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PubMedDate not supplied

Spousal caregivers of dementia victims: longitudinal changes in immunity and health.

Providing long-term care for a demented relative profoundly affects caregivers' lives. We assessed changes in depression, immune function, and health in 69 spousal caregivers who had already been caregiving for an average of five years and 69 sociodemographically matched control subjects. Between the initial sample ("intake") and the follow-up data collected an average of 13 months later, caregivers showed decrements relative to controls on three measures of cellular immunity. Caregivers also reported significantly more days of infectious illness, primarily upper respiratory tract infections. Caregivers had a much greater incidence of depressive disorders than controls, with 25% of caregivers meeting syndromal criteria at intake and 32% at follow-up, compared with no cases among controls at intake and 6% at follow-up. Caregivers who reported lower levels of social support at intake and who were most distressed by dementia-related behaviors showed the greatest and most uniformly negative changes in immune function at follow-up.

Adaptation, Psychological↗
PubMed1987

Longitudinal changes in allergen skin test reactivity in a community population sample.

A cohort of 1333 subjects, aged 3 years and older, was followed for a mean of 8.1 years to assess changes in allergen skin test reactivity. The overall prevalence of reactivity to the five antigen mixtures was 39.1% during the initial survey and 50.7% after the follow-up period. The greatest increase in prevalence occurred among children and teenagers (22.2% and 19.5%) with only minimal increases after the age of 65 years (6.0%). No difference in prevalence between male and female subjects was apparent, either initially or at the end of the follow-up period. In-migration to the Tucson area was a major factor in determining changes in reaction prevalence. Among subjects more than 35 years of age, recent in-migrants accounted for most of the increased prevalence. Comparisons of atopy among consistent smoking groups confirmed the previous observation that smokers are less atopic than either nonsmokers or exsmokers, probably because of a self-selection process. In contrast, exsmokers were generally the most atopic, both initially and at the end of the longitudinal observation period. The high overall prevalence of allergen reactivity in this population is believed to be due in large measure to high year-round concentrations of multiple aeroallergens in the Tucson environment.

Adult↗
PubMedDate not supplied

Longitudinal changes in cognitive function and regional cerebral function in Alzheimer's disease: a SPECT blood flow study.

In Alzheimer's disease (AD), SPECT imagining of regional cerebral blood flow (rCBF) has emphasized deficits in the posterior association cortex. Previous studies have shown an association between these deficits and cognitive performance, both on overall cognitive tests and more specific tests such as praxis and language. Frontal deficits have been reported in more severe patients. This has led to the conclusion that the deficit in AD, at least with functional neuroimaging, starts in the posterior association cortex, and later in the disease process "spreads" to involve the frontal cortex. This study set out to measure, in a group of AD patients, the change over time of cognitive performance and the pattern of functional deficit measured by neuroimaging. Change in function was measured using 99TCm-HMPAO and SPECT and change in cognitive function using the CAMCOG. Two time points were used, 0 and 2 years. Twenty-four patients satisfying the DSM-III R criteria for probable AD were studied, nine of whom were subsequently diagnosed as having AD at post-mortem. The most striking finding was the effect that decreases in frontal lobe function had on cognitive function. A similar study by the same group, using the same techniques and many of the same patients but at only one time point, showed a correlation between cognitive function and rCBF in the parietal and posterior temporal lobes. This suggests that as AD patients deteriorate from unaffected to mild or moderately affected, the posterior association cortex exerts the greatest effect on cognitive deficit. In this longitudinal study, we found, using a MANOVA, that there were significant decreases over time for all the cortical regions studied, but that no region decreased significantly more than any other. In addition we found a correlation between change in frontal rCBF and change in cognitive function (both overall cognitive function and the CAMCOG sub tests of language and praxis). These data suggest, in contrast to the previous study, that as the disease progresses from mild or moderate to moderate or severe, the frontal cortex exerts the greatest effect on cognitive decline. These data support the concept of the deficit in functional imaging spreading from posterior to anterior as the disease progresses. However, both the initial pattern of deficit and the change over time were very heterogeneous when examined qualitatively. A posterior to anterior spread is the predominant pattern for the group as a whole, but individual patients, and possibly groups of patients, may well show alternative patterns.

Aged↗
PubMed1987

Longitudinal changes in left ventricular architecture and function in peripartum cardiomyopathy.

Left ventricular (LV) function was quantitated in 14 patients with peripartum cardiomyopathy, in 10 using 2-dimensional (2-D) echocardiography and in 4 radionuclide ventriculography, and values were compared with those in 11 normal women in the immediate postpartum period. LV end-diastolic and end-systolic volume indexes, LV wall mass index and ejection fraction were calculated during the acute phase of the illness and serially through long-term follow-up (mean 24 months). During the acute phase of illness there was marked LV dilatation: mean end-diastolic volume index was 95 +/- 22 ml/m2, vs 67 +/- 9 ml/m2 in control subjects (p less than 0.005), and mean end-systolic volume index was 66 +/- 18 ml/m2, compared to 27 +/- 5 ml/m2 in control subjects (p less than 0.001). Mean heart rates and mean systolic pressures in the patients with peripartum cardiomyopathy and the control subjects were similar, 91 +/- 24 vs 79 +/- 14 beats/min and 120 +/- 14 vs 117 +/- 10 mm Hg, respectively. LV wall mass index was higher, 139 +/- 38 vs 96 +/- 8 g/m2 (p less than 0.005), and ejection fraction much lower, 29 +/- 5% vs 67 +/- 5% (p less than 0.001), in control subjects. Five patients underwent endomyocardial biopsy during the acute illness, which showed interstitial fibrosis but no evidence of active inflammation. There was rapid and early improvement in LV function in 13 of 14 patients. Changes in LV volume, mass and ejection fraction all followed an exponential time course during LV remodeling.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Longitudinal changes in serum fructosamine do not parallel those in glycated haemoglobin in young adults with insulin-dependent diabetes.

In 93 adolescent and young adult patients with type 1 diabetes (163 paired comparisons) changes in fructosamine concentration correlated poorly with changes in HbA1 (r = 0.53); this correlation was no better if fructosamine values were adjusted for serum albumin by calculating a fructosamine/albumin index, F.A.I. (155 pairs, r = 0.50). These correlation coefficients were lower than those for cross-sectional comparisons (HbA1 vs. fructosamine, r = 0.74; HbA1 vs. F.A.I., r = 0.80). One-way analysis of variance showed that values of HbA1, fructosamine and F.A.I. all tended to increase as glycaemic control, judged by the clinician, worsened (P less than 0.001). HbA1 correlated better with clinical assessment than did either uncorrected fructosamine or F.A.I. We conclude that changes in fructosamine from one clinic visit to the next do not provide a basis for changing therapy. Clinical assessments tend to agree with values for HbA1, which may be more reliable than fructosamine because of its longer biological half life.

Adolescent↗
PubMed2005

Aging and longitudinal change in perceptual-motor skill acquisition in healthy adults.

Knowledge about aging of perceptual-motor skills is based almost exclusively on cross-sectional studies. We examined age-related changes in the retention of mirror-tracing skills in healthy adults who practiced for 3 separate days at baseline and retrained 5 years later at follow-up. Overall, the speed and accuracy of an acquired skill were partially retained after a 5-year interim, although the same asymptote was reached. Analyses with individual learning curves indicated that the effects of age on mirror-tracing speed were greater at longitudinal follow-up than at baseline, with older adults requiring more training to reach asymptote. Thus, although the long-term retention of acquired skills declines with age, older adults still retain the ability to learn the skill. Moreover, those who maintained a processing speed comparable with that of the younger participants evidenced no age-related performance decrements on the mirror-drawing task.

Adult↗
PubMed1995

Longitudinal changes in the diameter of the ductus arteriosus in ventilated preterm infants: correlation with respiratory outcomes.

This study aimed to examine the early natural history of ductal shunting in ventilated preterm infants (< 1500 g) and to document the association between this shunting and respiratory outcomes. The size of the ductal shunt was assessed in 48 infants using serial echocardiographic measurement of colour Doppler internal ductal diameter and pulsed Doppler postductal aortic diastolic flow (PADF). At all postnatal ages, normal antegrade PADF was invariably seen when the ductal diameter was 1.5 mm or less, and was usually abnormal (absent or retrograde) when more than 1.5 mm. Longitudinal progress of ductal diameter fell into three groups: (i) asymptomatic spontaneous closure (n = 31)--in 20 of these infants closure occurred within 48 hours; (ii) symptomatic PDA which enlarged after a postnatal constriction (n = 9); and (iii) symptomatic PDA that showed minimal postnatal constriction (n = 8). Infants in group 2 were significantly less mature and had PDAs which became symptomatic significantly later than those in group 3. Logistic regression showed that ductal shunting had a significant correlation with mean oxygenation index over the first five days but not with ventilator or oxygen days. Gestation had the most significant association with the latter two variables, with atrial shunting also being related to days in oxygen. The preterm duct displays a wide spectrum of postnatal constrictive activity. Symptomatic PDAs usually showed slower early postnatal constriction. Ductal shunting independently related to short term but not long term respiratory outcomes.

Diastole↗
PubMed1990

[Relation between articulatory function and prosthesis. I-1. Longitudinal changing aspects in the duration of speech sound, muscular discharge of facial muscle and tongue pressure before pronunciation caused by the experimental palatal plate].

The author noticed the relation between articulatory functions and the prosthesis. For the purpose of clarifying the influence of the insertion of denture on the duration of speech sound and the articulatory functions before pronunciation and on the self-compensation of these organs. The experimental palatal plates were inserted on 13 subjects with natural dentition, assuming that they were inserted with complete denture, and the duration of speech sound, muscular discharge of facial muscle and tongue pressure before pronunciation were evaluated longitudinally with the pre-insertion of palatal plate as basis. As the result of this study, the following conclusions were obtained. The results of this study suggest that speech sound, lips and tongue being important organs as the articulators are placed under strong influence before pronunciation by insertion of the denture, whereas on the self-compensation of the articulators before pronunciation differed according to the point of articulation and the manner of articulation of each speech sound. Therefore, it was necessary to take care on the relation between the shape of palatal plate and the articulatory functions of lips and tongue in the clinical prosthodontics.

Articulation Disorders↗
PubMed1999

Longitudinal changes of bone density and bone resorption in hyperthyroid girls during treatment.

Low bone mineral density (BMD) and increased bone turnover are common features of untreated hyperthyroidism in adult patients. The effect of treatment on BMD is still controversial. BMD and bone metabolism in hyperthyroid children have not been thoroughly investigated. In the present study, we measured spinal and whole body BMD by dual-energy X-ray absorptiometry in a group of 13 girls (aged 5.0-14.9 years) at diagnosis of hyperthyroidism. The bone resorption rate was assessed by urine measurement of N-terminal telopeptide of type I collagen (NTX). Hyperthyroid patients have been studied longitudinally during treatment. BMD values and NTX urine concentrations have been also determined in 155 healthy Caucasian girls (aged 2.4-24.2 years). Spinal and whole body bone density measurements were significantly lower compared with healthy controls in untreated hyperthyroid girls, after correction for differences in age and anthropometric measurements (p </= 0.033). Bone density measurements obtained after 12 and 24 months of treatment were no longer different from those of healthy girls. NTX urine levels at diagnosis of thyrotoxicosis were significantly higher than those found in healthy controls (p < 0.0001); 6 months after treatment, the urine levels did not show significant differences, and they remained stable after 12 and 24 months of therapy. Inverse correlations at diagnosis were found between serum-free thyroxine (FT4) serum levels and spinal (r = -0.42) and whole body bone density (r = -0.41); FT4 and free triiodothyronine serum levels directly correlated with the NTX concentration (r = 0. 77, and r = 0.71, respectively). In conclusion, the results of the present study demonstrate that low bone density values and high bone resorption rates are found in hyperthyroid children and adolescents at diagnosis of the disease. Our data also demonstrate that antithyroid treatment is able to reduce dramatically the bone resorption and to increase significantly both spinal and total body BMD, granting physiologic conditions for the achievement of the best obtainable peak bone mass.

Adolescent↗
PubMed2000

Longitudinal changes in body composition, physical capacities and energy expenditure in boys and girls during the onset of puberty.

BACKGROUND: The onset of puberty is a period of rapid anatomical and physiological alterations expected to induce changes in metabolic rate and energy requirements of children. AIM OF THE STUDY: To evaluate the changes in anthropometrical features, body composition, physical capacities, and energy expenditure (EE) of boys and girls during the period of onset of puberty. METHODS: Sixteen children (8 boys and 8 girls were recruited in the same school-class and studied both at 10.4 and 12.8 years of age. Body composition was assessed by bioimpedance analysis. Peak oxygen uptake (peak VO2) was measured using an automated on-line system during exercising on a cycle ergometer. Energy expenditure (EE) was determined by whole-body indirect calorimetry over a 24-h period after a 12-h period of adaptation to the calorimeters. Volunteers followed the same activity programme that included four 15-min periods of exercise. RESULTS: During the onset of puberty, boys and girls gained 4.7 +/- 2.1 kg x y(-1) (P < 0.0003) fat-free mass (FFM), whereas fat mass gain was 1.0 +/- 1.2 kg x y(-1) (P < 0.05) in girls and 0.20 +/- 0.66 kg x y(-1) in boys (NS). Peak VO2 adjusted for differences in FFM was not significantly affected by gender or pubertal stage. However, adjusted external mechanical power performed at peak VO2 was higher in pubertal than in prepubertal children, by 40% (P < 0.0001) and 22% (P < 0.003) in boys and girls, respectively. It was also 17% (P < 0.0002) higher in pubertal boys than in pubertal girls. Daily and sleeping EE increased by 38% and 32% in boys and girls, respectively, during the 2.4-y period (P< 0.0001). Adjusted EEs were also significantly higher in pubertal than in prepubertal boys (P< 0.05 and P< 0.003), but not in girls. The main significant determinants of daily EE were FFM (r2 = 0.866, P < 0.0001), peak VO2 (r2 = 0.017, P < 0.04), and age (r2 = 0.014, P < 0.05). Tanner's stage was an additional determinant of sleeping EE (r2 = 0.025, P < 0.006). CONCLUSIONS: The increases in physical capacities and EE during the onset of puberty indicated clear gender differences, which could be explained mainly by alterations of body composition in boys and girls, and by changes in hormonal status in boys. They also stressed the significant increase in energy requirements of children, especially boys, at an early stage of puberty.

Adipose Tissue↗
PubMed1997

Longitudinal changes in body composition measured with a variety of methods in patients with AIDS.

We test the hypothesis that human immunodeficiency virus (HIV)-related weight loss is accompanied by inappropriately large losses of fat-free mass (FFM). Our secondary aims were to examine whether FFM increases during weight gain and to compare several techniques for measuring FFM change. FFM was measured at intervals averaging 5 months in 21 AIDS patients by means of skinfold thickness (SF), dual-energy x-ray absorptiometry (DEXA), total body water (TBW), and bioelectrical impedance using the equation of the manufacturer of the equipment (BIA(EZComp)) and a published prediction equation (BIA(Segal)). The FFM content of weight loss was similar for SF (57%), DEXA (60%), TBW (55%) and BIA(EZComp) (65%), but the result from BIA(Segal) (78%) was higher. The results were close to predicted starvation values apart from the results with BIA(Segal), which were significantly higher than predicted values. Weight gain was also composed of a large proportion of FFM. There were large intermethod differences in measurements of absolute FFM, but for measuring changes in FFM, the bias between SF, DEXA, and TBW was minimal. The results of BIA vary with the prediction equation used. In this group of patients with the acquired immune deficiency syndrome (AIDS), weight loss was composed of a large proportion of FFM, but in general this is compatible with undernutrition as the underlying cause and does not support the hypothesis of excessive FFM catabolism in HIV disease. SF, DEXA, TBW, and BIA(Segal) show reasonable agreement for measuring body composition changes. This information should be considered in the design of future intervention studies for HIV-related wasting.

Absorptiometry, Photon↗
PubMed1998

Longitudinal changes in college students' exercise participation.

A 4-page questionnaire was mailed to 708 randomly selected 1st-year university students to assess changes in the students' exercise behavior from the 1st year of college to the 2nd year. The questionnaire assessed student demographics and participation in vigorous and moderate exercise over the preceding 7 days. Three hundred thirty-two students responded. A year later, a similar questionnaire was mailed to the same 332 students; responses were obtained from 242 students. Although no changes in reported exercise participation were found in the group as a whole, subgroups of students who either increased or decreased exercise participation were identified. Implications for exercise intervention programs among college students are presented.

Adolescent↗
PubMed2002

Longitudinal changes in mandibular bone mineral density compared with hip bone mineral density and quantitative ultrasound at calcaneus and hand phalanges.

The aim of this prospective study was to evaluate changes in bone mineral density (BMD) of the mandible (m-BMD) compared with hip BMD and ultrasound parameters of the calcaneus and hand phalanges over 28 months. The study group consisted of 18 post-menopausal edentulous women with no reasons known to affect bone metabolism, such as disease or medication. Each woman had undergone natural menopause. No previous fractures were noted. Measurements were performed at baseline and repeated after 28 months. Bone status was assessed by measuring BMD using dual energy X-ray absorptiometry (DXA) at the mandible and hip and by measuring speed of sound (SOS), broadband ultrasound attenuation (BUA), stiffness index (SI) and amplitude-dependent SOS (Ad-SOS) using quantitative ultrasound at the calcaneus and phalanges of the hand. The coefficient of variation for mandibular measurements was 2.06%. BMD of the mandible, femoral neck and Ward's triangle decreased significantly (-7.54%, -1.2%, -1.97% per year, respectively, p<0.05), whilst BUA, SI and Ad-SOS decreased, but not significantly (-1.1%, -0.47%, -0.08% per year, respectively). Both SOS and BMD of the trochanter had almost the same value without significant differences. The least significant change (LSC), denoting the minimum difference between two successive results in an individual that can be considered to reflect a real change, was calculated. With the exception of changes in m-BMD, no significant changes were observed at any of the sites for the majority of the women (39-89%). 67% of women had a decrease in m-BMD greater than the LSC and 22% had an increase in m-BMD greater than the LSC. Apart from the mandible, other sites showing a large percentage of women with a decrease in BMD greater than the LSC were the Ward's triangle (39%) and the femoral neck (28%). In conclusion, a 28-month longitudinal study of post-menopausal women revealed mandibular bone loss assessed by DXA to be much higher than in other skeletal sites.

Absorptiometry, Photon↗
PubMed2004

Longitudinal change in peritoneal membrane function with continuous ambulatory peritoneal dialysis (CAPD) after peritonitis episodes.

BACKGROUND: To assess changes in the peritoneal membrane after peritonitis episodes in patients undergoing continuous ambulatory peritoneal dialysis (CAPD). METHODS: From 1989 to 2002, CAPD patients who had peritonitis episodes were enrolled. We used the peritoneal equilibration test (PET) and measured plasma creatinine (Cr) levels at 2 hours, and dialysate Cr and glucose levels at 0, 2, and 4 hours. In addition, the dialysate-to-plasma ratio of Cr (D/PCr) at 0, 2, and 4 hours, the ratio of glucose levels in the dialysate effluent and infused dialysate ((D/D0)G), the drained ultrafiltration (UF) volume at 4 hours, and the mass transfer area coefficient of Cr (MTAC) normalized for the body surface area were also calculated. D/PCr, (D/D0)G, UF volume, and MTAC were measured at the baseline and after 2 years, and the results were analyzed and compared. RESULTS: Totally 27 patients were enrolled in the peritonitis group, including 17 males and 10 females. They had received CAPD for 71.23 +/- 28.13 months. Forty-nine peritonitis episodes were noted during the study period. Twenty-four patients were enrolled as controls, including 9 males and 15 females. They had undergone CAPD for 55.83 +/- 25.94 months. The baseline and 2-year levels of D/PCr (0.66 +/- 0.11 vs. 0.62 +/- 0.10, p<0.05), (D/D0)G (0.37 +/- 8.45 vs. 0.43 +/- 7.71, p<0.05), and MTAC (9.36 +/- 3.53 vs. 8.08 +/- 3.41, p<0.05) showed significant changes, but UF volume (253.70 +/- 224.43 vs. 311.54 +/- 186.71 ml, p>0.05) showed no significant change. In the control group, there were no significant changes in D/PCr, (D/D0)G, MTAC, or UF volume. CONCLUSION: Peritonitis episodes affect the peritoneal membrane solute transport function in CAPD patients.

Female↗
PubMed2005

The systemic lupus erythematosus tri-nation study: longitudinal changes in physical and mental well-being.

OBJECTIVE: We have shown that SLE patients in Canada and the UK incurred 20% and 13% lower health costs than those in the US, respectively, but did not experience worse outcomes as expressed by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. We now compare change in quality of life in these patients. PATIENTS AND METHODS: Seven hundred and fifteen SLE patients (Canada 231, US 269, UK 215) completed the SF-36 annually over four years. The annual change in the SF-36 Physical and Mental Component Summary (PCS and MCS) scores over the course of the study were summarized by estimating a linear trend for each individual patient using hierarchical modelling. Cross-country comparison of the slopes in the PCS and MCS scores was then performed using simultaneous regressions. RESULTS: The estimated mean annual changes (95% credible interval [CrI]) in the PCS scores in Canada, the US, and the UK were 0.18 (-0.07, 0.43), -0.05 (-0.27, 0.17), and 0.03 (-0.20, 0.27), respectively; the mean annual changes in the MCS scores were 0.15 (-0.04, 0.34), 0.23 (0.09, 0.37), and 0.08 (-0.10, 0.27), respectively. Regression results showed that the mean annual changes in PCS and MCS scores did not substantially differ across countries. CONCLUSION: Quality of life remained stable across countries. Despite Canadian and British patients incurring lower health costs, on average, patients experienced similar changes in physical and mental well-being.

Adult↗
PubMed2005

Longitudinal changes in the amount of informal care among publicly paid home care recipients.

PURPOSE: This study examined how the amount of informal care received by disabled elders changes when they are receiving publicly paid home care, and whether formal service use, disability, caregiving arrangements, and demographic characteristics of older adults predict changes in the amount of informal care. DESIGN AND METHODS: Hierarchical linear models were estimated, using 3-year data (12 repeated observations) collected from elderly participants (N = 888) in Michigan's Home- and Community-Based Medicaid Waiver Program. RESULTS: The amount of informal care declined in the beginning period when publicly paid home care was received, and then it stabilized. Changes in activities and instrumental activities of daily living and caregiver residence predicted changes in the amount. The living arrangement and age of elders predicted different patterns of change over time. Neither formal service amount nor its change significantly predicted the amount of informal care. IMPLICATIONS: Informal caregivers do not relinquish caregiving when publicly paid home care is available. Expanding community-based long-term care is a means of fostering partnerships between formal and informal caregivers.

Activities of Daily Living↗
PubMed1994

Longitudinal change of ear advantage for receptive language function in 2 1/2- to 9-year-old children.

In Study I, 24 children at the average ages of 41.1 and 46.1 mo. were presented dichotic digits while another 27 children were tested at average ages of 40.0, 49.6, and 54.6 mo. In Study II, 40 children were tested at average ages of 50.7 and again at 91.8 mo. No significant change in right-ear advantage (REA) appeared across 4- or 9-mo. intervals; however, significant increases were found over the 14-mo. (Study I) and 41-mo. (Study II) intervals. There were no significant effects of sex or phenotypic or family history of handedness.

Attention↗
PubMed1968

Pulse wave propagation in elastic tubes having longitudinal changes in area and stiffness.

The behavior of both step waves and sinusoidal waves in fluid-filled elastic vessels whose area and distensibility vary with distance is explored theoretically. It is shown that the behavior of these waves may be explained, to a large extent, by considering the effect of the continuous stream of infinitesimal reflections that is set up whenever any wave travels in a region of vessel where the local impedance, (that is, the ratio of elastic wavespeed to tube area) is not constant. It is found that in such vessels the behavior of sinusoidal waves over distances which are a fraction of a wavelength can be quite different from their average behavior over several wavelengths. Both behaviors are described analytically. The results are applied to the mammalian circulatory system, one of the most interesting results being that a longitudinal variation in the pressure and velocity amplitudes which has a wavelength roughly one-half that of standing waves is predicted. The treatment is essentially a linearized quasi-one-dimensional one, the major assumptions being that the fluid is inviscid, the mean flow is zero, and the vessel is perfectly elastic and constrained from motion in the longitudinal direction. As in the physiological situation, the ratio of fluid velocity to pulse propagation speed is assumed small. For comparison with the analytical results, the linearized equations are also solved numerically by computer.

Blood Flow Velocity↗