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PubMed2005

Parental longevity and 7-year changes in blood pressures in adult offspring.

In this report, we examined the cross-sectional and the 7-year longitudinal changes in blood pressures in adult offspring according to parental longevity. A population of volunteers free of symptomatic cardiovascular diseases who participated to the Supplementation en Vitamines et en Minéraux Antioxydants (SUVIMAX) Vascular Study (mean age 52.3 years; 48.3% women) were examined at baseline and 7 years later. Paternal (n=994) and maternal (n=896) longevity were analyzed separately. The prevalence of hypertension at baseline in subjects whose father died at <65 years of age, in those whose fathers were alive by age 65 but died by 80 years of age, and in those whose fathers were alive by age 80 was respectively 34.9%, 28.5%, and 20.2% (P<0.001). The means of systolic blood pressure in the 3 groups of paternal longevity were respectively 128.4 (+/-16.0), 125.3 (+/-14.2), and 123.6 (+/-14.4) mm Hg (P<0.001). During the follow-up, the mean systolic blood pressure increases in the 3 groups of paternal longevity were respectively 5.3 (+/-17.0), 4.2 (+/-14.0), and 1.6 (+/-13.2) mm Hg (P<0.001). In subjects without hypertension at baseline, hypertension occurred during the follow-up in 26.6%, 17.7%, and 15.3% (P<0.009), respectively. Multivariate analyses adjusted for baseline or changes in cardiovascular risk factors did not modify these results. In contrast, there was no relationship between maternal longevity and blood pressure measurements in either cross-sectional or longitudinal analyses. This study suggests that paternal premature death was associated with accelerated progression of systolic blood pressure and higher occurrence of hypertension in offspring. These results indicate that there are dynamic and continuous processes linking paternal longevity to blood pressure in adults.

Adult Children↗
PubMed1982

Changes in cholesterol and triglyceride as predictors of ischemic heart disease in men.

We examined the relation of longitudinal changes in cholesterol and triglyceride to the subsequent development of heart disease. The data were from 1437 participants of the Normative Aging Study, a prospective study of men from the Boston area who were free of ischemic heart disease on two examinations approximately 5 years apart. Forty-four had symptoms or ECG findings of ischemic heart disease after their second but before their third examination, a period of 3-5 years. The risk of heart disease was studied using a multiple logistic risk model that took into account smoking and other risk factors. Changes in cholesterol and triglyceride levels between Exams 1 and 2, when corrected for regression to the mean, were better predictors of heart disease incurred between Exams 2 and 3 than initial levels of cholesterol, triglyceride or systolic blood pressure. When two age groups (28-52 years and 53-85 years) were considered, changes were important predictors in each age group. These findings suggest the importance of monitoring lipid changes over time.

Adult↗
PubMed1988

Changes in the axis of astigmatism: a longitudinal study.

Changes in the axis of astigmatism have been followed up in the same individuals over several decades. Only a proportion of subjects with direct astigmatism in their youth change to inverse astigmatism by way of oblique astigmatism.

Adolescent↗
PubMed1999

Impaired development of bone mineral density during chemotherapy: a prospective analysis of 46 children newly diagnosed with cancer.

Osteopenia and osteoporosis are becoming increasingly recognized in children with cancer, though reasons for these changes are poorly understood. The purpose of the present study was to evaluate longitudinal changes in bone mineral density (BMD) and bone turnover in newly diagnosed children with a malignancy. Lumbar spine (L2-L4) and femoral neck bone mineral density (BMDareal, g/cm2) was measured by dual-energy X-ray absorptiometry in 46 children (age 2.9-16.0, median 8.0 years; 15 leukemias, 12 lymphomas, 19 solid tumors) at diagnosis, and after 6 months from the baseline. The apparent volumetric bone mineral density (BMDvol) was calculated to minimize the effect of bone size on BMD. Serum levels of osteocalcin (OC), type I collagen carboxy-terminal propeptide (PICP), and type I collagen carboxy-terminal telopeptide (ICTP) were analyzed at diagnosis, and during a 6-month follow-up. A significant decrease in lumbar BMDvol (-2.1%, p < 0.05), and in femoral BMDareal (-9.9%, p = 0.0001) and BMDvol (-8.5%, p = 0.0001) was observed after 6 months when compared with baseline measurements. The markers of bone formation (PICP, OC) were significantly decreased, and the marker of bone resorption (ICTP) was significantly increased at diagnosis as compared with normal values. By the end the follow-up, the levels of PICP and OC were normalized, whereas the level of ICTP continued to increase indicating that there was a negative balance in bone turnover. A deficient accumulation of bone mass might predispose children with a malignancy to impaired development of peak bone mass. A controlled study determining the benefits of an early intervention on bone turnover should be considered in these patients.

Adolescent↗
PubMed2000

A decrease in diastolic blood pressure combined with an increase in systolic blood pressure is associated with a higher cardiovascular mortality in men.

OBJECTIVES: The study evaluated the risk of cardiovascular mortality according to combined spontaneous (non-treatment-related) changes in both systolic and diastolic blood pressure (BP). BACKGROUND: Long-term longitudinal changes in blood pressure may be a more accurate determinant of cardiovascular risk since changes in systolic or diastolic blood pressure over a period of time reflect the evolution of arterial and arteriolar alterations. METHODS: Two independent French male cohorts were studied: the IPC cohort (Investigations Préventives et Cliniques) composed of 15,561 men aged 20 to 82 years who had had two visits spaced four to 10 years apart, and the Paris Prospective Study composed of 6,246 men aged 42 to 53 years, examined annually for a period of four years. None of the subjects were taking antihypertensive medication. Annual changes in BP were estimated, and subjects were divided into groups according to the increase, lack of change, or decrease of systolic or diastolic BP. Nine groups were formed by combining the changes of systolic and diastolic BP. Cardiovascular mortality was assessed for a mean period of 13.5 years for the IPC Study and 17 years for the Paris Prospective Study. RESULTS: In both cohorts, after adjustment for age and major risk factors, the group with an increase in systolic and a decrease in diastolic BP presented the highest relative risk of cardiovascular mortality compared to the group with no changes in either systolic or diastolic BP (relative risk: 2.07 [1.05 to 4.06] in the IPC Study and 2.16 [1.16 to 4.01] in the Paris Prospective Study). CONCLUSIONS: Assessment of spontaneous changes of BP over a long period of time can contribute to the evaluation of cardiovascular risk. Subjects whose systolic BP increased while their diastolic BP decreased had the highest cardiovascular risk independently of absolute values of BP or other risk factors.

Adult↗
PubMed1988

A new model of genetic hypertension in rats with superficial glomeruli.

Despite renal involvement in the genesis of hypertension, the precise renal hemodynamic events prior to and during development of hypertension have not been obtainable by direct study in the available rat models of genetic hypertension. We have developed a model of genetic salt-sensitive hypertension in rats with superficial glomeruli, using the protocol described by Dahl to develop the Brookhaven model. Adult Munich Wistar rats were purchased from Charles River and bred in our laboratory. Offspring were allowed to mature without intervention. Systolic blood pressure and body weight were measured weekly to determine the normal longitudinal changes with increasing age for this strain. Balance studies were also carried out longitudinally, and during these studies plasma renin activity (PRA) was determined. When the rats were 16 weeks old, the availability of superficial glomeruli was assessed under microscopic examination and only those rats with numerous superficial glomeruli/field were mated. The offspring of these breeders were used as the zero generation (F0) of salt-sensitive rats, and were treated as described by Dahl. Systolic blood pressure, body weights and balance studies were carried out in this and in all subsequent generations. Sibling breeding was maintained and rats were bred for salt-sensitivity (systolic blood pressure greater than 155 mmHg at the age of 2 months) and availability of superficial glomeruli. Those rats with systolic blood pressure of less than 120 mmHg were bred in an attempt to develop a salt-resistant strain, and untreated Munich Wistar rats were bred to provide another control.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2000

Seasonal changes in buoyancy and diving behaviour of adult grey seals.

Phocid seals go through dramatic seasonal changes in body mass and composition as a result of the spatial and temporal separation of foraging, reproduction and moulting. These changes in body fat content and body mass result in seasonal changes in buoyancy, which in turn may influence diving behaviour. We examined the longitudinal changes in buoyancy and diving behaviour of 14 adult grey seals (Halichoerus grypus) during two periods that represent maximal contrast in body mass and composition. During both the post-moulting (PM) and pre-breeding (PB) periods, grey seals were negatively buoyant. However, buoyancy increased by 47.9 % between the PM and PB periods. Descent rate was significantly faster during the PM period (1.0+/-0.07 m s(-1)) than during the PB period (0.7+/-0.06 m s(-1)), suggesting that seals were aided by negative buoyancy during the downward portion of dives. Ascent rate was also significantly faster during the PM period (0.8+/-0.06 m s(-1)) than during the PB period (0.6+/-0.05 m s(-1)), contradicting the prediction that more buoyant animals should ascend faster. The effects of drag could not account for this discrepancy. Dive depth and surface interval between dives did not differ significantly between the two periods. Similarly, the distribution of dive shapes used by individuals did not differ between the two periods. However, dive duration was significantly longer during the PB period than during the PM period (5.5+/-0.25 min compared with 4.4+/-0.24 min, respectively) as was time spent at the bottom of the dive (3.1+/-0.22 min compared with 2.5+/-0.15 min, respectively).

Adipose Tissue↗
PubMed1990

Longitudinal voice quality changes following Isshiki thyroplasty type I: the Yale experience.

Longitudinal voice quality changes following Isshiki thyroplasty type I were investigated in a group of 13 patients exhibiting unilateral vocal fold paralysis. Thyroplasty type I medializes the paralyzed fold by using a Silastic implant for external lateral compression of the abducted fold. No perioperative complications were experienced. We observed significantly higher voice fundamental frequency, significantly louder voice intensity, and significantly longer maximum phonation time, both immediately following phonosurgery and up to 3 months postoperatively. Surgical refinements of thyroplasty type I are described.

Adult↗
PubMed1995

Changes in aerobic power of men, ages 25-70 yr.

This study quantified and compared the cross-sectional and longitudinal influence of age, self-report physical activity (SR-PA), and body composition (%fat) on the decline of maximal aerobic power (VO2peak). The cross-sectional sample consisted of 1,499 healthy men ages 25-70 yr. The 156 men of the longitudinal sample were from the same population and examined twice, the mean time between tests was 4.1 (+/- 1.2) yr. Peak oxygen uptake was determined by indirect calorimetry during a maximal treadmill exercise test. The zero-order correlations between VO2peak and %fat (r = -0.62) and SR-PA (r = 0.58) were significantly (P < 0.05) higher that the age correlation (r = -0.45). Linear regression defined the cross-sectional age-related decline in VO2peak at 0.46 ml.kg-1.min-1.yr-1. Multiple regression analysis (R = 0.79) showed that nearly 50% of this cross-sectional decline was due to %fat and SR-PA, adding these lifestyle variables to the multiple regression model reduced the age regression weight to -0.26 ml.kg-1.min-1.yr-1. Statistically controlling for time differences between tests, general linear models analysis showed that longitudinal changes in aerobic power were due to independent changes in %fat and SR-PA, confirming the cross-sectional results.

Adipose Tissue↗
PubMed1989

Strategies for measuring the rate of age-related cataract formation in vivo.

The Lens Opacities Classification System (LOCS II) has been tested as a method for detecting and grading longitudinal changes in cataract severity. The LOCS I and II systems have already been tested and validated for cross-sectional classification of human cataracts in vivo. 130 eyes (of 68 patients) were photographed at baseline and follow-up visits with Neitz CTR and Zeiss slit photography. The mean length of follow-up was 14.7 +/- 4.4 months. The severity of nuclear opalescence (NO), cortical (C) and posterior subcapular cataract (P) was graded in a masked fashion using the LOCS II standards. Side-by-side comparisons of baseline and follow-up photos were also done in a masked fashion to detect more subtle changes than might be evident in the LOCS II gradings. The annual percent progression in cataracts graded by LOCS II standards are: (NO): 12.4%, (C): 17.9%, and (P): 6.5%. The LOCS II standards are offered as a promising subjective method for longitudinal grading of human cataractous change in vivo.

Aged↗
PubMed1989

Acute lower respiratory illness in childhood as a predictor of lung function and chronic respiratory symptoms.

This study investigated the relationship of acute lower respiratory illness (LRI) to level and change in level of forced expiratory volumes in a cohort of 801 children, followed longitudinally for a maximum of 13 yr. The co-occurrence of respiratory illness before 2 yr of age and two or more LRI during a single surveillance year was associated with a 20.3% lower mean cross-sectional level of FEF25-75, and with reduced longitudinal change in level of FEF25-75. The effect of LRI on lung function was uniformly stronger for boys than for girls. Of the children with illness before 2 yr of age and two or more LRI, six of 14 were male asthmatics with mean levels of FEF25-75 that were lower than those of other asthmatic children. Pneumonia and/or hospitalization for respiratory illness prior to the onset of study were associated with lower cross-sectional levels of forced expiratory volumes at entry to the study, even when asthmatics/persistent wheezers were eliminated from the analysis (6.1% lower level of FEV1 for a nonasthmatic boy with previous hospitalization versus a nonasthmatic boy without hospitalization). In the longitudinal analysis, pneumonia and/or hospitalization were associated with slower increase in level of forced expiratory volumes, even after adjusting for "ever diagnosis of asthma/current any wheeze" (starting at the same leve, after eight years a boy with hospitalization would develop a 5.0% lower FEV1 than a boy without hospitalization). Acute LRI also was evaluated as a predictor of chronic respiratory symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1996

Changes in aerobic power of women, ages 20-64 yr.

This study quantified and compared the cross-sectional and longitudinal influence of age, self-report physical activity (SR-PA), and body composition (%fat) on the decline of maximal aerobic power (VO2peak) of women. The cross-sectional sample consisted of 409 healthy women, ages 20-64 yr. The 43 women of the longitudinal sample were from the same population and examined twice, the mean time between tests was 3.7 (+/-2.2) yr. Peak oxygen uptake was determined by indirect calorimetry during a maximal treadmill test. The zero-order correlation of -0.742 between VO2peak and %fat was significantly (P < 0.05) higher then the SR-PA (r = 0.626) and age correlations (r = -0.633). Linear regression defined the cross-sectional age-related decline in VO2peak at 0.537 ml.kg-1.min-1.yr-1. Multiple regression analysis (R = 0.851) showed that adding %fat and SR-PA and their interaction to the regression model reduced the age regression weight of -0.537, to -0.265 ml.kg-1.min-1.yr-1. Statistically controlling for time differences between tests, general linear models analysis showed that longitudinal changes in aerobic power were due to independent changes in %fat and SR-PA, confirming the cross-sectional results. These findings are consistent with men's data from the same lab showing that about 50% of the cross-sectional age-related decline in VO2peak was due to %fat and SR-PA.

Adult↗
PubMed1995

Changes in dyspnea, health status, and lung function in chronic airway disease.

The purpose of this study was to examine longitudinal changes in clinical parameters in patients with chronic obstructive pulmonary disease (COPD). We postulated that progressive dyspnea and decline in lung function over time would influence or impact patient's health status. Clinical ratings of dyspnea, general health status, and physiologic lung function were measured every 6 mo over a 2-yr period in an original group of 110 male patients with stable but symptomatic COPD and no significant comorbidity. At enrollment, age was 67 +/- 8 yr (mean +/- SD), forced expiratory volume in one second (FEV1) was 1.28 +/- 0.59 I (44 +/- 17% of predicted), and forced vital capacity (FVC) was 2.84 +/- 0.84 I (68 +/- 18% of predicted). A total of 34 patients "dropped out" because of death (n = 20), relocation (n = 7), and other reasons (n = 7). Dyspnea was measured using the transition dyspnea index (TDI), which represented changes from the baseline state; general health status was measured using the Medical Outcomes Study (MOS) 20-item short-form survey; physiologic lung function was assessed by spirometry (FVC and FEV1) and inspiratory muscle strength (PImax). Statistical analyses were performed using all available data for each patient, including results until the time at which patients died or were lost to follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2001

Patterns and risk factors of change in somatic and mood symptoms among older adults.

PURPOSE: This paper was concerned with patterns of individual-level, longitudinal change in depressive symptoms and factors related to those patterns among Americans 70+ years of age. Two types of depressive symptoms were considered, somatic and mood symptoms. The paper focused on whether the patterns of change and the risk factors for these two types of symptoms differed, as we might expect among old and oldest-old adults. METHODS: The analytic sample included self-respondents of the 1993--1995 Asset and Health Dynamics among the Oldest Old (AHEAD) study who were born in 1923 or earlier. Depressive symptoms were assessed using an abbreviated Center for Epidemiologic Studies-Depression (CES-D) Scale. The analyses involved examination of respondents' change scores in depressive symptoms and multivariate models using ordinary least squares (OLS) and seemingly unrelated regressions (SUR). RESULTS: In aggregate, somatic symptoms were more common than mood symptoms initially and over time. Despite differences in aggregate rates, AHEAD respondents' individual-level patterns of change for the two types of symptoms were similar; i.e., stability was the principal trend (53--60%), followed by improvement (21--26%). A number of factors related to change in one aspect of depressive symptoms and not the other, or had greater effects on one aspect of depressive symptoms than the other; e.g., physical health had greater effects on somatic than mood symptoms. CONCLUSIONS: This study suggests that, in investigations of the course and risk factors for depressive symptoms among people 70+ years of age, it is important to separate somatic symptoms from mood symptoms; their etiology may differ. In general, factors reflecting respondents' social milieu (e.g., bereavement, residential relocation) may have greater effects on mood than somatic symptoms, whereas certain factors representing physical health may have greater effects on somatic symptoms.

Age Factors↗
PubMed1998

Modeling developmental changes in strength and aerobic power in children.

The present study examined two contrasting multilevel model structures to describe the developmental (longitudinal) changes in strength and aerobic power in children: 1) an additive polynomial structure and 2) a multiplicative structure with allometric body size components. On the basis of the maximum log-likelihood criterion, the multiplicative "allometric" model was shown to be superior to the additive polynomial model when fitted to the data from two published longitudinal studies and to provide more plausible solutions within and beyond the range of observations. The multilevel regression analysis of study 1 confirmed that aerobic power develops approximately in proportion to body mass, m1/3. The analyses from study 2 identified a significant increase in quadriceps and biceps strength, in proportion to body size, plus an additional contribution from age, centered at about peak height velocity (PHV). The positive "age" term for boys suggested that at PHV the boys were becoming stronger in the quadriceps and biceps in relation to their body size. In contrast, the girls' age term was either negligible (quadriceps) or negative (biceps), indicating that at PHV the girls' strength was developing in proportion to or, in the case of the biceps, was becoming weaker in relation to their body size.

Adolescent↗
PubMed1993

Serum levels of soluble CD8, neopterin, beta 2-microglobulin and p24 antigen as indicators of disease progression in children with AIDS on zidovudine therapy.

OBJECTIVE: To test the hypothesis that serum levels of soluble markers in children change after initiation of zidovudine therapy and that the extent and pattern of these longitudinal changes correlates with clinical outcome. PATIENTS AND METHODS: We measured serum levels of soluble CD8, neopterin, beta 2-microglobulin (beta 2M), and p24 antigen, and CD4 cell counts, before the initiation of zidovudine therapy and at 12, 24 and 48 weeks of treatment in 24 HIV-1-infected children (Centers for Disease Control classification P2) and 15 controls. RESULTS: Soluble CD8 levels were elevated before therapy in 70% of the infected children; subsequent decreases were associated with lower risk of disease progression. The mean serum neopterin level before treatment was elevated in infected children; decreases in neopterin levels marginally reflected improved or stable clinical status. Serum beta 2M levels and CD4+ cell counts were not associated with clinical outcome. Only 10 out of the 24 patients had detectable levels of serum p24 antigen before treatment; again, the amount of decline after initiation of therapy did not predict clinical outcome. CONCLUSION: Decreasing levels of soluble CD8 and neopterin in HIV-1-infected children receiving zidovudine therapy might reflect a good response to treatment and a slowing of disease progression.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Urinary free cortisol increases in adolescent caucasian females during perimenarche.

Urinary free cortisol (UFC) excretion has been thought to be constant during female reproductive maturation when normalized for body surface area. We sought to determine whether there are longitudinal changes in urinary free cortisol excretion during perimenarche in adolescent females. We performed a longitudinal study of 24-h UFC excretion obtained at 6-month intervals over a 4-yr period in a cohort of 112 adolescent non-Hispanic white perimenarchal females from south central Pennsylvania. The overall mean values (mean +/- SD) for UFC/24 h for all measurements between ages 12 and 17 yr was 67.4 +/- 43.8 micro g/24 h (to convert to nanomoles per day, multiply by 2.759). In our model, we found a significant positive association between UFC excretion with both gynecological age (P = 0.002) and chronological age (P = 0.0001). For every incremental increase in Tanner stage, the UFC/BSA increased by 3.0 microg/24 h per square meter. Correcting the UFC values by both creatinine and BSA creates a fairly constant number (6.3 +/- 3.1 microg/mg per square meter per 24 h) over the age range 12-17 yr represented in this study. An increase in cortisol excretion may be part of normal reproductive maturation.

Aging↗
PubMed2004

A pilot study of long-term monitoring of human movements in the home using accelerometry.

We assessed the feasibility of using a waist-mounted, wireless triaxial accelerometer (TA) to monitor human movements in an unsupervised home setting to detect changes in functional status. A pilot study was carried out with six healthy subjects aged 80-86 years. The subjects wore a TA unit every day for two to three months. Each morning they carried out a short routine of directed movements that included standing, sitting, lying and walking. Important movement variables were measured. During the rest of the day, subjects were monitored for falls, and variables such as metabolic energy expenditure were measured. All subjects remained healthy; there was no overall change in functional status and there were only slight fluctuations in health status. No longitudinal changes were detected in any of the variables measured during the directed routine. There was a moderate correlation between weekly self-reported health status and energy expenditure: subjects reported a lower health status for weeks in which they expended less energy. The TA system was found to be practical for long-term, unsupervised home monitoring. All subjects found the system simple to use and the TA unit unobtrusive and comfortable to wear. High compliance rates were achieved: the TA units were worn on 88% of the days in the study, for an average of 11.2 hours per day.

Acceleration↗