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Longitudinal P300 latency changes in Alzheimer's disease.

A longitudinal study of the changes in latency of the P300 (P3) wave of the auditory event-related brain potential was undertaken in a group of 18 thoroughly screened and diagnosed possible and probable Alzheimer's disease (pAD) patients and 15 normal controls. On initial recording, P3 latency was significantly prolonged in the pAD group by more than 1.5 standard deviations (40 msec) beyond the normal group. Over the course of the next 3 years, the rate of increase in P3 latency was significantly greater for the patient group than for the controls. The rate of change in P3 latency may reflect accelerated senescence in Alzheimer's disease. Development of the auditory P300 as a marker of neurobiological processes in aging and dementia is discussed.

Aged↗

Changes in physical performance in elderly Europeans. SENECA 1993 - 1999.

OBJECTIVE: To assess longitudinal changes in subjective and objective measures of physical performance in elderly Europeans. DESIGN: Longitudinal study including SENECA measurements 1993-1999. SETTING: Data were collected in 9 'traditional' European towns. SUBJECTS AND METHODS: In total 444 men and women, born 1913-1918 participated both in the follow-up survey in 1993 and in the finale in 1999. Changes in Activities of Daily Living (ADL), the 7 item Physical Performance Test (PPT) and in the ability to perform the chair stand and the tandem test were measured. RESULTS: ADL and PPT did not change significantly between the 2 surveys, while participants needed more time to perform the chair stand (p<0.02) and their balance declined according to the tandem test (p< 0.01). Men were significantly better than women, in all measures of physical performance. However, the decline in functioning was of the same magnitude. All tests showed significant variation between centres in physical function. Significant cross cultural variation was found for changes in the capacity to perform the objective tests. Tests of distributions showed good association between the self reported and objective measures of physical performance. Rather than assessing the same task in several ways, the measures may reflect different levels of disability, and as such be important end point measures. CONCLUSIONS: Both ADL and objective tests of simple functions applied well in the SENECA population. Physical performance declines with age. Across European towns variation in physical performance was identified.

Activities of Daily Living↗

Microbial changes associated with the development of puberty gingivitis.

In this study, longitudinal changes in the composition of the subgingival microbiota of children between the ages of 11 and 14 and their association with changes of clinical parameters describing gingival health were investigated. During 4 years, subgingival microbial samples were taken in 22 boys and 20 girls 10 times. At the same time the gingival bleeding tendency was recorded by the Papillary Bleeding Index (PBI). A total of 840 samples was evaluated using darkfield microscopy and anaerobic culturing on non-selective and selective media. Children, who developed a marked and sustained increase in mean PBI scores (n = 21), had higher frequencies and mean proportions of spirochetes and Eikenella corrodens than children without pronounced puberty gingivitis (p less than = 0.05). The mean proportion of Actinomyces viscosus was also higher in these children (p less than = 0.05). Among the species discriminated, only Capnocytophaga sp. were found at a higher rate in samples taken immediately before a rise of PBI (p less than = 0.05). The detection frequencies of black-pigmented Bacteroides (particularly B. intermedius) increased later, and were significantly elevated after the establishment of a high bleeding tendency (p less than = 0.05). These findings implicate Capnocytophaga sp. in the initiation of puberty gingivitis, whereas the increased presence of Bacteroides may reflect a change in the subgingival environment secondary to increased bleeding.

Adolescent↗

Changes in serum lipid levels during a 10 year period in a large Japanese population. A cross-sectional and longitudinal study.

To determine the recent secular trends in serum lipid levels and characterize their influence on the aging process, we examined a large cohort of Japanese cross-sectionally and longitudinally. The participants included 80331 Japanese men and women 20-79 years of age, who had received annual health examinations from 1989 to 1998. In cross-sectional analysis, an increase in total and LDL cholesterol as well as triglyceride levels was observed in the population during the period of 1989-1998. The longitudinal changes showed that total and LDL cholesterol increased with age in men between the birth cohorts of the 1920s and 1960s. In women, these cholesterol levels increased in the 1930s and younger cohorts. HDL cholesterol decreased in men of all birth cohorts. However, HDL cholesterol increased in women of the 1940s and younger cohorts. Triglyceride levels increased in men of the 1940s and younger cohorts but decreased in the 1930s and older. Triglyceride levels increased in women of the 1930s and younger. Longitudinal analysis also suggested a birth cohort effect except for the triglyceride level for women. These results suggest that Japanese serum lipid levels continue to increase and that there exist birth cohort effects regarding serum lipid levels in the Japanese population.

Adult↗

Cerebral atrophy precedes the change in cerebral blood flow in patients with ischemic cerebrovascular disease: a short-term follow-up study.

Cerebral atrophy and the decrease in cerebral blood flow (CBF) progress with advancing age. Which of them takes first place, the changes in CBF or cerebral atrophy? We investigated longitudinal changes in CBF and cerebral atrophy in 14 patients with ischemic cerebrovascular disease (CVD): 11 patients with supratentorial lacunar infarction and 3 with carotid transient ischemia attack who were neurologically stable during the 1-3 years of observation. Cerebral atrophy was estimated by the brain atrophy index (BAI): one of the CT area measurement methods, and CBF was measured using the 133Xe inhalation technique. While significant progression of cerebral atrophy was observed, there was no significant change in CBF. Cerebral atrophy precedes the change in CBF and CVD.

Aged↗

Respiratory burst activity in bronchopulmonary dysplasia and changes with dexamethasone.

The first objective of this study was to evaluate longitudinal changes in respiratory burst activity in circulating neutrophils and monocytes in infants of less than 30 weeks of gestation with respiratory distress syndrome (RDS), and to examine differences in neonates who subsequently developed bronchopulmonary dysplasia (BPD) compared with those neonates who did not. The second objective was to investigate the effects of dexamethasone on respiratory burst activity in neutrophils and monocytes. We measured burst activity on neutrophils and monocytes in fresh heparinized blood in response to E. coli, N-formyl-met-leu-phe (fMLP), and phorbol 12-myristate 13-acetate stimulation on days 3, 7, 14, and 21 of life, before and 2-3 days after initiating a 6-day course of dexamethasone treatment. Infants with RDS participating in the study were followed until discharge, and were classified as non-BPD and either 1) BPD d28, reflecting their oxygen requirement at day of life 28, or 2) BPD 36 weeks, reflecting oxygen dependence at 36 weeks' corrected gestational age. The diagnosis of BPD was supported by radiological changes of BPD. The percentage of activated neutrophils producing a respiratory burst increased in all premature infants with increasing postnatal days during the first 28 days of life, when the physiological stimulus E. coli was used as an activator (P < 0.02). There was no significant difference in respiratory burst activity measured either as percent activation or as mean fluorescence intensity between non-BPD and BPD infants after adjusting for the difference in weight and gestational age between the two groups. The treatment of premature infants with dexamethasone was associated with decreased activation of neutrophils (P < 0.005) when E. coli was used as a stimulus. In conclusion, a significant increase in neutrophil respiratory burst activity occurs during the first month of life in very low birth weight infants. Greater pulmonary damage in BPD cannot be attributed to reduced burst activity in either neutrophils or monocytes. Dexamethasone treatment was associated with decreased neutrophil respiratory burst activity.

Anti-Inflammatory Agents↗

Variability in fundamental frequency during speech in prodromal and incipient Parkinson's disease: a longitudinal case study.

Nearly two centuries ago, first observed that a particular pattern of speech changes occur in patients with idiopathic Parkinson's disease (PD). Numerous studies have documented these changes using a wide variety of acoustic measures, and yet few studies have attempted to quantify any such changes longitudinally, through the early course of the disease. Moreover, no attempt has been made to determine if speech changes are evident during the prodromal period, prior to the onset of clinically noticeable symptoms. This case-control pilot study is a first attempt to determine if changes in fundamental frequency variability during speech, an acoustic measure known to be affected later in the course of the disease, are evident during the prodromal period. A retrospective analysis of videotape footage recorded and made available by a leading national television news service. Videotape samples were obtained for a single individual (and a well-matched control subject) over an 11-year period of this individual's life (7 years prior to diagnosis of PD, and 3 years post-diagnosis). Results suggest that changes in F0 variability can be detected as early as 5 years prior to diagnosis (consistent with findings from other laboratories that have relied on cross-sectional study approaches). This pilot study supports the utility of such a design approach, and these results warrant continued effort to better understand the onset of PD and sensitivity of measurement of voice acoustical changes during the prodromal period.

Adult↗

Serial changes in static and dynamic cerebral autoregulation after acute ischaemic stroke.

BACKGROUND: The longitudinal changes in static and dynamic cerebral autoregulation (CA) following acute ischaemic stroke are unknown and were assessed in this study. METHODS: Fifty-four ischaemic stroke patients were studied within 96 h of ischaemic stroke and again 7-14 days later, using transcranial Doppler techniques to measure CA. Results were compared to an age-, sex- and blood pressure (BP)-matched control group. Static BP pressor stimulus was produced by thigh cuff inflation and dynamic stimulus by rapid thigh cuff release. RESULTS: Dynamic, but not static, CA was globally impaired at initial (mean dynamic CA index 3.9 +/- 3.1 vs. 6.2 +/- 2.3, p < 0.005) and follow-up studies (dynamic CA 3.9 +/- 2.8 vs. 6.2 +/- 2.3, p < 0.01) in stroke patients compared to controls. Static CA was similar in stroke patients and controls and was unchanged during follow-up. CONCLUSIONS: Dynamic, but not static, CA is impaired after acute ischaemic stroke and remains abnormal for at least 1-2 weeks post ictus. These changes are present in both the affected and non-affected hemispheres and are unrelated to previous antihypertensive treatment, baseline BP levels or BP changes after stroke, age or stroke type.

Acute Disease↗

The Trp(64)Arg polymorphism of the beta(3)-adrenergic receptor gene is not associated with body weight or body mass index in Japanese: a longitudinal analysis.

The beta(3)-adrenergic receptor (ADRB3) is expressed mainly in visceral adipose tissue and is thought to contribute to lipolysis and the delivery of free fatty acids to the portal vein. Although many studies have examined the relationship between the Trp(64)Arg mutation of ADRB3 and obesity, the results have been inconsistent. We examined the cross-sectional relationship of ADRB3 variants with indexes of obesity, and their longitudinal changes over 10 yr, in men and women, aged 40-69 yr, who were randomly selected from the Japanese rural population. The study considered both dietary energy intake and physical activity levels. Among the 746 participants, the genotype frequencies of the Trp(64)Trp, Trp(64)Arg, and Arg(64)Arg variants were 483, 224, and 39, respectively. The cross-sectional analysis showed no significant differences in height, weight, body mass index, blood pressure, serum total and high density lipoprotein cholesterols, and hemoglobin A(1c) among the genotype groups even after adjustments for gender, age, smoking, alcohol drinking, physical activity, and energy intake. No significant differences in the weight changes between the genotype groups were evident in the longitudinal analysis. We conclude that the Trp(64)Arg mutation of ADRB3 has little or no influence on either body weight or body mass index in the general Japanese population.

Adult↗

Beyond longitudinal data: causes, consequences, changes, and continuity.

Longitudinal data have very important advantages for both measurement and the testing of causal hypotheses on the causes or course of psychopathology, but cross-sectional studies should usually be used first. The investigation of causes needs to encompass the several different types of causal question. The study of within-individual change constitutes a most important research strategy to test causal hypotheses, but it is not the only approach. Their testing requires specification of possible mechanisms, together with attention to the differential impact of risk experiences, of the possible role of person-environment interactions and protective mechanisms. This article addresses several strategies needed in using longitudinal data to test cause-and-effect relationships, including natural experiments, testing of competing hypotheses on mechanisms, study of reversal effects, multiple replications in different circumstances, use of designs to dissociate possible mechanisms, testing for dose-response relationships, examination of effect-specificity, considering biological plausibility, and assessing the strength of effects.

Cross-Sectional Studies↗

Effect of aging on the electrocardiogram.

Previous cross-sectional population studies have shown age differences in electrocardiographic wave patterns, including lower wave amplitudes and a leftward shift of the frontal plane axis in older people. However, cross-sectional results may be due to cohort differences and the data imply only that these changes actually occur in persons as they age. In order to examine electrocardiographic changes with aging in the same persons, serial recordings, obtained 10 years apart, were taken in 440 healthy male participants of the Normative Aging Study, who were 23 to 66 years old on their first examination. At examination 1, R and S wave amplitudes were smaller and frontal plane axis measurements were shifted to the left in older men. Longitudinal changes in these same variables were consistent with the cross-sectional results. In addition, the P-R and Q-T interval durations were longer, the QRS duration was shorter and the T wave amplitude was smaller at the second examination. The longitudinal rate of change of S wave amplitude varied among age groups, decreasing more in younger men. Thus, some previously described cross-sectional age differences truly represent longitudinal age trends in electrocardiographic patterns.

Adult↗

Socioeconomic disadvantage and change in blood pressure associated with aging.

BACKGROUND: Few studies have examined how the longitudinal change in blood pressure associated with aging differs across social groups within industrialized countries. METHODS AND RESULTS: Data from the Atherosclerosis Risk In Communities Study were used to investigate differences in the incidence of hypertension and in aging-related changes in blood pressure by neighborhood and individual socioeconomic factors over a 9-year follow-up. Disadvantage in multiple socioeconomic dimensions was associated with the greatest risk of developing hypertension (age- and sex-adjusted hazard ratio [HR] and 95% CI: HR 1.95, 95% CI 1.38 to 2.75 in whites and HR 1.43, 95% CI 0.96 to 2.13 in blacks). Aging-related increases in systolic blood pressure were inversely associated with socioeconomic position in whites (mean [SEM] 5-year increase in systolic blood pressure 7 [0.7] mm Hg in the most disadvantaged category and 5.4 [0.4] mm Hg in the most advantaged category). In whites, low socioeconomic position was also associated with more rapid declines in diastolic blood pressure after 50 years of age. Socioeconomic differences in hypertension incidence and changes in systolic blood pressure were reduced after adjustment for baseline blood pressure. CONCLUSION: The change in blood pressure associated with aging varies by social groups within the United States.

Black or African American↗

Longitudinal assessment of changes in reproductive hormones during normal pregnancy.

The concentrations of hormones measured in serum from maternal blood change dramatically during pregnancy. While the relative contributions of sex steroids shift from maternal ovaries and adrenals to the fetoplacental unit, other maternal tissues such as pituitary and liver respond to increasing concentrations of estrogen and secrete increasing amounts of prolactin and sex-hormone-binding globulin. To determine longitudinal changes in circulating maternal hormones, we collected blood from 60 women on three occasions during their pregnancies. We observed a 1.7-fold increase in testosterone concentration in serum; concentrations of sex-hormone-binding globulin in serum rose 5.6-fold. The major increase (6.8-fold) in estradiol in serum occurred within the first 16 weeks, followed by a further 4.8-fold increase by term. Mean concentrations of progesterone, 17-hydroxyprogesterone, and androstenedione in serum increased 11.9-, 3-, and 1.3-fold, respectively, whereas concentrations of dehydroepiandrosterone sulfate (DHEAS) fell by 50%. Mean serum prolactin concentrations increased 3.8-fold during the first trimester and by a similar amount during the final 24 weeks of pregnancy. We used these data, obtained from a cohort of women with uncomplicated pregnancies, to construct reference intervals for hormones in maternal serum.

Androgens↗

Longitudinal effects of change in body mass on measurements of ventilatory capacity.

BACKGROUND: In several longitudinal studies changes in body mass and in forced expiratory volume in one second (FEV1) have been found to be negatively correlated. This paper tests the hypothesis that failure to allow for the association can lead to error in the interpretation of longitudinal measurements of ventilatory capacity. METHODS: Male shipyard workers (n = 1005) were assessed on two occasions with an average interval between measurements of 6.9 years. A respiratory symptoms questionnaire, detailed anthropometric measurements, and dynamic spirometric tests were undertaken. Multiple regression analysis was used to identify variables which contributed to the changes in lung function. RESULTS: After allowing for age and growth in stature, a change in body mass of 1 kg was, on average, associated with a mean (SE) converse change in FEV1 of 17.6 (2.0) ml, and in forced vital capacity (FVC) of 21.1 (2.5) ml. Neglect of changes in body mass (which in this context reflected changes in body fat) led to underestimation of the longitudinal decline in FEV1 with age and failure to detect significant improvements in FEV1, both in smokers following discontinuation of smoking and in shipyard welders and caulker/burners as a consequence of leaving their employment. The estimated peak ages and associated peak levels of the indices were found to differ, depending on whether or not they were expressed at constant body mass. CONCLUSIONS: Neglect of changes in body mass can lead to erroneous conclusions being drawn from longitudinal measurements of FEV1.

Adolescent↗

Long-term changes in dyspnea, lung function, and exercise capacity in COPD patients.

OBJECTIVE: To examine longitudinal changes in dyspnea, lung function, and exercise capacity in COPD patients and to compare baseline data of frequent and infrequent exacerbators at trial entry. METHODS: Nineteen stable COPD patients without significant co-morbidity (age, 58.4 +/- 8.4 years; FEV1% = 33 +/- 12%; mean +/- SD) participated in the study. After a mean period of 36 months (range = 24 - 49) the patients were retested using an identical protocol. RESULTS: Repeated measures analysis showed that there was significant deterioration of FEV1 L (from 1.028 +/- 0.349 to 0.928 +/- 0.307; p = 0.007), PImax cm H2O (from 61.9 +/- 24.2 to 42.0 +/- 22.1; p = 0.007), PaO2 mm Hg (from 69.0 +/- 8.6 to 60.1 +/- 6.8; p = 0.003), PaCO2 mm Hg (from 43.1 +/- 4.9 to 47.3 +/- 4.5; p = 0.001), ATS (from 2.4 +/- 1.0 to 2.8 +/- 0.8; p = 0.031), and 6MWD m (from 389 +/- 130 to 341 +/- 135; p = 0.014). There were also changes in IC, T(L,CO)/V(A), PAP and Borg, but they were not statistically significant. Differentiation of patients by frequency of exacerbations per year of observation (> 2 < or =) discriminated them with respect to functional parameters (FEV1, FVC, IC), dyspneic indices (ATS, VAS and Borg) and exercise capacity (6MWD) at the time of enrollment. CONCLUSIONS: 1) Lung function parameters, blood-gas and dyspneic indices, and exercise capacity decline over a mean period of 36 month in patients with COPD; 2) Patients with frequent exacerbations experience more dyspnea and have lower levels of lung function and exercise capacity at trial entry.

Disease Progression↗

Evidence for a major gene influencing 7-year increases in diastolic blood pressure with age.

The contribution of genetic factors to blood pressure levels is well established. The contribution of genes to the longitudinal change in blood pressure has been less well studied, because of the lack of longitudinal family data. The present study investigated a possible major-gene effect on the observed increase with age in diastolic blood pressure (DBP) levels. Subjects included 965 unmedicated adults (age > or = 18 years) in 73 pedigrees collected in Utah as part of a longitudinal cardiovascular family study. Segregation analysis of DBP change over 7.2 years of follow-up identified a recessive major-gene effect with a gene frequency of p = .23. There was also a significant age effect on the genotypic means, which decreased expression of the major gene at older ages. For those inferred to have the genotype responsible for large DBP increases, DBP increased 32.3%, compared with a 1.5% increase in the nonsusceptible group (P < .0001). The relative risk of developing hypertension between the susceptible and nonsusceptible groups after 7.2 years was 2.4 (P = .006). Baseline DBP reactivities to mental arithmetic (P < .0001), and isometric handgrip (P < .0001) stress tests were greatest in those assigned to the susceptible genotype. We conclude that age-related changes in DBP are influenced by a major gene. Characteristics of this major-gene effect for greater age-related blood pressure increases include greater reactivity to mental and physical stressors. The present study thus provides evidence for genetic control of changes in blood pressure, in addition to the previously suggested genetic control of absolute blood pressure level.

Adult↗

Cognitive changes in very old persons with dementia: the influence of demographic, psychometric, and biological variables.

Longitudinal changes in global cognitive functioning, indexed by the Mini-Mental State Examination (MMSE), in subjects with dementia (Alzheimer's disease and vascular dementia) were examined. The roles of several demographic, psychometric, and biological indices in predicting cognitive deterioration were also examined. The sample consisted of 36 very old (M age at entry = 83.0 years, range = 75-95) adults with dementia from a community-based study. Subjects were tested on two occasions separated by approximately 2.5 years. Results indicated significant longitudinal decline in MMSE scores over the retest interval; the average decline was estimated as 2.43 (SD = 1.81) points per year. Several factors were associated with cognitive deterioration. Higher initial MMSE scores were associated with greater deterioration, whereas superior forward digit span and Block Design at entry were associated with attenuated decline, once differences in baseline severity were accounted for. By contrast, a variety of other putatively important variables exhibited no relationship to decline, including age, gender, education, onset age, dementia type, backward digit span, as well as a number of biological parameters (e.g., vitamin B12, folic acid). The results suggest that although the magnitude of cognitive deterioration in dementia is highly variable, several indicators may be useful predictors of future changes in cognitive functioning.

Age of Onset↗

Progression of atherosclerosis at one-year follow-up seen with volumetric intravascular ultrasound in femoropopliteal arteries.

Volume measurements derived from intravascular ultrasound (IVUS) images assessed with an automated contour analysis system are accurate and reproducible. However, it is unknown to what extent plaque volume may change at follow-up. Therefore, the purpose of this longitudinal study is to examine whether IVUS is a sensitive means to identify progression of atherosclerosis and its derived primary end point plaque volume at 1-year follow-up. Patients (n = 11) undergoing percutaneous transluminal angioplasty (PTA) of the femoropopliteal artery were studied with IVUS immediately after PTA in the same session and at 1-year follow-up. Matched, well-identified vascular segments (3 to 4 cm in length), not subjected to PTA, imaged at baseline and after 1-year follow-up, were used for calculation of the longitudinal change in lumen, vessel and plaque volume, and mean plaque thickness. The median length of the selected vascular segments was 4 cm. At follow-up (12+/-2 months) a nonsignificant increase in lumen volume (2.3+/-11%), vessel volume (2.0+/-7.0%), and plaque volume (3.0+/-5.1%) was seen; the mean plaque thickness increase was 2.2+/-5.6%. In conclusion, progression of atherosclerosis implies changes in plaque and vessel volume, resulting in lumen volume change. This observation has important implications for future clinical trials aimed at monitoring the effect of pharmacologic agents on the progression and/or regression of atherosclerosis.

Adult↗