[Effective utilization of the available data on disease incidence using longitudinal analysis].
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Data Interpretation, Statistical↗
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[Longitudinal analysis of the development of pulmonary function in childhood].
In order to evaluate, longitudinally, the development of pulmonary function in childhood, maximal expiratory flow volume (MEFV) curves, height, and weight of 441 fourth grade school children were measured in 1980, and again two and four years later. The same instruments were used to measure pulmonary function, height, and weight in all three surveys. In addition, pulmonary function tests were performed by the same examiner in all three surveys. Three hundred and twenty five children had acceptable results for MEFV curves at all of three surveys. Two simple linear models were fitted to the distribution of pulmonary function measurements. One has age, height, functional level of the individual child, and the interaction of age and height as explanatory variables. In the other model, the natural logarithm of pulmonary function measurements was considered as a dependent variable, and age, height, and functional level of the individual child were employed as explanatory variables. The models explained the distribution of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximal expiratory flows (MEFs) quite well both in males and in females. These results suggest that the development of FVC and FEV1 against height was not linear, and that age was an independent contributor to the development even after adjusting for height. Tracking in the development of MEFs as well as FVC and FEV1 was observed, suggesting that functional development of MEFs for an individual child could be evaluated accurately utilizing percentile curves as in the case of FVC and FEV1.
Adolescent↗
Can caregivers independently rate cognitive and behavioral symptoms in Alzheimer's disease patients?: A longitudinal analysis.
To examine whether informant-based assessments of patients with Alzheimer's disease (AD) can be used longitudinally to track patient functioning, the authors followed AD patients (N=153) and their caregivers over 1 year with the Relative's Assessment of Global Symptomatology-Elderly (RAGS-E) and the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADASc). Factor analysis of the RAGS-E yielded two subscales, Cognitive Functioning and Mood Disturbance. The cognitive subscale and ADASc correlated at all visits, whereas the mood subscale did not. After 12 months (n=62), the cognitive scale worsened at a rate similar to the ADASc, suggesting concurrent validity. Therefore, informant-based measures appear to be reliable and valid methods of identifying cognitive change in AD patients.
Activities of Daily Living↗
A Dutch family with hearing loss linked to the DFNA20/26 locus: longitudinal analysis of hearing impairment.
OBJECTIVES: To perform linkage analysis and to outline hearing loss characteristics in a family exhibiting a nonsyndromic, autosomal dominant type of progressive sensorineural hearing loss. DESIGN: Genetic analysis was performed using microsatellite markers. Audiometric data were collected and analyzed longitudinally. Sigmoidal dose-response curves enabled us to perform nonlinear regression analysis per frequency and on phoneme recognition scores. Speech recognition scores were compared with those of DFNA2, DFNA5, DFNA9, and presbyacusis subjects. SUBJECTS: Affected family members of a Dutch family (W99-060). RESULTS: We revealed linkage of hearing loss to the DFNA20/26 locus (maximum logarithm of odds score, 3.1 at theta=0.04) and reduced the critical region from 12 to 9.5 centimorgans. Patients younger than 15 years already showed gently downsloping audiograms. At ages 15 to 20 and 25 to 40 years, hearing loss was profound at 8 kHz and 1 to 4 kHz, respectively. The 0.25- to 0.5-kHz thresholds showed more gradual progression by about 1.5 to 2 dB/y. From about age 40 years onward, hearing was residual. Hearing impairment took a more severe course than in a known DFNA20 family. Score recognition in DFNA20/26 subjects was better than in DFNA9 subjects at any pure-tone average (1-4 kHz) threshold. Compared with subjects having DFNA2 and DFNA5, speech recognition in those with DFNA20/26 scored better at threshold levels below 85 dB hearing level, but worse at levels above 90 dB. Compared with presbyacusis subjects, those with DFNA20/26 scored better in speech recognition at levels below 100 dB and worse at levels above 100 dB. CONCLUSIONS: Autosomal dominant hearing loss is linked to the DFNA20/26 locus in this Dutch family. The critical region is reduced from 12 to 9.5 centimorgans. Phenotypically, patients are more severely affected than those of a known DFNA20 family.
Adolescent↗
Long-term physiologic changes of intraocular pressure: a 10-year longitudinal analysis in young and middle-aged Japanese men.
OBJECTIVE: Although the intraocular pressure (IOP) is the most important factor related to the onset and progression of glaucoma, there is little evidence on long-term aging effects on IOP. This article examines the changes of IOP over 10 years in normal eyes to assess physiologic changes related to aging. DESIGN: Population-based long-term longitudinal study. STUDY POPULATION AND OBSERVATION PROCEDURE: Two thousand nine hundred eighty-seven Japanese male aircraft crew members underwent IOP measurement by Goldmann apparatus and received physical and complete ophthalmologic examinations every year for 10 years. A total of 2330 healthy persons (21-49 years; mean age, 35.9+/-6.8 [standard deviation]) who had no history of treatment for ophthalmic diseases, current illnesses, and no missing data for 10 consecutive years were analyzed. MAIN OUTCOME MEASURES: For analysis of the longitudinal index (trend), the linear regression coefficients for 11 points of measurement were determined. Ophthalmologic and physiologic factors affecting the 10-year mean values and a trend of IOP were examined by multivariable linear regression analysis. RESULTS: Intraocular pressure tended to decrease with age in all age groups. The mean linear regression coefficient (right eye/left eye) = -0.076/-0.060 (95% confidence interval [CI]: (-0.094 to -0.057)/(-0.078 to -0.041), -0.073/-0.060 [95% CI: (-0.084 to -0.062)/(-0.071 to -0.049)], and -0.060/-0.050 [95%CI: (-0.075 to -0.046)/(-0.064 to -0.036)] (mmHg/year) in the 20s, 30s, and 40s, respectively). In investigating correlations between the 10-year mean values of IOP and factors examined in this study, multivariate analysis showed a significantly inverse correlation with spherical power (partial regression coefficient [B] = -0.155/-0.144) and positive correlation with esophoria (B = 0.536/0.521), systolic blood pressure (B = 0.021/0.022), heart rate (B = 0.024/0.024), and hematocrit (B = 0.041/0.043) with IOP. The trend of IOP was significantly positively associated with the trends of systemic factors: body mass index (BMI) (B = 0.117/0.119), blood pressure (systolic) (B = 0.020/0.020), and hematocrit (B = 0.057/0.045), but not with any ophthalmologic factor. CONCLUSIONS: The long-term observation clearly demonstrated that, in normal eyes, the IOP decreased with aging. The IOP value was negatively associated with spherical power and positively with esophoria, blood pressure, heart rate, and hematocrit. The change of IOP could be affected mainly by the change of body mas index, blood pressure, and hematocrit.
Adult↗
Professional socialization in dentistry. A longitudinal analysis of attitude changes among dental students towards the dental profession.
In a longitudinal study conducted as part of a broad project dealing with socialization of health professionals in Israel, it was observed that during the course of professional socialization several major transformations occur in the dental student's image of the 'competent' dentist and in his self-image as a professional. Although students initially emphasized people-oriented traits as important to the competent dentist, this emphasis gradually decreased as their professional socialization advanced, concomitant with an increase in importance placed on status-oriented traits. The people-oriented elements likewise decreased in importance with regard to the student's self-image as professionals as they became more accustomed to professional reality. The correlation between these variables indicates the changes occurring in the students' acceptance or rejection of various aspects of their chosen profession throughout their years of study.
Attitude of Health Personnel↗
Effects of body fat on weight concerns, dating, and sexual activity: a longitudinal analysis of black and white adolescent girls.
Using data from a 2-year longitudinal study of 200 Black and White adolescent girls (mean age was 13.8 years at study entry), the authors investigated the implications of differences in body fat for dating and sexual activity and the implications of heterosexual activity for dieting and weight concerns. Among White girls, and Black girls with college-educated mothers, more body fat was associated with a lower probability of dating, even among nonobese girls. However, dating and sexual experience were unrelated to subsequent dieting and weight concerns. For both Blacks and Whites, body fat was the key determinant of dieting, weight dissatisfaction, and eating concerns. These findings indicate that adolescent girls' concerns about weight have a basis in real experiential differences, and efforts to promote healthy attitudes and eating habits may be more effective if the experiential implications of weight differences are taken into account.
Adipose Tissue↗
The PedsQL in pediatric cancer pain: a prospective longitudinal analysis of pain and emotional distress.
The objective of this prospective study was to investigate the cross-sectional and longitudinal associations between pain and emotional distress in children and adolescents with cancer as measured by the Pediatric Quality of Life Inventory (PedsQL) Emotional Functioning and Pain Scales. The PedsQL 1.0 Generic Core Scales are multidimensional scales developed as the generic core measure to be integrated with the PedsQL Disease-Specific Modules. The PedsQL 1.0 Cancer Module was designed to measure pediatric cancer-specific health-related quality of life. The PedsQL Generic Core Scales, Emotional Functioning Scale and Cancer Module Pain Scale, were administered to 69 children and 59 adolescents and their parents at Time 1 and Time 2, which was 6 months on average after Time 1. Prospective hierarchical multiple regression analyses supported a longitudinal predictive model with Time 1 pain predicting Time 2 pain and Time 1 emotional distress predicting Time 2 emotional distress, respectively. Time 1 emotional distress did not predict Time 2 pain, and Time 1 pain did not predict Time 2 emotional distress. The results demonstrate that pediatric cancer pain and emotional distress, although associated cross-sectionally, are differentially predictive in prospective longitudinal analyses. These results suggest that both pain and emotional distress should be targeted for treatment interventions concurrently to enhance long-term health-related quality of life of the pediatric patient with cancer.
Adolescent↗
Why do primary school children smoke? A longitudinal analysis of predictors of smoking uptake during pre-adolescence.
The objectives of this longitudinal study were to determine the prevalence of smoking among primary school children in Liverpool, and to identify the predictors of experimentation with cigarettes during pre-adolescence. A cohort of children (n = 270) completed questionnaires that elicited patterns of child smoking behaviour and children's experiences of smoking in their families and communities each year between the ages of 9 and 11 years. Parents also completed questionnaires. Children's first trials with cigarettes and repeated smoking were reported. The independent variables measured were socio-economic status, familial and peer smoking, and intentions to smoke. By age 11, 27% of children had tried smoking, 12% had smoked repeatedly and 3% were smoking regularly. Variables measured at age 9 predicting experimentation with cigarettes by age 11 were male gender 9P = 0.041) paternal smoking (P = 0.001) fraternal smoking (P = 0.017) a best friend who smoked (P = 0.026) and knowing someone with a smoking-related disease (P = 0.006) Intentions to smoke at age 9 did not predict smoking at age 11 (P < 0.001). In univariate analyses, child smoking was also associated with maternal smoking (P = 0.002 at age 11), living in a low-income household (P < 0.001 at age 10) and living in a deprived area ( P = 0.025 at age 11). Early smoking presents a considerable challenge to health promoters, not least because it is socially patterned. The interventions required must tackle the structural and social pressures that shape smoking behaviour during childhood.
Child↗
A sexual selection theory longitudinal analysis of sexual segregation and integration in early adolescence.
The three objectives in this longitudinal study were motivated by sexual selection theory. The theory specifies the role of sexually segregated groups and the effects of dominance in male groups and relational/indirect aggression in female groups for heterosexual relationships. Using a multi-method, multi-informant, longitudinal design we studied youngsters (N=138) across their first two years of middle school. First, we examined the nature of change in segregation and dating popularity across two years during early adolescence. Second, a model derived from sexual selection theory is tested to explain the ways in which boys and girls are nominated for hypothetical dates (dating popularity). Third, we examined the role of "poke and push courtship" behavior in boys' and girls' dating popularity. Results indicate that although groups did not become more integrated with time, changes in peer group sexual integration co-varied dynamically with dating popularity. Secondly, dominance-related strategies were more important for boys than girls in dating popularity whereas indirect, or relational, aggression strategies were more important for girls than boys. Third, "poke and push courtship" behaviors did not influence peer group integration or dating.
Adolescent↗
Natural history of asymptomatic rotator cuff tears: a longitudinal analysis of asymptomatic tears detected sonographically.
The purpose of this study was to examine longitudinally the natural history of asymptomatic rotator cuff tears over a 5-year period and to assess the risk for development of symptoms and tear progression. Since 1985 through the present, bilateral sonograms were done on all patients. A review of consecutive sonograms done from 1989 to 1994 revealed 58 potential patients with unilateral symptoms who had contralateral asymptomatic rotator cuff tears. Of these 58 patients, 45 (22 men, 23 women) responded to a comprehensive questionnaire and 23 additionally returned for examination and repeat sonographic evaluation. The questionnaire was based on the American Shoulder and Elbow Surgeons score and included several outcome-based questions. A physical examination was performed in a standardized fashion along American Shoulder and Elbow Surgeons guidelines. Repeat high-resolution sonograms were performed by a single experienced radiologist. Primary and repeat sonograms were then reassessed for tear size and location by two independent experienced radiologists blinded to the clinical data results. Twenty-three (51%) of the previously asymptomatic patients became symptomatic over a mean of 2.8 years. The average Activities of Daily Living score for those remaining asymptomatic was 28.5 of 30 and for those becoming newly symptomatic, 22.9 of 30 (P <.5). The mean visual analog pain score (1 = no pain) for those remaining asymptomatic was 1.1 and for the newly symptomatic patients, 4.0. Of the 23 patients who returned for ultrasound, 9 were asymptomatic and 14 symptomatic. Only 2 of the 9 patients remaining asymptomatic had progression of their tears. Overall, 9 of 23 patients had tear progression. No patient had a decrease in the size of the tear. Our results demonstrate that symptoms can develop in patients with previously asymptomatic rotator cuff tears when seen in the context of a contralateral symptomatic tear. Development of symptoms was associated with a significant increase in pain and decrease in the ability to perform activities of daily living (P <.05). There appears to be a risk for tear size progression over time.
Activities of Daily Living↗
Predictors of hand function in older persons: a two-year longitudinal analysis.
OBJECTIVE: To validate a hierarchical model of hand function in older persons, using longitudinal data. DESIGN: Longitudinal observational study (2-year data from an ongoing longitudinal study). SUBJECTS: 689 persons older than age 60, including Continuing Care Retirement Community (n = 230), homebound (n = 204), and ambulatory (n = 255) respondents. Mean age at baseline 76.6 (SD = 8.8). MEASUREMENT: Independent variables included sociodemographics, physician measures of upper joint impairment, self-reported comorbidity, arthritis pain, depression, and anxiety. The dependent variables included grip strength and a timed manual performance test. MAIN RESULTS: Using generalized estimated equations (GEE) to test our hierarchial model, we found that gender and upper extremity joint impairment were the strongest predictors of a longitudinal measure of grip strength. Grip strength, in turn, along with demographics, comorbidity, and a measure of psychological status, was significantly related to timed manual performance. CONCLUSIONS: The longitudinal analyses confirmed a previous cross-sectional finding that upper extremity joint impairment contributes significantly to reduced grip strength, which, in turn, contributes to reduced hand performance on a timed test.
Activities of Daily Living↗
Longitudinal analysis of the effects of infant-feeding practices on postpartum amenorrhea.
The Cebu Longitudinal Health and Nutrition Survey is used to examine the effect of various components of infant-feeding patterns on return of menses postpartum. The results show that factors such as active suckling, the use of two breasts versus one, breast-feeding on demand versus on a fixed schedule, and the feeding of other milks and of nonnutritive or low-caloric other liquids can be important under selected circumstances. Discrete-time logistic hazards modeling is used to estimate the weekly probability of return to menses.
Amenorrhea↗
A longitudinal analysis of unmet need for oral treatment in a national sample of medical HIV patients.
This longitudinal study examines perceived unmet dental need in a nationally representative probability sample of HIV-infected persons in medical care. A logistic regression analysis modeled the relationship between unmet need and explanatory variables. We estimate that 40% of HIV/AIDS patients report an unmet need associated with being male, being unemployed, injecting drugs, being heterosexual, lacking dental insurance, and having less education. Disparities in unmet need are related to socioeconomic status rather than to disease stage or ethnicity.
Adult↗
Disparities in psychological distress across education and sex: a longitudinal analysis of their persistence within a cohort over 19 years.
PURPOSE: Disparities in psychological distress across socioeconomic status and sex persist throughout adulthood as cohorts age. In this study, we investigate the extent to which this persistence represents either (i) a single set of individuals who at the start of adulthood show distress that is chronic and long lasting or (ii) different sets of individuals that have a staggered onset of short-term distress throughout adulthood. METHODS: We use path analysis on data from the National Child Development Study, a longitudinal cohort study that assessed psychological distress at ages 23, 33, and 42 years. RESULTS: About 80% of distress disparities at age 42 result from chronic distress that was present in a single set of individuals at least 19 years earlier at the beginning of adulthood. CONCLUSIONS: These results support a targeted approach to the reduction of distress disparities that focuses on young adults with high levels of distress and seeks to improve their long-term mental health.
Adult↗
A longitudinal analysis of efficacy expectations and exercise in older adults.
The purpose of this study was to consider the longitudinal changes in self-efficacy and outcome expectations for exercise and the impact of these variables on maintaining regular exercise over a 4-year period in a group of older adults living in a continuing care retirement community. There were 78 individuals who completed all four surveys. The participants had at least a high school education, and the majority were Caucasian (99%), female (83%) and either widowed or never married (80%). The mean age of the participants was 84.4+/-5.1 years. Based on repeated measure analysis of covariance, controlling for mental and physical health, there was not a statistically significant difference in self-efficacy expectations (F = 2.0, p > .05) or outcome expectations (F = 2.2, p > .05) over time. There was a statistically significant decrease in exercise over time (F = 9.9, p < .05). Using path analysis it was demonstrated that self-efficacy expectations, outcome expectations, and physical health directly and indirectly influenced maintenance of regular exercise. Age, gender, and mental health had a limited and inconsistent influence on maintenance of exercise. Future research and clinical work should focus on developing and testing interventions that strengthen both self-efficacy and positive outcome expectations in older adults to facilitate maintenance of exercise behavior over time.
Aged↗
A longitudinal analysis of adherence and health status in childhood diabetes.
Applied structural equation modeling to a longitudinal data set of 193 youngsters with insulin-dependent diabetes mellitus assessed on two occasions, an average of 1.65 years apart. Six adherence constructs, Injection, Exercise, Diet Type, Testing-Eating Frequency, Calories Consumed, and Concentrated Sweets, were quantified from 24-hr recall interviews conducted with mother and child. Glycemic control was indexed by glycosylated hemoglobin (HA1C); lipid metabolism was indexed by fasting triglyceride levels (TRIG). The relationship of each adherence construct to metabolic control was tested separately. Patient age and disease duration served as exogenous variables in all models. Testing-Eating Frequency was associated with HA1C and Injection was associated with TRIG; in both cases better adherence was associated with better metabolic control. However, the standardized regression weights and variance accounted for were small. Patient age was a predictor of both adherence and metabolic control; older youngsters were less adherent and were in worse metabolic control. Inspection of models for younger versus older children suggested that age-homogeneous models improved prediction, but adherence and metabolic control linkages remained weak. Suggestions for refining the model are provided.
Blood Glucose↗
A longitudinal analysis of selected risk factors for childhood psychopathology.
Eight-year and two-year longitudinal analyses of prevalence and risk factors for adult and adolescent psychopathology were carried out for a random sample of 776 children drawn from households in New York State. A 17.7% prevalence rate for one or more DSM-III disorders was estimated. In general, the risk factors studied were more related to externalizing than internalizing diagnoses. Risk factors assessed over 8-year and 2-year intervals were very similar.
Adolescent↗