Psychosocial development during the adult years: Age and cohort comparisons.

E. H. Erickson's (1963) theory of psychosocial development throughout the life cycle has been called into question by previous research in which substantial evidence of ontogenetic change during the adult years has not been found. A partial sequential design was used to study personality development over a 10-yr period. Data on the Inventory of Psychosocial Development were collected from 292 college students in 1966 and again in 1976, when this same sample had become college alumni. Data from 224 undergraduates were also collected in 1976. The results of the longitudinal and cross-sectional analyses are consistent with the existence of age-related changes. An interaction effect obtained in the time-lag analysis suggested that the increase in psychosocial maturity among males involved a process of ontogenetic development whereas that for females may have been a function of a historical trend. (11 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized walking trial in postmenopausal women: effects on physical activity and health 10 years later

BACKGROUND: It is important to determine if permanent lifestyle changes may result from physical activity interventions and whether health may be affected by these changes. OBJECTIVE: To conduct a 10-year follow-up of physical activity and self-reported health status in participants of a randomized clinical trial of walking intervention. METHODS: Of the original 229 volunteer postmenopausal women who participated in the original clinical trial, 196 (N = 96 intervention and 100 controls) completed the 10-year follow-up telephone interview. The interview protocol included questions on self-reported walking for exercise and purposes other than exercise, the Paffenbarger sport and exercise index, functional status, and various chronic diseases and conditions. RESULTS: The median values for both usual walking for exercise and total walking were significantly higher for walkers compared with controls (for both, P = .01), with median differences of 706 and 420 kcal/wk, respectively. After excluding women who reported heart disease during the original trial, 2 women in the walking group (2%) and 11 women in the control group (12%) reported physician-diagnosed heart disease over the last 10 years (P = .07). There were also fewer hospitalizations, surgeries, and falls among women in the walking group, although these differences were not statistically significant (P>.05). CONCLUSIONS: Although limited by self-report, this study may be the first to demonstrate long-term exercise compliance to a randomized control trial in older women and to suggest that health benefits may have ensued as a result of these increased activity levels.     

Predictive factors of physical disability in a cohort of retired persons in Paris followed during 10 years

OBJECTIVE: The objective of the present study was to examine predictors of physical disability in a survey of retired men and women living in the Paris area followed-up longitudinally for 10 years. METHODS: Subjects were randomly selected in a supplementary retirement pension fund. In all 627 subjects took part in the first phase of the survey (1982-83) and 392 in the follow-up phase (1992-93). At the 10-year follow-up, there were 185 confirmed deaths and 50 subjects refused to participate or could not be traced. Physical disability was measured by difficulties reported by the subjects for seven basic activities of daily life. Possible predictors, socio-demographic, impairments, physical activities, working conditions during working life were explored at T1. RESULTS: The incidence of physical disability was 41.4% for men and 57.6% for women. For disability in mobility, the incidence was 37.1% for men and 54.7% for women. In multivariate analysis, predictors of physical disability were social category (clerks), no physical activities, use of medicine, mental impairment. The predictors of disability in mobility were sex (women), social category (clerks), use of medicine, cardio-respiratory and sensory impairments. On the contrary, subjects with mental impairment had a lower incidence of disability in mobility than subjects without mental impairment. CONCLUSION: The results confirm the two poles of disability: biomedical and social. Working conditions during working life do not seem to play a direct part in incidence of disability at ten years follow-up.     

Serum homocysteine and risk of coronary heart disease and cerebrovascular disease in elderly men: a 10-year follow-up

Hyperhomocysteinemia is an independent risk factor for atherosclerotic disease in the middle-aged. We investigated whether a high serum homocysteine level is a risk factor for vascular disease in 878 elderly men (mean age at baseline, 71.5 years; range, 64 to 84 years) in a population-based, representative cohort followed up for 10 years in Zutphen, the Netherlands. Thirty-one percent had nonfasting homocysteine levels >/=17 micromol/L. After adjustment for other major risk factors, high homocysteine levels at baseline (the third compared with the first tertile) were associated with an increased baseline prevalence of myocardial infarction (odds ratio [OR], 1.81; 95% confidence interval [CI], 1.07 to 3.08; P for trend, 0.03) and with a marginally significant increase in the risk of dying of coronary heart disease (relative risk [RR], 1.58; 95% CI, 0.93 to 2.69; P for trend, 0.09) but not with an increased risk of first-ever myocardial infarction. In addition, high homocysteine levels at baseline were associated with an increased baseline prevalence of stroke (OR, 4.61; 95% CI, 1.79 to 11.89; P for trend, 0.002) and with an increased risk of dying of cerebrovascular disease in subjects without hypertension (RR, 6.18; 95% CI, 2.28 to 16.76) but not in those with hypertension. High homocysteine levels were associated with an increased risk of first-ever stroke among normotensive subjects that was not statistically significant (RR, 1. 77 [95% CI, 0.83 to 3.75; P for trend, 0.14]). In a general population of elderly men, a high homocysteine level is common and is strongly associated with the prevalence of coronary heart disease and cerebrovascular disease. It is a strong predictive factor for fatal cerebrovascular disease in men without hypertension but less so for coronary heart disease.     

The effects of smoking on bone mass and the rates of bone loss among elderly Japanese-American men

Bone density and bone loss rates were examined among Japanese-American men categorized as current cigarette smokers, past smokers, and nonsmokers. The design included a retrospective study of smoking and bone density and a prospective study of current smoking and bone loss rates. The mean length of follow-up was 5 years; the setting was the island of Oahu. The subjects included 1303 men in the Hawaii Osteoporosis Study, 51-82 years old at their initial examination. Twenty percent were current smokers, 45% past smokers, and 35% had never smoked. Their bone density was measured at the distal and proximal radius and calcaneus using single photon absorptiometry. Compared with never smokers, current and past smokers had significantly lower bone density, especially in the predominantly cancellous calcaneus (4.8 and 4.3% lower, respectively) and partially trabecular distal radius (1.8 and 3.3% lower, respectively). The magnitude of the smoking effect was linked strongly to the duration of smoking and also to the number of cigarettes smoked. Bone loss rates subsequent to the initial measurement were greater in the current smokers than the never smokers (20.5, 27.2, and 9.7% greater at the calcaneus, distal, and proximal radius, respectively) but the differences did not achieve significance. Smokers of more than one pack per day had 32.0, 77.6, and 30.7% greater loss rates than never smokers in these same sites; the difference achieved significance at the distal radius. The results from the distal radius suggest that these smokers may increase their fracture risk 10-30% per decade of smoking. The adverse effects of smoking appeared to be greater in cancellous than cortical bone.     

An approach to the attribution of aging, period, and cohort effects.

To extricate the inherently confounded factors of maturation, cultural change, and generational differences, life-span methodologists have proposed a variety of analytic designs and interpretative decision rules. Recent critiques have shown that the proposed rules are inadequate and that there are logical limits to any such set of rules. A number of alternatives have been offered, most of which require the investigator to have strong, theoretically guided hypotheses and presume that the data conform strictly to the demands of the design. This article addresses the common situation in which data analysis is exploratory rather than hypothesis testing and in which the model is applied to data that only loosely meet the requirements of the design. In this case, aging, period, or cohort effects can be inferred if the researcher is willing to make appropriate restrictive assumptions and use scientific judgment rather than fixed decision rules. The application of judgmental principles is illustrated on 2 longitudinal data sets, and it is argued that the analytic designs are useful if intelligently applied and interpreted. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social support, activity, and health among the elderly]

The present study examined the relationship between social support, activity level and physical health among a sample of 96 Puerto Rican elderly persons. The Spanish version of the Inventory of Socially Supportive Behaviors (ISSB28) was used to assess social support. Two structured questionnaires were administered to obtain measures of activity level and physical health. A multiple correlation-regression analysis was performed, and partial correlation coefficients were also obtained. A partial correlation of .48 (p < .001) was observed between the ISSB scores and the measure of physical health, indicating a direct relationship between poor health and social support. This finding is inconsistent with previous studies, which suggest that better health is associated with higher levels of social support. Moderate-low, negative correlations were found between activity level and 3 indicators of poor health. Thus, higher activity levels were associated with better physical health. For example, partial correlations of-.31 (p = .003) and -.29 (p = .007), respectively, were found between the activity level and the number and length of hospital stays. The correlation between the amount of surgical interventions undergone by the patient during the previous year and the activity level was -.28 (p = .009). These findings demonstrate that higher levels of activity are associated with better physical health in elderly persons, as indicated by less frequent and shorter hospital stays, and lower frequency of surgical interventions. Several multiple regression analyses showed that social support and activity level, taken together, are statistically significant predictors of the number and length of hospital stays, and the number of surgical interventions undergone by the elderly patient. Together, these two factors explain from 11 to 18% of the variability in several indicators of physical health.     

Education and the risk of physical disability and mortality among men and women aged 65 to 84: the Italian Longitudinal Study on Aging

BACKGROUND: Most studies report that people with higher education enjoy better health and longer life. Although it is well known that most risk factors are more common among individuals with a lower level of education, the underlying mechanism of this association is not fully understood. The objective of this study was to assess the association between education, disability, and mortality. METHODS: We analyzed data on 1,817 men and 1,643 women, aged 65-84 years, to assess the association of educational level with physical disability and mortality adjusting for age, sex, smoking habit, occupation, and major chronic conditions. RESULTS: The association between educational level and disability was characterized by a dose-response effect, with the relative odds significantly decreased by about 30%, 60%, and 79% in those with 4 or 5, 6 to 8, and more than 8 years of education, compared to those with 3 or less years of education. Death rates were lower among persons with 4 or more years of education compared to those with less education. However, after adjusting for disability status, education was no longer associated with mortality (RR=0.97, CI=0.65-1.43). CONCLUSIONS: The strong association of low education with disability found in this study may explain the inverse association with mortality reported in previous studies. Disability, indeed, seems to be the mediator between education and mortality and might be due to the higher severity level of diseases, leading to death, in the lower educated group.     

Phenomenology of life satisfaction among elderly men: Quantitative and qualitative views.

Standardized measures of subjective well-being were compared with qualitative analysis of life satisfaction from 100 elderly men (70 years and older) from New Delhi, India, and London, England. 3 structured measures were used, Life Satisfaction Index (A), Cantril Self-Anchoring Ladder, and a one-item happiness question. Qualitative data were obtained from semistructural interviews covering the past and present experiences. Meaning units were extracted from interview protocols, emerging themes were identified for each respondent, and overall summaries were written for English and Indian samples. Groups did not differ significantly on any of the structured measures, but showed marked differences in the qualitative analysis. Limitations of structured measures of subjective well-being are discussed in terms of "context-stripping," both in data collection and data analysis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Physical activity, physical fitness, and all-cause and cancer mortality: a prospective study of men and women

We studied physical fitness and physical activity in relation to all-cause and cancer mortality in a cohort of 7080 women and 25,341 men examined at the Cooper Clinic in Dallas, Texas, during 1970 to 1989. Physical fitness was assessed at baseline by a maximal treadmill exercise test, while physical activity was self-reported on the attendant health habits questionnaire. Both men and women averaged about 43 years of age at baseline (range, 20 to 88 years), and they were followed for approximately 8 years on average. Through the end of 1989, the women contributed 52,982 person-years of observation and incurred 89 deaths, including 44 deaths due to cancer. The men contributed 211,996 person-years and incurred 601 deaths, with 179 due to cancer. After adjustment for baseline differences in age, examination year, cigarette habit, chronic illnesses, and electrocardiogram abnormalities, we found a strong inverse association between risk of all-cause mortality and level of physical fitness in both men and women (P for trend < 0.001). Physically active men also were at lower risk of all-cause mortality than were sedentary ones (P for trend = 0.01). Among women, however, self-reported physical activity was not significantly related to risk of death from all causes. The risk of mortality from cancer declined sharply across increasing levels of fitness among men (P for trend < 0.001), whereas among women the gradient was suggestive but not significant (P for trend = 0.07). Physically active men also were at lower risk of death from cancer than were sedentary men (P for trend = 0.002), but among women physical activity was unrelated to cancer mortality.     

Frequency and characteristics of silent dementia among elderly Japanese-American men. The Honolulu-Asia Aging Study

OBJECTIVE: To determine the frequency of unrecognized dementia in a group of men found to have dementia by population survey, and to identify factors associated with the failure of a family informant to recognize significant memory impairment. DESIGN AND SETTING: The Honolulu-Asia Aging Study, a population-based study of dementia among elderly Japanese-American men living on the island of Oahu, Hawaii. Data for this study were from the dementia prevalence survey, 1991-1993. STUDY PARTICIPANTS: A total of 191 noninstitutionalized men with dementia who had a reliable family informant. MAIN OUTCOME MEASURES: Failure of family informants to recognize a problem with thinking or memory in subjects with dementia. RESULTS: A total of 21% of family informants failed to recognize a problem with memory among subjects subsequently found to have dementia. Among subjects with very mild dementia, 52% of family informants failed to recognize a significant memory problem compared with 13% among more severely demented subjects. Of the subjects with dementia whose family informants did recognize a memory problem, 53% failed to receive a medical evaluation for this problem. For all family informants, increasing age, fewer years of education, less severe dementia, fewer behavioral complications, fewer functional disabilities, and better performance on certain tests of memory and language were significantly associated with the family informant's failure to recognize a problem with memory. When the family informants were wives living with husbands, less severe dementia, fewer behavioral complications, fewer functional disabilities, and intact remote memory were associated with unrecognized dementia. CONCLUSIONS: Unrecognized dementia was common in our population, especially among mild cases. Cognitive screening programs for the elderly and public education policies designed to increase awareness of early signs of dementia are needed if interventions for individuals with potentially treatable dementias are to be implemented.     

Athletic classmates, physical self-concept, and free-time physical activity: A longitudinal study of frame of reference effects.

The systematic analysis of factors that promote or impede physical activity in children is an urgent task for educational researchers. The present study investigated the reciprocal relationship between physical self-concept, teacher-assigned grades in physical education classes, and free-time physical activity, and analyzed positive and negative consequences of being in a class with high class-average physical ability. Data from a large, representative sample of 1,095 preadolescents from 66 classrooms were examined within a longitudinal framework. Multilevel analyses showed that membership in a class with high class-average physical ability was associated with lower physical self-concept and free-time physical activity and highlighted the significant role of teacher-assigned grades in the development of physical self-concept and physical activity. Furthermore, as predicted, there were positive reciprocal effects between physical self-concept and physical activity levels. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Age, individuality, and context as factors in sustained visual attention during the preschool years

In 3 studies, the authors explored age changes and individual differences in preschool children's sustained attention in several different contexts--watching a videotape, playing with toys, and performing reaction time tasks. Various indexes of attention increased from 30 months to 54 months, whereas inattention decreased. Changes tended to occur earlier for play and television viewing than for the reaction time task. Together, the results also provide evidence for individual differences in measures of attention and inattention through high internal consistency and stability over time within situations. Correlations across situations, however, were low to modest. These results suggest that children have stable tendencies to focus and sustain attention in particular contexts but that their attention varies with the demands of the task and their ability or interest in meeting those demands.     

Changes in physical activity, mortality, and incidence of coronary heart disease in older men

BACKGROUND: We studied the relations between physical activity and changes in physical activity, all-cause mortality, and incidence of major coronary-heart-disease events in older men. METHODS: In 1978-80 (Q1), 7735 men aged 40-59 were selected from general practices in 24 British towns, and enrolled in a prospective study of cardiovascular disease, which included physical activity data. In 1992 (Q92), 12-14 years later, 5934 of the men (91% of available survivors, mean age 63 years) gave further information on physical activity and were then followed up for a further 4 years. The main endpoints were all-cause mortality during 4 years of follow-up from Q92, and major fatal and non-fatal coronary-heart-disease events during 3 years of follow-up from Q92. FINDINGS: Among 4311 men with no history of coronary heart disease, stroke, or "other heart trouble" by Q92 and who did not report "poor health", there were 219 deaths. In the inactive/occasionally active, light, moderate, and moderately vigorous/vigorous activity groups there were 101 (18.5/1000 person-years) 48 (11.4), 23 (7.3), and 47 (9.1) deaths, respectively (adjusted risk ratios 1.00, 0.61 [95% CI 0.48-0.86], 0.50 [0.31-0.79], 0.65 [0.45-0.94]). Men who were sedentary at Q1 and who began at least light activity by Q92 had significantly lower all-cause mortality than those who remained sedentary, even after adjustment for potential confounders (risk ratio=0.55 [0.36-0.84]). Physical activity improved both cardiovascular mortality (0.66 [0.35-1.23]) and non-cardiovascular mortality (0.48 [0.27-0.85]). The relation between physical activity at Q92, changes in physical activity, and mortality were similar for men with pre-existing cardiovascular disease. INTERPRETATION: Maintaining or taking up light or moderate physical activity reduces mortality and heart attacks in older men with and without diagnosed cardiovascular disease. Our results support public-health recommendations for older sedentary people to increase physical activity, and for active middle-aged people to continue their activity into old age.     

Food preferences, eating patterns, and physical activity among adolescents: correlates of eating disorders symptoms

PURPOSE: Food preferences, eating patterns, and physical activity patterns were examined in a cohort of adolescent females and males participating in a longitudinal study of the developmental antecedents of eating disorders. METHODS: All adolescents (n = 1494) in grades seven through ten in an entire school district completed a survey about their dieting behaviors, eating, and exercise patterns. RESULTS: Principal components analysis showed similar factor structures for food preferences and eating patterns among males and females. Gender differences were present in physical activity patterns. Sports participation was correlated with healthy food preference and was a significant predictor of eating disorders symptoms. Junk food preference was marginally inversely related to eating disorders symptoms in females. Preference for other types of foods and reported intake of foods were not related to eating disorders symptoms. The percent of variance in risk score accounted for by dietary intake and physical activity patterns was small. CONCLUSIONS: Psychological and social/environmental variables may explain a larger proportion of the variance in eating disorders risk than the dietary and physical activity variables examined in this study. Implications for understanding the etiology and behavioral expression of eating disorders are discussed.     

The influence of physical activity and fractures on ultrasound parameters in elderly people

A fluorine-18-labeled analog of the potent nicotinic agonist epibatidine is a candidate radioligand for positron emission tomographic (PET) studies of nicotinic acetylcholine receptors (nAcChR). Following intravenous administration of [18F]exo-2-(2'-fluoro-5'-pyridinyl)-7-azabicyclo[2.2.1]heptane (NFEP), high uptake in thalamus was visualized in sections of mouse and rat brain by autoradiography using a phosphor imaging device. Binding of [18F]NFEP to rat thalamic homogenate was consistent with a single class of binding site with a Kd value of 71 pM. In vitro autoradiography of thaw-mounted sections of human thalamus revealed a heterogeneous pattern of binding; Bmax values for ventrolateral nucleus, insular cortex and dorsomedial nucleus, and internal capsule were 20, 8, and 3 pmol/cc of tissue, respectively. However, similar Kd values close to 50 pM were calculated for all regions. These studies support the suitability of [18F]NFEP as a radioligand for PET studies of nAcChR in the living human brain.     

Childhood reflux and urinary infection: a follow-up of 10-41 years in 226 adults

To ascertain the outcome of childhood vesicoureteric reflux (VUR), 226 adults (37 males), mean age 27 years, were studied after 10-35 years, extended to 41 years by postal questionnaire in 161. At presentation (mean age 5 years) all had VUR (grade III-V in 68) and urinary tract infection (UTI); there was renal scarring in 85 (acquired before referral in 11 and during follow-up in 1), hypertension in 6 and impaired renal function in 5. They were managed and followed prospectively by one paediatrician; 63% of these children remained free from UTI; VUR persisted in 63 and had resolved in 69% of 193 children managed medically. At follow-up, 61% of adults had remained free from infection; 17 adults had hypertension and/or raised plasma creatinine, 16 with scarred kidneys. Their deterioration was predictable because of scar type, blood pressure or plasma creatinine levels in childhood. No new scars developed after puberty. Renal growth rates were unaffected by initial severity or persistence of VUR. On the later questionnaire, 9 further adults, mean age 38 years, had moderate hypertension. The adults with complications were those with extensive renal scarring and/or at least borderline hypertension in childhood. Those with VUR, but no scarring, and managed carefully in childhood, did not suffer serious consequences as adults. There is a need for early recognition and treatment of children with VUR and UTI to limit scar development.     

The effects of lidocaine on the vulnerable period during ventricular fibrillation

INTRODUCTION: It was postulated that a subthreshold defibrillation shock failed to halt ventricular fibrillation because the shock itself reinitiated ventricular fibrillation by falling into the vulnerable period of the wavefronts. Whether or not the timing of the vulnerable period is determined by the ventricular fibrillation cycle length is unknown. METHODS AND RESULTS: We determined the patterns of epicardial activation in ten dogs by computerized mapping techniques during unsuccessful defibrillation. Lidocaine was then given to prolong the ventricular fibrillation cycle length, and the computerized mapping studies were repeated. The results showed that lidocaine increased the ventricular fibrillation cycle length from 110 +/- 13 msec to 156 +/- 5 msec (P < 0.001). Among 55 episodes of unsuccessful defibrillation, the site of the earliest postshock activation occurred in the center of the mapped tissue 12 times at baseline and 14 times during lidocaine infusion. At electrodes that registered as postshock early sites, the preshock intervals clustered within a narrow range both before (58 +/- 14 msec) and during (101 +/- 18 msec, P < 0.001) lidocaine infusion. The correlation between the preshock intervals and the ventricular fibrillation cycle length was significant for these 26 sites (r = 0.87, P < 0.001). CONCLUSION: We conclude that a vulnerable period is present during ventricular fibrillation, and the timing of the vulnerable period is determined by the ventricular fibrillation cycle length.