mechanism, and treatment of depression should distinguish between these two types of depression.

Adult↗
PubMed2000

Major depression and cancer: the 13-year follow-up of the Baltimore epidemiologic catchment area sample (United States).

OBJECTIVE: The relationship between depression and development of cancer is not well understood, with some studies finding a significant but small increase in risk for cancer among persons with depression. No studies have employed standardized interviews keyed to the diagnostic criteria for Major Depression. Our objective was to evaluate the relationship between Major Depression at baseline and new onset of cancer at follow-up. METHOD: The study was based on a population-based 13-year follow-up survey of community-dwelling adults living in East Baltimore in 1981. After excluding 372 persons with a history of cancer or those whom reported their health as poor at the baseline interview, 3109 adults remained. Information on baseline depression status and cancer at follow-up was available for 2017 persons. A diagnosis of cancer was ascertained at follow-up through interview of survivors and from death certificates. RESULTS: There were 203 new cases of cancer among 2017 persons at risk. Neither Major Depression (relative risk (RR) = 1.0, 95% confidence interval (CI) 0.5-2.1) nor dysphoric episode (RR = 1.3, 95% CI 0.9-1.9) were significantly associated with increased risk of cancer at follow-up. However, among women with Major Depression, the risk of breast cancer was increased (adjusted RR = 3.8, 95% CI 1.0-14.2). CONCLUSIONS: We found no overall association of depression with cancer. However, among women, Major Depression (but not dysphoric episode alone) was associated with the onset of breast cancer.

Adolescent↗
PubMed1998

An association between an aggrecan polymorphic allele and bilateral hand osteoarthritis in elderly white men: data from the Baltimore Longitudinal Study of Aging (BLSA).

OBJECTIVE: The aggrecan proteoglycan is a major component of articular cartilage and supports the biomechanical function of this tissue. A variable number tandem repeat (VNTR) polymorphism has been discovered recently in a region of the human aggrecan gene that codes for the chondroitin sulfate attachment sites. We examined whether alleles of this polymorphism displayed a non-random association with bilateral hand or knee osteoarthritis (OA) in men from the Baltimore Longitudinal Study of Aging (BLSA). DESIGN: DNA was obtained from 93 Caucasian men, aged 60 and above, who had bilateral hand and standing knee radiographs read for changes of OA. The DNA was analyzed by polymerase chain reaction (PCR) and/or Southern blotting for the presence of the VNTR alleles. RESULTS: Bilateral hand OA and knee OA were present in 46 and 30% of the men respectively. The following distribution of alleles was observed: allele 33 (0.5%), 29 (2.2%), 28 (31.7%), 27 (43.0%), 26 (16.7%), 25 (3.2%), 22 (2.2%) and 19 (0.5%). This distribution was similar to that detected in a random population of individuals from a separate study. In multiple logistic regression analysis, adjusting for age and body mass index, the presence of allele 27 was associated with bilateral hand OA with an odds ratio (OR) = 3.23 (95% confidence intervals (CI): 1.24-8.41). No other alleles showed an association with bilateral hand OA and the association between allele 27 and bilateral knee OA was not statistically significant (OR = 1.14; 95% CI: 0.45-2.88). CONCLUSIONS: These data demonstrate the first association between a human aggrecan gene polymorphic allele and hand OA. This finding supports the concept that genetic factors may play a role in the development and/or progression of some forms of age-onset OA.

Aged↗
PubMed2000

Hourly personal exposures to fine particles and gaseous pollutants--results from Baltimore, Maryland.

A study to characterize 1-hr multi-pollutant exposures was performed in Baltimore, MD, during the summer of 1998 and the winter of 1999, and was conducted over a 15-day period in each of the two seasons. Personal exposures were measured by a trained field technician, who wore a newly developed Roll-Around System (RAS) to measure 1-hr PM2.5 and gaseous (CO, O3, NO2, SO2, volatile organic compounds [VOCs]) exposures. One-hour O3, NO2, and SO2 personal exposures were measured using samplers developed in our laboratory, while short-term PM2.5, CO, and VOCs exposures were measured using currently available monitors. All 1-hr multi-pollutant exposures were measured while the technician performed pre-determined activities, beginning at 7:00 a.m. and ending at 7:00 p.m. of the same day. Activities were scripted to simulate activities performed by older adults (65+ years of age). Corresponding 1-hr ambient pollutant concentrations were obtained from federal or state monitoring networks. In this paper, we discuss the results from our study and present our descriptive analysis of the 1-hr personal particulate and gaseous exposure data. Personal PM2.5, O3, CO, and VOCs exposures showed substantial variability over the 12-hr sampling periods. Multiple pairwise comparison tests showed that 1-hr personal O3 exposures were significantly lower in indoor microenvironments as compared with outdoor microenvironments. One-hour personal CO exposures measured in vehicles were significantly higher than those measured in other microenvironments. The associations between 1-hr personal exposures and corresponding ambient concentrations differed by pollutant and by microenvironment. For example, the correlation between personal PM2.5 exposures and ambient concentrations was lowest (rs = 0.36, p < 0.05) in the winter for indoor non-residential microenvironments, and was highest (rs = 0.90, p < 0.05) in the winter for in-vehicle microenvironments. For O3, the correlation between personal exposures and ambient levels was weakest in the winter for residential microenvironments (rs = 0.05, p > 0.05), and was strongest in the summer for outdoor near-roadway microenvironments (rs = 0.91, p < 0.05).

Activities of Daily Living↗
PubMed2005

The first case of Hb E-Saskatoon associated with Hb Lepore-Baltimore found in Spain.

Hb E-Saskatoon [beta22(B4)Glu-->Lys] does not cause any clinical symptoms in the heterozygous state. The homozygous state shows moderate phenotype expression. It has also been detected in association with beta-thalassemia. We present the first case of Hb E-Saskatoon associated with Hb Lepore-Baltimore. This unusual combination of mutations does not aggravate the clinical picture, as only microcytosis and hypochromia have been observed. Hb E-Saskatoon can only be correctly characterized by ion exchange high performance liquid chromatography (HPLC) or by DNA sequencing.

Adult↗
PubMed2002

Distribution of penicillin-nonsusceptible pneumococcal clones in the Baltimore metropolitan area and variables associated with drug resistance.

We assessed the distribution of the clonal groups (as determined by pulsed-field gel electrophoresis) of penicillin-nonsusceptible Streptococcus pneumoniae that caused invasive pneumococcal infection in the Baltimore metropolitan area during 1995 and 1996. Although S. pneumoniae caused invasive disease in individuals from a variety of demographic groups and locations, strains isolated during the season in which respiratory infections are most common were more likely to be from clonal groups associated with penicillin resistance than from other groups.

Adolescent↗
PubMed1994

Vitamin A and E intakes and plasma concentrations of retinol, beta-carotene, and alpha-tocopherol in men and women of the Baltimore Longitudinal Study of Aging.

Antioxidants have been linked to protection against degenerative diseases associated with aging. Plasma concentrations were determined for and 7-d diet records collected from 200 women and 231 men aged 20-95 y who took part in the Baltimore Longitudinal Study of Aging. Men consumed more vitamin A from animal and less from vegetable sources than did women. These sex differences are reflected in plasma concentrations of retinol and beta-carotene. About 20% of subjects had vitamin A intakes less than recommended dietary allowances; however, no men and only two women had marginal plasma retinol (< 0.35 mumol/L) concentrations. Older people had higher plasma alpha-tocopherol, which correlated with total intake. Forty-two men and 35 women had plasma alpha-tocopherol concentrations that were considered marginal. Sex differences in sources of dietary and plasma vitamin A may have consequences in relation to aging and longevity. Apparent marginal intakes and plasma concentrations of vitamin E need to be further examined to determine effects on health status.

Adult↗
PubMed2003

Longitudinal evaluation of an educational intervention for preventing tick bites in an area with endemic lyme disease in Baltimore County, Maryland.

The authors attempted to determine whether a targeted educational intervention in an area with endemic Lyme disease could increase knowledge, positive attitudes, and reported behaviors related to tick bite prevention and consequently decrease tick bites, as measured by a biomarker of tick bites. Between April and September of 1999, 317 subjects in Baltimore County, Maryland, were randomized to receive either tick-related or general health-related educational materials bimonthly through the mail. At each of three clinic visits, participants completed a self-administered questionnaire and provided a serum sample. Anti-recombinant tick calreticulin antibody (ARTCA), measured in ng/ micro l, was used as a biomarker of tick bites. Linear and logistic regression analyses were used to determine 1) whether the educational intervention was associated with a change in knowledge, attitudes, and behaviors (KAB) and 2) whether change in KAB predicted change in ARTCA levels. Proportions of desired responses increased significantly among intervention subjects versus the comparison group on KAB measures related to examining the body for ticks and insect repellent use. Levels of ARTCA were low among all study subjects. Only six of 37 models exhibited a significant relation between change in a KAB variable and change in ARTCA levels over time. The behavioral intervention was associated with an increase in the KAB measures in the intervention group, but this change was not associated with change in ARTCA levels.

Adolescent↗
PubMed2002

Relationship between in vivo age and in vitro aging: assessment of 669 cell cultures derived from members of the Baltimore Longitudinal Study of Aging.

We examined the in vitro proliferative potential of 669 cell cultures established from skin biopsies of members of the Baltimore Longitudinal Study of Aging. The colony size distribution was used to estimate the proliferative life span of the cultures. A significant decline in proliferative potential with donor age was observed for female but not male donors. For both male and female donors, the proliferative potential was significantly greater for donors under the age of 30 years compared with all donors over the age of 30 years. In an attempt to reduce genetic heterogeneity, we examined the proliferative potential of cultures derived at different ages from the same donor. These studies revealed a trend (approaching statistical significance) toward low proliferative potential as donors aged. Interestingly, samples obtained from donors who had a history of skin cancer at the time of biopsy had a significantly lower doubling potential than those from donors who did not. The implications of these results for the use of cells derived from donors of different ages for aging research are discussed.

Adult↗
PubMed2006

Longitudinal trajectories in Guilford-Zimmerman temperament survey data: results from the Baltimore longitudinal study of aging.

We examined developmental trends in personality traits over a 42-year time period by using data from the Baltimore Longitudinal Study on Aging (N = 2,359; individuals aged 17-98), collected from 1958 to 2002. Hierarchical linear modeling analyses revealed cumulative mean-level changes averaging about 0.5 SD across adulthood. Scales related to extraversion showed distinct developmental patterns: General Activity declined from age 60 to 90; Restraint increased; Ascendance peaked around age 60; and Sociability declined slightly. Scales related to neuroticism showed curvilinear declines up to age 70 and increases thereafter. Scales related to agreeableness and openness changed little; Masculinity declined linearly. We found significant individual variability in change. Although intercepts differed, trajectories were similar for men and women. Attrition and death had no effect on slopes. This study highlights the use of lower order traits in providing a more nuanced picture of developmental change.

Adult↗
PubMed1988

Fiber intake, age, and other coronary risk factors in men of the Baltimore Longitudinal Study (1959-1975).

Fiber intake was estimated by 7-day diet record in community-dwelling men of the Baltimore Longitudinal Study of Aging. The mean intake of 845 men (age 20-103) was 3.82 +/- 0.03 g crude fiber/day which corresponds to approximately 15 g/day of dietary fiber. Fiber intake increased across the age span (slope = +0.022 +/- 0.003 g/yr, p less than .01). Longitudinal analysis of 380 men, each of whom provided 3-8 diet records over an average period of 8 yr, indicated that the increase in fiber intake occurred in each age group and was not the result of differential survival. Fiber intake was negatively correlated with body mass index. After clinical screening to eliminate variables which could independently influence coronary risk factors, multiple regression analyses including age and body mass index were conducted to examine the effect of fiber (adjusted for total calorie intake) on blood pressure, blood lipids, and glucose tolerance. For systolic and diastolic blood pressure, triglyceride, and fasting plasma glucose, higher fiber intake was associated with lower levels of the risk factors (p less than .05).

Adult↗
PubMed2005

Alpha-synuclein lesions in normal aging, Parkinson disease, and Alzheimer disease: evidence from the Baltimore Longitudinal Study of Aging (BLSA).

Alpha-synuclein (alpha-synuclein) lesions are characteristic of idiopathic Parkinson disease (PD) and other alpha-synucleinopathies. To study the frequency of alpha-synuclein lesions in normal aging and how frequently they coexist with lesions of Alzheimer disease (AD), we examined the autopsy brains from normal and demented subjects in the Baltimore Longitudinal Study of Aging (BLSA) (n = 117). We found that the overall frequency of alpha-synuclein lesions was 25%, with 100% in 7 cases of PD, 31.5% in 56 cases with AD lesions, and 8.3% among 36 older control brains. Among brains with AD lesions, the frequency of alpha-synuclein pathology was higher in those with higher scores for neuritic plaques, but not in those with higher scores for neurofibrillary tangles. Our observations indicate that alpha-synuclein lesions are uncommon in aged control subjects. Finally, the coexistence of Abeta amyloid and alpha-synuclein pathology in AD brains suggests that the pathogenic mechanism/s leading to the accumulation of Abeta and alpha-synuclein may be similar.

Aged↗
PubMed1985

Congenital heart disease: prevalence at livebirth. The Baltimore-Washington Infant Study.

The Baltimore-Washington Infant Study is a regional epidemiologic study of congenital heart disease. Among Infants born in the study area in 1981 and 1982, 664 had a diagnosis of congenital heart disease confirmed in the first year of life by echocardiography, cardiac catheterization, cardiac surgery, or autopsy. The prevalence rate was 3.7/1,000 livebirths for all cases and 2.4/1,000 livebirths for cases confirmed by invasive methods only. Diagnosis-specific prevalence rates of congenital heart disease are compared with those of eight previous case series. Changing diagnostic categorizations in the time span covered and methodological differences resulted in great variation of the data. However, the data of the New England Infant Cardiac Program which used the same case discovery methods showed similar occurrences of major morphologic abnormalities, suggesting that these are stable basic estimates in the eastern United States. For all case series, the rate of confirmed congenital heart disease was approximately 4/1,000 livebirths over the 40-year time span.

Cardiac Catheterization↗
PubMed1987

Epizootiology of Hantavirus infections in Baltimore: isolation of a virus from Norway rats, and characteristics of infected rat populations.

Rats trapped from 14 locations in Baltimore, Maryland, were shown to have antibody to Hantavirus. Antibody prevalence rates were higher in residential locations than in parks. Infected rats were obtained continuously over a six-year period from 1980-1985 at five locations, indicating the enzootic nature of this infection in urban rats in the United States. Prevalence of antibody and geometric mean titers increased with rat mass and sexual maturity, suggesting that infections in rats are acquired through age-related mechanisms. Three isolates of Hantavirus were obtained from rats. One of these isolates was shown by serologic tests and monoclonal antibody reactivity patterns to be similar, if not identical, to rat virus previously obtained from Philadelphia. The presence of rats in many urban settings and the high prevalence of Hantavirus infection in this species suggest that human exposure to this virus is occurring in the United States, although human disease from this exposure has not been recognized.

Animals↗
PubMed1979

The public's view of physicians' assistants and nurse practitioners: a survey of Baltimore urban residents.

This study of public attitudes toward physicians' assistants and nurse practitioners finds that the public regards the two groups of health workers as remarkably similar. A telephone survey of 2,583 households in the Baltimore, Maryland, metropolitan area indicates that about half the population have heard of a PA or NP, though only 4 per cent report receiving care from such workers. In this urban sample, respondents accepted the principle that important medical care functions can be delegated, as long as the PA or NP is considered assistant to the physician. The public reported more acceptance of tasks performed by nurse practitioners than by physicians' assistants, though the differences are small.

Attitude↗
PubMed1997

Reductions in high-risk drug use behaviors among participants in the Baltimore needle exchange program.

OBJECTIVE: To determine whether enrollment in the Baltimore Needle Exchange Program (NEP) was associated with short-term reduction in risky injection practices. METHODS: Demographic information was collected on NEP participants upon enrollment. A systematic sample of enrollees was interviewed at program entry, 2 weeks, and 6 months later on recent drug-related behaviors. Comparisons were performed using paired t-tests. RESULTS: Among 221 NEP participants who completed baseline, 2-week and 6-month follow-up visits, significant reductions (p < .01) were reported in using a previously used syringe (21.6%, 11.0%, 7.8%, respectively), lending one's used syringe to a friend (26.7%, 18.4%, 12%, respectively), and several indirect sharing activities. Reductions were reported in the mean number of injections per syringe and the mean number of injections per day (p < .001). CONCLUSIONS: These results show rapid and mostly large reductions in a variety of risky injection drug use behaviors. Study findings are consistent with earlier reports showing an association between behavioral risk reduction and participation in a needle exchange program.

Adult↗