Coping in longitudinal perspective: Findings from the bonn longitudinal study on aging

Within the Bonn Longitudinal Study on Aging (BOLSA) 221 women and men, born between 1890–95 and between 1900–05, were tested and interviewed in the year 1965 for the first time. Survivors were followed at seven measurement points until 1980. One of three lengthy interviews was related to the topic of stress and coping. Information on perceived stresses in the areas of housing, income, family and health were rated. Furthermore, responses to these different stress areas were analyzed by an empirically developed classification system. Findings point to a complex system of response patterns even in the group of very old participants. These response patterns were different for the four areas of stress, such as family or health etc. Response patterns related to the same problem area remained consistent over the 15-year span. Cluster analyses point to situation specific as well as person specific response patterns.This paper was originally presented at the XIV International Congress of Gerontology, Acapulco, Mexico, 18–23 June 1989.     

Generations and aging: a longitudinal study.

This study is a longitudinal investigation of the relationship between age and subjective outlook. Over the years, a number of theoretical positions have been introduced to either account for or to minimize age differences in attitudes, values and beliefs. The author has organized these theories of aging into three basic sociological fremeworks or models: the "generations" model, the "age status" model and the "illusion of differences" model. Using a relatively simple methodological desihn, hypotheses derived from these models were tested through secondary analysis of survey data. Strong support was found for the "generations" hypothesis, weak support for the "age status" hypothesis, and no support at all for the "illusion of differences" hypothesis.     

北京人口老龄化多维纵向研究的基线调查

目的拟通过纵向观察老年人在增龄过程中社会角色、身体健康、心理健康、价值观等的变化，了解老龄化对社会经济、文化发展的影响。本资料为基线调查概况的简介。方法根据１９９０年人口普查资料，按整群、分层、随机原则在北京市城、郊区抽样。经问卷调查和体格检查获得数据，利用ＳＰＳＳ软件包，由计算机进行数据库建立及数据统计分析。结果老年人中仍参加社会、家务劳动者的加权值分别为２８．４％和４９．８％。６７．１％有慢性病史，２５．０％生活不能自理，其中５．０％依赖他人，２０．０％自觉健康差或很差。量表检查显示总体心理健康尚好，生活满意度也较高。结论基线调查结果为了解北京市老年人的现状提供资料，并为纵向调查打下基础     

Predictors of dropout and burnout in AIDS volunteers: a longitudinal study

Burnout among HIV/AIDS volunteers contributes to the loss of dedicated personnel resulting in strain on the HIV/AIDS care system. Past research has suggested that there were significant stresses and burnout associated with AIDS caregiving. We investigated the predictors of dropout in AIDS volunteers over time, and specifically, which of the variables of the stressors and rewards of being a volunteer (collected at baseline) predicted who would drop out two years later. The volunteers were the subjects of Nesbitt et al. (1996), who were members of an interfaith religious-based organization in Houston, Texas. The subjects were re-contacted by mail after two years, and 76 of the 174 respondents completed a brief questionnaire which gave details of current volunteering activity, reasons for dropout (if they had dropped out) and completed the Texas Revised Inventory of Grief (TRIG). Forty dropped-out from volunteering while 36 continued. Data show the independent variables of total stressor score, the Maslach Burnout Inventory score of Depersonalization intensity and the three subscale scores involving stress: client problems and role ambiguity, emotional overload and organizational factors as being significant in predicting dropout in HIV/AIDS volunteers over time. The best predictors of the dropping-out of HIV/AIDS volunteers can be divided into the stresses (client problems and role ambiguity, emotional overload and organizational factors) and depersonalization intensity. The results showed that volunteers who experienced more client problems and role ambiguity, more emotional overload and more problems with organizational factors are more likely to drop out from the volunteer programme. They also show that the dropout volunteers have a significantly higher level of depersonalization intensity than the continuing volunteers, with the risk of dropout increasing by almost a third in the highest tertile of depersonalization intensity scores compared with those with lower scores. These data indicate that it is the stressors of AIDS volunteering, including the intensity of depersonalization, which lead to dropout, and that rewards do not appear to have a protective effect.     

Change in depressive symptoms in the Baltimore longitudinal study of aging

Depressive symptoms have been represented in the research and clinical literature in terms of both an episodic phenomenon and as enduring individual differences. We investigated depressive symptoms longitudinally in a sample of older adults. Participants were 737 individuals (M(Age) = 73 years initially, 39% women) in the Baltimore Longitudinal Study of Aging who provided biennial Center for Epidemiological Studies-Depression data on up to five occasions over an 8-year period. We found both trait and state-residual variability, with symptoms increasing longitudinally on all subscales and accounting for an approximately 1-point increase per decade. Trait-like variability accounted for at least two thirds of the reliable variance. Interindividual differences were consistent over time, but occasion-specific variability diminished across occasions.     

Predictors of mortality: an international comparison of socio-demographic and health characteristics from six longitudinal studies on aging: the CLESA project

PURPOSE: Multiple factors contribute to mortality in the elderly, but the extent to which traditional factors contribute independently to mortality in different countries is not known. Our objective is to determine the differential impact of socio-demographic variables, selected diseases, health habits and disability on all-cause mortality, among older people living in five European countries and Israel. METHODS: From six longitudinal studies on aging (TamELSA-Tampere (Finland), CALAS-Israel, ILSA-Italy, LASA-Netherlands, AL-Leganés (Spain), SATSA-Sweden), a harmonized common database was created in the context of the CLESA Project (Cross-national determinants of quality of life and health services for the elderly). A common five-year follow-up was used. RESULTS: The highest mortality rate was found in Tampere among females (98.7%) and in Israel among males (108.3%), whereas the lowest was observed in Leganés for males (72.3%) and in The Netherlands for females (44.6%). In multivariate models, some predictors were homogeneously, significantly distributed across the six countries, including older age (HR = 1.57) and male sex (HR = 1.60) among the socio-demographic variables; smoking status (HR = 1.15) and alcohol consumption (HR = 0.81) among the health habits variables; presence of heart disease (HR = 1.34), diabetes (HR = 1.46), cancer (HR = 1.93), respiratory disease (HR = 1.19), and disability (HR = 2.92) among the health status variables. Marital status, education, and drug use did not have homogeneous effects in the six countries. DISCUSSION: This large international study shows that multiple factors contribute to increased risk of all cause mortality among older people and that most risk factors are similar across countries. Disability, age greater than 80 years, cancer and male sex were identified as the strongest common risk factors of mortality.     

Predictors of locomotive syndrome in community-living people: A prospective five-year longitudinal study

Abstract

Objectives: Locomotive syndrome (LS) in middle-aged and elderly people has a high risk of a need for nursing care. The goal of the study was to examine predictors of LS in a prospective longitudinal study.

Methods: The subjects were 205 people (87 males, 118 females) aged >40 years who underwent physical examinations and completed health questionnaires in health checkups in the Yakumo study in 2011 and 2016. LS was defined as ≥16 on the 25-Question Geriatric Locomotive Function Scale (GLFS-25). Subjects with LS in 2011 were excluded. Associations of all variables with the GLFS-25 score were analyzed using univariate and multivariate analyses. A receiver operating characteristic (ROC) curve for each physical measurement test was constructed to determine the best threshold value.

Results: The subjects were divided into LS (n?=?21) and non-LS (n?=?184) groups, based on the 2016 checkup. In multivariate analysis, GLFS-25 (odds ratio [OR]?=?1.437; p?<?0.01), one-leg standing time (OR= 1.043, p?<?0.05), and back muscle strength (OR =0.961, p?<0.05) were significant predictors of LS. ROC analyses gave GLFS-25 scores of 6.2 and 6.8, one-leg standing times of 26.8 and 23.3?s, and back muscle strengths of 75.2 and 49.5?kg as thresholds for prediction of future LS in males and females, respectively.

Conclusions: GLFS-25 score, one-leg standing time, and back muscle strength were identified as significant risk factors for LS in community-dwelling people, and threshold values were determined for these factors in a longitudinal study. For elderly people, these indicators could be predictors of locomotive syndrome, and may have validity for assessment of improvement of physical abilities through muscle training and body balance training.     

High plasma insulin and lipids profile in older individuals: the Italian longitudinal study on aging

BACKGROUND: The inverse relationship of insulin level to high-density lipoprotein (HDL)-cholesterol and its positive association with hypertriglyceridemia has been demonstrated in several studies; however, the relationship of insulin to low-density lipoprotein (LDL)-cholesterol in elderly persons is not clear. This study investigates the relationships of fasting plasma insulin and selected metabolic and biological risk factors in an aged population. METHODS: The present study is based on a cross-sectional analysis of the data collected at baseline of the Italian Longitudinal Study on Aging in 1992 on a random sample of 5632 Italians aged 65-84 years. Analyses were performed to compare the distribution of risk factors, such as blood level of lipids, creatinine, albumin, fibrinogen, apolipoprotein A-1 and B, blood pressure, and body mass index (BMI), by quartiles of insulin, in both diabetic and nondiabetic participants. RESULTS: Significantly higher levels of triglycerides and BMI and lower levels of HDL-cholesterol were found in the upper quartile of insulin among nondiabetic individuals. In men, we also found significantly higher levels of systolic and diastolic blood pressure. The same trend for these variables, although not significant for HDL-cholesterol and blood pressure, was seen in diabetic men. In diabetic women, total and LDL-cholesterol were significantly lower in the highest insulin quartile (p <.001), while no significant differences were seen in nondiabetic women or in men. We also found higher levels of white blood cells in the highest insulin quartile of diabetic women. CONCLUSIONS: These results, apparently in disagreement with earlier reports on the clustering of cardiovascular disease risk factors in hyperinsulinemic individuals, could be due to the high frequency of chronic inflammation and the high prevalence of urinary infections in older diabetic women.     

Predictors of AIDS-preventive behavior among homosexually active men: a longitudinal study

Predictors of adoption of safer sexual behaviors were examined in a cohort of 278 homosexually active men with stable HIV-antibody status followed over 12 months at a Boston community health center. The behaviors examined included: (1) restriction of partners to one monogamous or steady relationship and (2) among men who maintained multiple or non-steady partners, the avoidance of unprotected receptive and insertive anogenital contact. For each behavior, men who adopted consistently safer behavior were compared with those who remained unsafe, using bivariate analyses and multiple logistic regression modelling. The strongest predictor of all behaviors was the initial level of the unsafe behavior. After controlling for this, weak effects of several health beliefs were found, including perceived susceptibility and medical efficacy. Men who became aware of a positive HIV-antibody test result and who reported greater effort to change their behavior were more likely to adopt safer insertive anogenital contact. In this generally well-educated cohort with high levels of knowledge about AIDS, adoption of safer sexual behaviors is best predicted from previous levels of unsafe behavior.     

Predictors of depressive symptoms in persons with diabetic peripheral neuropathy: a longitudinal study

Aims/hypothesis  The aim of the study was to determine whether diabetic peripheral neuropathy (DPN) is a risk factor for depressive symptoms and examine the potential mechanisms for this relationship. Methods  This longitudinal study (9 and 18 month follow-up) of 338 DPN patients (mean age 61 years; 71% male; 73% type 2 diabetes) examined the temporal relationships between DPN severity (mean ± SD; neuropathy disability score [NDS], 7.4 ± 2.2; mean vibration perception threshold, 41.5 ± 9.5 V), DPN somatic experiences (symptoms and foot ulceration), DPN psychosocial consequences (restrictions in activities of daily living [ADL] and social self-perception) and the Hospital Anxiety and Depression subscale measuring depressive symptoms (HADS-D; mean 4.9 ± 3.7). Results  Controlling for baseline HADS-D and demographic/disease variables, NDS at baseline significantly predicted increased HADS-D over 18 months. This association was mediated by baseline unsteadiness, which was significantly associated with increased HADS-D. Baseline ADL restrictions significantly predicted increased HADS-D and partly mediated the association between baseline unsteadiness and change in HADS-D. Increased pain, unsteadiness and ADL restrictions from baseline to 9 months each significantly predicted increased HADS-D over 18 months. Change in social self-perception from baseline to 9 months significantly predicted increased HADS-D and partly mediated the relationships of change in unsteadiness and ADL restrictions with change in HADS-D. Conclusions/interpretation  These results confirm that neuropathy is a risk factor for depressive symptoms because it generates pain and unsteadiness. Unsteadiness is the symptom with the strongest association with depression, and is linked to depressive symptoms by perceptions of diminished self-worth as a result of inability to perform social roles.     

State-of-the-art in longitudinal studies on aging: an overview of the supplement

The articles in this supplement are based on a conference held in January 2008 sponsored by a grant from the Robert Wood Johnson Foundation. The purpose of the conference was to summarize major findings and methodological issues in previous and ongoing longitudinal studies on aging and to identify potentially fruitful areas for future research. This article is a review and synthesis of the articles in this supplement. Each of the articles makes important contributions to summarizing existing research, identifying challenging methodological issues, or proposing areas that should be explored in future research. Three themes were identified: general improvement in the health status of the population aged 65 and older in the United States, a shift in longitudinal research on aging from a focus on the endpoints of disease to a focus on the preclinical stage and underlying mechanisms of these diseases, and contemporary developments in longitudinal research methodology. A number of practical suggestions were also drawn from the articles reviewed.     

Resolute italian study in all comers

Objectives : To assess clinical performance of the second‐generation Endeavor Resolute^® drug‐eluting stents (DES) in an unrestricted high‐risk cohort of patients. Background : New‐generation DESs aim to further increase its clinical safety and efficacy by means of more biocompatible components limiting inflammatory response, assuring strut coverage and preserving endothelial vascular function. Methods : Between January 2008 and April 2009 820 unselected consecutive high‐risk patients (1,352 lesions) treated with the Endeavor Resolute^® stent were enrolled in an independent multicenter registry. Primary end‐points of this registry were immediate procedural outcome, incidence of target lesion failure (TLF, defined as composite of cardiac death, myocardial infarction, and target lesion revascularization) and rate of ARC stent thrombosis at 12‐months follow‐up. Results : High‐risk patient/lesion profile included acute coronary syndrome diagnosis in 57% of patients, diabetes mellitus in 23% and ACC/AHA type B2/C lesion in 74%. Endeavor Resolute^® stent was used in an off‐label indication in 52% of cases with stent/patient ratio of 1.93 and average stented segment of 39.8±26.6mm. Immediate procedural success was accomplished in 96.0% of cases and at median 12‐month follow‐up TLF rate was 7.1% with 4.0% of clinically driven repeat revascularizations and 1.1% of definite/probable stent thrombosis incidence. At multivariable analysis, nor off‐label Endeavor Resolute^® stent use or multiple stent implantations were associated to an increased risk of adverse events. Conclusions : Extensive use of the new Endeavor Resolute^® stent was associated with favorable procedural and 12‐month outcomes despite the treatment of unselected complex clinical and anatomical presentation. Endeavor Resolute^® stent showed excellent safety and efficacy profile also in off‐label indications. © 2011 Wiley Periodicals, Inc.     

Characteristics of dropouts in longitudinal research on aging: A study of Mexican Americans and Anglos

The characteristics of dropouts in a four-year longitudinal study of Mexican Americans and Anglos aged 60 years and over are investigated. Dropouts are found to be significantly older, to be less healthy, to view themselves as older, and to be less active than persons remaining in the study. Subgroups of dropouts differ from each other: deceased persons and those who could not be located were found to be generally less advantaged than restudied persons, while refusers were found to be advantaged. Implications for longitudinal studies on aging are discussed.     

Depressive symptoms and development of coronary heart disease events: the Italian longitudinal study on aging

BACKGROUND: Studies on the association between depressive symptomatology (DS) and cardiovascular events and mortality in elderly persons have yielded contradictory findings. To address this issue, the authors assessed DS and an extensive array of sociodemographic, behavioral, and biological variables in the largest population-based sample of older Italians ever studied and analyzed their association with coronary heart disease (CHD) morbidity and total number of deaths. METHODS: This prospective, community-based cohort study included a sample of 5632 Italians, 65 years and older, who were recruited from the demographic registries of eight municipalities in Italy. Depressive symptomatology was assessed using the Geriatric Depression Scale, and a score > or =10 was used to indicate the presence of DS. All traditional cardiovascular disease risk factors were assessed at baseline, through questionnaires, blood tests, and physical examinations. The outcomes were CHD fatal and nonfatal events and total number of deaths. The association of the predictive variables with the outcomes was assessed using different Cox models. RESULTS: Baseline DS was associated with a higher incidence of fatal and nonfatal CHD events (hazard ratio [HR], 1.66; 95% confidence interval [CI], 1.06-2.60) and with cardiovascular mortality in men (HR, 2.49; 95% CI, 1.60-3.87) and with total mortality in men (HR, 2.02; 95% CI, 1.58-2.58) and women (HR, 1.43; 95% CI, 1.04-1.95) at the 4-year follow-up assessment. This association was observed after adjusting for a vast array of potential confounding variables, including major chronic conditions. CONCLUSIONS: Depressive symptomatology confers an increased risk for CHD in men and for total mortality in men and women but is not explained by health behaviors, social isolation, or biological or clinical determinants.