The Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences

Julie Robison, Cynthia Gruman, Sonia Gaztambide, Karen Blank

doi: 10.1093/gerona/57.5.M308pmid: 11983725

Background. Brief depression screens have recently been developed, but their use in older or minority populations has not been studied. To date, optimal depression screens and optimal cutpoints have not been identifed for middle-aged and older Hispanic primary care patients. Methods. This study compares multiple versions of four depression screening tools—Center for Epidemiologic Studies–Depression Scale (CES-D), Geriatric Depression Scale, Yale 1-question screen, and PRIME-MD 2-question screen—to the Composite International Diagnostic Interview (CIDI), the World Health Organization's diagnostic interview, which has been validated in adult Latino populations, to assess convergent validity. Three hundred and three Puerto Rican primary care patients age 50 and older completed all screens and the CIDI in a face-to-face interview. Sensitivity and specificity for each screen were calculated, and receiver operator characteristic curves were generated. Results. Between 34% and 61% of patients screened positive for depression, depending on the measure, with 12% meeting DSM-IV criteria for major depression (CIDI). The 10-item CES-D worked best to identify major depression in this population, with a sensitivity of 84% and specificity of 64% using a cutpoint of 3. Conclusions. The 10-item CES-D, which takes about 2 minutes to administer, is a useful tool for identifying Puerto Rican patients in need of an in-depth mental health evaluation in a primary care setting. A lower cutpoint of 3 (instead of the conventional cutpoint of 4) is recommended for optimal sensitivity and specificity. The Gerontological Society of America « Previous | Next Article » Table of Contents This Article J Gerontol A Biol Sci Med Sci (2002) 57 (5): M308-M314. doi: 10.1093/gerona/57.5.M308 » Abstract Free Full Text (HTML) Free Full Text (PDF) Free Classifications Journal of Gerontology: Medical Sciences Services Article metrics Alert me when cited Alert me if corrected Find similar articles Similar articles in Web of Science Similar articles in PubMed Add to my archive Download citation Request Permissions Citing Articles Load citing article information Citing articles via CrossRef Citing articles via Scopus Citing articles via Web of Science Citing articles via Google Scholar Google Scholar Articles by Robison, J. Articles by Blank, K. Search for related content PubMed PubMed citation Articles by Robison, J. Articles by Gruman, C. Articles by Gaztambide, S. Articles by Blank, K. Related Content Load related web page information Share Email this article CiteULike Delicious Facebook Google+ Mendeley Twitter What's this? Search this journal: Advanced » Current Issue November 2015 70 (11) Alert me to new issues The Journal About the journal Translational Articles Free Editors’ Choice Articles Impact Factor Articles The Journals of Gerontology, Series A Supplements Special Issues Rights & permissions We are mobile – find out more Journal Career Network Published on behalf of The Gerontological Society of America Impact Factor: 5.416 5-Yr impact factor: 5.406 Editorial Boards The Journals of Gerontology, Series A: Biological Sciences Rafael de Cabo, PhD, Editor View full editorial board The Journals of Gerontology, Series A: Medical Sciences Stephen B. Kritchevsky, PhD View full editorial board For the Media GSA Press Room For Authors Instructions to authors Services for authors Submit Now: Biological Sciences Submit Now: Medical Sciences Self-Archiving Policy Online Submission Open access options for authors - visit Oxford Open WhsSvhnOkaAwYG81FJCYgwG7z1LnIP2F true Looking for your next opportunity? Looking for jobs... jQuery_1_11 = jQuery.noConflict(true); Corporate Services What we offer Advertising sales Reprints Supplements Classified Advertising Sales Alerting Services Email table of contents CiteTrack XML RSS feed

Reynolds, Thomas H.; Krajewski, Katherine M.; Larkin, Lisa M.; Reid, Pamela; Halter, Jeffrey B.; Supiano, Mark A.; Dengel, Donald R.

doi: N/Apmid: N/A

The purpose of this study was to determine if age-related muscle atrophy is associated with an increased rate of protein degradation in extensor digitorum longus (EDL) muscles from young (YG; 2–4 months), middle-aged (MA; 12–17 months), and aged (AG; 22–24 months) B6C3F1 mice. EDL muscles from AG mice weighed less than EDL muscles from MA mice (p = .01). EDL muscles from MA mice weighed more than EDL muscles from YG mice (p = .02). The rate of protein degradation, as assessed by tyrosine release during in vitro incubations, was higher in EDL muscles from AG mice than it was in those from MA mice (p = .03). The rate of protein degradation was higher in EDL muscles from YG mice than it was in those from MA mice (p = .04). An inverse relationship existed between muscle mass and protein degradation (r = −.67; p = .0001). We conclude that skeletal muscle protein degradation rates decrease with maturation and increase with advancing age.

Singh, Maria Antoinette Fiatarone

doi: N/Apmid: N/A

Graziano Onder, Brenda W.J.H. Penninx, Pablo Lapuerta, Linda P. Fried, Glenn V. Ostir, Jack M. Guralnik, Marco Pahor

doi: 10.1093/gerona/57.5.M289pmid: 11983722

Background. Although lower and upper extremity performance measures are widely used and represent validated physical function measures in older adults, there is limited information regarding the magnitude of changes in these measures over time. This study (i) assesses prospective changes in physical performance measures, (ii) defines a summary score that demonstrates a significant amount of change over time, and (iii) examines rates of decline according to age and baseline performance levels. Methods. Data from the Women's Health and Aging Study (WHAS) were analyzed to assess change in the one third most disabled older women living in the community. Lower extremity function was assessed using walking speed, balance, and chair stands tests. The putting-on-blouse test, the lock and key test, the Purdue Pegboard test, and grip strength were used to gauge upper extremity function. Continuous and categorical summary performance scores were calculated using continuous and categorical data of lower and upper performance measures. Results. After 3 years, lower extremity performance measures declined by 16%–27%, while upper extremity performance measures declined less (7%–24%). For lower extremity function, the continuous summary performance score showed a slightly greater 3-year decline from baseline (decline vs baseline mean: 23%; decline vs SD of the baseline mean: 59%) than the categorical score (22% and 41%, respectively). Older age and intermediate level of baseline performance were associated with the greatest decline, especially for lower extremity function. Conclusions. In moderately to severely disabled women aged 65 or older, lower extremity measures show more change over 3 years than upper extremity measures. Among the lower extremity summary scores, the continuous score changes more over time than the categorical score with respect to the baseline SD . The lower extremity continuous summary performance score may be a useful outcome measure for clinical studies of physical performance in older women. The Gerontological Society of America « Previous | Next Article » Table of Contents This Article J Gerontol A Biol Sci Med Sci (2002) 57 (5): M289-M293. doi: 10.1093/gerona/57.5.M289 » Abstract Free Full Text (HTML) Free Full Text (PDF) Free Classifications Journal of Gerontology: Medical Sciences Services Article metrics Alert me when cited Alert me if corrected Find similar articles Similar articles in Web of Science Similar articles in PubMed Add to my archive Download citation Request Permissions Citing Articles Load citing article information Citing articles via CrossRef Citing articles via Scopus Citing articles via Web of Science Citing articles via Google Scholar Google Scholar Articles by Onder, G. Articles by Pahor, M. Search for related content PubMed PubMed citation Articles by Onder, G. Articles by Penninx, B. W. Articles by Lapuerta, P. Articles by Fried, L. P. Articles by Ostir, G. V. Articles by Guralnik, J. M. Articles by Pahor, M. Related Content Load related web page information Share Email this article CiteULike Delicious Facebook Google+ Mendeley Twitter What's this? Search this journal: Advanced » Current Issue November 2015 70 (11) Alert me to new issues The Journal About the journal Translational Articles Free Editors’ Choice Articles Impact Factor Articles The Journals of Gerontology, Series A Supplements Special Issues Rights & permissions We are mobile – find out more Journal Career Network Published on behalf of The Gerontological Society of America Impact Factor: 5.416 5-Yr impact factor: 5.406 Editorial Boards The Journals of Gerontology, Series A: Biological Sciences Rafael de Cabo, PhD, Editor View full editorial board The Journals of Gerontology, Series A: Medical Sciences Stephen B. Kritchevsky, PhD View full editorial board For the Media GSA Press Room For Authors Instructions to authors Services for authors Submit Now: Biological Sciences Submit Now: Medical Sciences Self-Archiving Policy Online Submission Open access options for authors - visit Oxford Open WhsSvhnOkaAwYG81FJCYgwG7z1LnIP2F true Looking for your next opportunity? Looking for jobs... jQuery_1_11 = jQuery.noConflict(true); Corporate Services What we offer Advertising sales Reprints Supplements Classified Advertising Sales Alerting Services Email table of contents CiteTrack XML RSS feed

Bortz, Walter M.

doi: N/Apmid: N/A

This article presents an overview of the increasingly common condition of frailty, which by and large lacks clarity of definition. A variety of sources provide this statement regarding definition, incidence, causation, rate, and time of appearance. Utilizing the newly elaborated process of symmorphosis, which explains the coadaptation of structure and function secondary to altered energy loads, I propose that frailty is a body-wide set of linked deteriorations including, but not confined to, musculoskeletal, cardiovascular, metabolic, and immunologic systems. The common final pathway that leads to this constellation of findings is usually keyed to a decline in physical activity either as a result of habit or disease inputs. As such, the state of frailty is largely separable from the process of aging and should thereby be susceptible to active intervention and reversal.

Juan J. Díez

doi: 10.1093/gerona/57.5.M315pmid: 11983726

Background . Several epidemiological studies on the prevalence of hypothyroidism in the elderly have been reported; however, extensive series of elderly patients with thyroid dysfunction have not been studied. Our aim has been to assess the relative frequency of the diverse causes of hypothyroidism in a group of patients older than 55 years and the adequacy of control of thyroid function attained by levothyroxine therapy. Method s. We performed a descriptive, observational, cross-sectional study in the setting of a hospital endocrinology clinic. From a total of 1581 patients older than 55 who were complaining of a thyroid disorder, we studied a group of 655 patients with hypothyroidism. There were 559 women (85.3%, age 65.01 ± 7.90 years) and 96 men (14.7%, 65.36 ± 8.39 years). In every patient, we collected etiology, presence of goiter, time of evolution from diagnosis and from therapy prescription, previous and present treatments, current thyroid functional status (free thyroxine and thyrotropin concentration), adequacy of disease control, and thyroid autoimmune status. Result s. The causes of hypothyroidism were as follows: autoimmune thyroiditis, 308 (47.0%); postoperative hypothyroidism, 175 (26.7%); therapy for previous thyrotoxicosis, 63 (9.6%); thyrotropin deficiency, 15 (2.3%); iodine excess, 6 (0.9%); subacute thyroiditis, 2 (0.3%); and unknown etiology, 86 (13.1%) patients. Most patients with autoimmune thyroiditis were positive for thyroid peroxidase antibodies at the time of the study (94.4%). Mean (± SD ) age at diagnosis was 61.8 ± 9.4 years in men and 59.8 ± 9.7 years in women. Median (range) duration of hypothyroidism was 1.4 (0–18) years in men and 3 (0–45) years in women ( p < .05). Adequacy of therapy was studied in 385 patients treated with replacement doses of levothyroxine. Two hundred and sixty (67.5%) of these subjects attained good control, whereas 125 (32.5%) showed inadequate control of the disease at the time of the study. A model of logistic regression showed that adequacy of therapy was dependent on the duration of therapy, but independent of age, gender, degree of hypothyroidism, etiology, autoimmune status, age at diagnosis, and dose of levothyroxine. A 2-year follow-up study performed in 56 newly diagnosed patients showed that an adequate control of hypothyroidism was attained in 35 (62.5%) patients at 6 months, in 46 (82.1%) patients at 1 year, and in 49 (87.5%) at 2 years of therapy with levothy-roxine. Conclusions. Autoimmune thyroiditis and postoperative hypothyroidism are the main causes of thyroid hypofunction in patients older than 55 years. The time from starting therapy is the main determinant of the adequacy of control of thyroid hypofunction in this population. With effective therapy and appropriate monitoring, more than 80% of the patients showed adequate control within 1 year of follow-up. The Gerontological Society of America « Previous | Next Article » Table of Contents This Article J Gerontol A Biol Sci Med Sci (2002) 57 (5): M315-M320. doi: 10.1093/gerona/57.5.M315 » Abstract Free Full Text (HTML) Free Full Text (PDF) Free Classifications Journal of Gerontology: Medical Sciences Services Article metrics Alert me when cited Alert me if corrected Find similar articles Similar articles in Web of Science Similar articles in PubMed Add to my archive Download citation Request Permissions Citing Articles Load citing article information Citing articles via CrossRef Citing articles via Scopus Citing articles via Web of Science Citing articles via Google Scholar Google Scholar Articles by Díez, J. J. Search for related content PubMed PubMed citation Articles by Díez, J. J. Related Content Load related web page information Share Email this article CiteULike Delicious Facebook Google+ Mendeley Twitter What's this? Search this journal: Advanced » Current Issue November 2015 70 (11) Alert me to new issues The Journal About the journal Translational Articles Free Editors’ Choice Articles Impact Factor Articles The Journals of Gerontology, Series A Supplements Special Issues Rights & permissions We are mobile – find out more Journal Career Network Published on behalf of The Gerontological Society of America Impact Factor: 5.416 5-Yr impact factor: 5.406 Editorial Boards The Journals of Gerontology, Series A: Biological Sciences Rafael de Cabo, PhD, Editor View full editorial board The Journals of Gerontology, Series A: Medical Sciences Stephen B. Kritchevsky, PhD View full editorial board For the Media GSA Press Room For Authors Instructions to authors Services for authors Submit Now: Biological Sciences Submit Now: Medical Sciences Self-Archiving Policy Online Submission Open access options for authors - visit Oxford Open WhsSvhnOkaAwYG81FJCYgwG7z1LnIP2F true Looking for your next opportunity? Looking for jobs... jQuery_1_11 = jQuery.noConflict(true); Corporate Services What we offer Advertising sales Reprints Supplements Classified Advertising Sales Alerting Services Email table of contents CiteTrack XML RSS feed

Carter, Christy S.; Sonntag, William E.; Onder, Graziano; Pahor, Marco

doi: N/Apmid: N/A

In humans, physical performance declines with increasing age, and in nondisabled older persons, scores on standardized performance measures, such as walking speed, repeated chair stands, and a balance test, predict the incidence of disability and reduced longevity. Here we show in aged rats (24-month-old Brown Norway × Fischer 344 male rats; n = 48) that conceptually similar performance measures, such as swimming speed and an inclined plane procedure, can be assessed longitudinally, and that over 6 months of follow-up from the age of 24 to 30 months, performance declines progressively with increasing age. High baseline performance scores predict long-term longevity, a relationship that is also found in humans. The application of standardized physical performance measures to a variety of animal models of aging may help to define similarities between species in the underlying mechanisms of the age-related decline in performance, disability, and longevity.

Allison, David B.; Coffey, Christopher S.

doi: N/Apmid: N/A

Microarray technology for gene expression studies offers powerful new technology for understanding changes in gene expression as a function of other observable or manipulable variables. However, microarrays also pose a number of new challenges. One of the most prominent of these is the difficulty in establishing a procedure for declaring whether a gene's expression level is associated with the independent variable that offers reasonable and specifiable false-positive (type 1 error) and false-negative (type 2 error) rates. A recent article described a two-stage testing procedure to address these goals. However, information was not provided to indicate whether this procedure would or would not meet its objectives. Herein, we show mathematically that the two-stage procedure proposed does not provide benefits in terms of minimizing false-negatives while controlling the false-positive rate relative to standard single-stage testing. Therefore, investigators are encouraged to consider alternative analytic approaches.

Kenny, Anne M.; Bellantonio, Sandra; Gruman, Cynthia A.; Acosta, Ruben D.; Prestwood, Karen M.

doi: N/Apmid: N/A

Background. Many men older than 50 years have bioavailable testosterone levels below the reference range for young adult men. The impact of the decreased androgen levels on cognition and health perception has received little attention.Methods. Sixty-seven men (mean age 76 ± 4 years, range 65–87) with bioavailable testosterone levels below 128 ng/dl (lower limit for adult normal range) were randomized to receive transdermal testosterone (2–2.5 mg patches/d) or placebo patches for 1 year. All men received 500 mg supplemental calcium and 400 IU vitamin D. Outcome measures included sex hormones [testosterone, bioavailable testosterone, sex hormone binding globulin (SHBG), estradiol, and estrone], cognitive tests (Digit Symbol, Digit Span, Trailmaking A and B), health perception (Medical Outcome Survey Short-form 36 or SF-36), lower extremity muscle strength and power, and calcium intake.Results. Twenty-three men (34%) withdrew from the study; 44 men completed the trial. Bioavailable testosterone levels increased from 93 ± 34 (SD) to 162 ± 100 ng/dl (p < .002) at 12 months in the testosterone group (n = 24) while no change occurred in the control group (n = 20). While there was no change in estradiol levels in either group, estrone levels increased in the testosterone group (28 ± 7 to 32 ± 9 pg/dl, p = .017). Scores on the Digit Symbol test improved in both the testosterone and placebo groups. Scores on Trailmaking B improved in men treated with testosterone (p < .005), although the changes were not statistically different from the changes seen in the placebo group. Twelve-month scores on Trailmaking B for the entire group were correlated with 12-month testosterone levels (p = .016). Scores for health perception measured by SF-36 did not change significantly, though scores of mental and general health declined in both groups during the 12-month intervention. Twelve-month bioavailable testosterone scores were directly correlated with scores for physical role (p = .022), vitality (p = .036), and the physical composite score (p = .010).Conclusions. Transdermal testosterone treatment in men with low bioavailable testosterone levels does not impair and may improve cognitive function. Treatment did not improve health perception but this may have been due to the side effects of skin irritation suggested by similar reactions in both the testosterone and placebo groups.

Marjolein Visser, Marco Pahor, Dennis R. Taaffe, Bret H. Goodpaster, Eleanor M. Simonsick, Anne B. Newman, Michael Nevitt, Tamara B. Harris

doi: 10.1093/gerona/57.5.M326pmid: 11983728

Background. A decline in muscle mass and muscle strength characterizes normal aging. As clinical and animal studies show a relationship between higher cytokine levels and low muscle mass, the aim of this study was to investigate whether markers of inflammation are associated with muscle mass and strength in well-functioning elderly persons. Methods. We used baseline data (1997–1998) of the Health, Aging, and Body Composition (Health ABC) Study on 3075 black and white men and women aged 70–79 years. Midthigh muscle cross-sectional area (computed tomography), appendicular muscle mass (dual-energy x-ray absorptiometry), isokinetic knee extensor strength (KinCom), and isometric grip strength were measured. Plasma levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were assessed by enzyme-linked immunosorbent assay (ELISA). Results. Higher cytokine levels were generally associated with lower muscle mass and lower muscle strength. The most consistent relationship across the gender and race groups was observed for IL-6 and grip strength: per SD increase in IL-6, grip strength was 1.1 to 2.4 kg lower ( p < .05) after adjustment for age, clinic site, health status, medications, physical activity, smoking, height, and body fat. An overall measure of elevated cytokine level was created by combining the levels of IL-6 and TNF-α. With the exception of white men, elderly persons having high levels of IL-6 (>1.80 pg/ml) as well as high levels of TNF-α (>3.20 pg/ml) had a smaller muscle area, less appendicular muscle mass, a lower knee extensor strength, and a lower grip strength compared to those with low levels of both cytokines. Conclusions. Higher plasma concentrations of IL-6 and TNF-α are associated with lower muscle mass and lower muscle strength in well-functioning older men and women. Higher cytokine levels, as often observed in healthy older persons, may contribute to the loss of muscle mass and strength that accompanies aging. The Gerontological Society of America « Previous | Next Article » Table of Contents This Article J Gerontol A Biol Sci Med Sci (2002) 57 (5): M326-M332. doi: 10.1093/gerona/57.5.M326 » Abstract Free Full Text (HTML) Free Full Text (PDF) Free Classifications Journal of Gerontology: Medical Sciences Services Article metrics Alert me when cited Alert me if corrected Find similar articles Similar articles in Web of Science Similar articles in PubMed Add to my archive Download citation Request Permissions Citing Articles Load citing article information Citing articles via CrossRef Citing articles via Scopus Citing articles via Web of Science Citing articles via Google Scholar Google Scholar Articles by Visser, M. Articles by Harris, T. B. Search for related content PubMed PubMed citation Articles by Visser, M. Articles by Pahor, M. Articles by Taaffe, D. R. Articles by Goodpaster, B. H. Articles by Simonsick, E. M. Articles by Newman, A. B. Articles by Nevitt, M. Articles by Harris, T. B. Related Content Load related web page information Share Email this article CiteULike Delicious Facebook Google+ Mendeley Twitter What's this? Search this journal: Advanced » Current Issue November 2015 70 (11) Alert me to new issues The Journal About the journal Translational Articles Free Editors’ Choice Articles Impact Factor Articles The Journals of Gerontology, Series A Supplements Special Issues Rights & permissions We are mobile – find out more Journal Career Network Published on behalf of The Gerontological Society of America Impact Factor: 5.416 5-Yr impact factor: 5.406 Editorial Boards The Journals of Gerontology, Series A: Biological Sciences Rafael de Cabo, PhD, Editor View full editorial board The Journals of Gerontology, Series A: Medical Sciences Stephen B. Kritchevsky, PhD View full editorial board For the Media GSA Press Room For Authors Instructions to authors Services for authors Submit Now: Biological Sciences Submit Now: Medical Sciences Self-Archiving Policy Online Submission Open access options for authors - visit Oxford Open WhsSvhnOkaAwYG81FJCYgwG7z1LnIP2F true Looking for your next opportunity? Looking for jobs... jQuery_1_11 = jQuery.noConflict(true); Corporate Services What we offer Advertising sales Reprints Supplements Classified Advertising Sales Alerting Services Email table of contents CiteTrack XML RSS feed