Publications by authors named "Carl Pieper"

Few physical performance batteries exist that appropriately evaluate physical limitations in middle-aged adults. We aimed to develop a physical performance summary score that is appropriate for use in epidemiology studies of middle-aged adults using data from the Coronary Artery Risk Development in Young Adults (CARDIA) Function study, which assessed self-reported function (PROMIS-SF20a) and physical performance measures (gait speed, balance, lower-body strength, grip strength, and cardiovascular endurance). The CARDIA Physical Performance (CAPP) score was developed using sex-specific quartiles, assigning points based on these quartiles (0 for not attempted, 1-4 for each quartile), and summing points across all performance measures (0-20, higher scores reflect greater performance).

View Article and Find Full Text PDF

Background/objective: In a subset of participants from the CALERIE Phase 2 study we evaluated the effects of 2y of ~25% Calorie Restriction (CR) diet on IgG N-glycosylation (GlycAge), plasma and complement C3 N-glycome as markers of aging and inflammaging.

Methods: Plasma samples from 26 participants in the CR group who completed the CALERIE2 trial and were deemed adherent to the intervention (~>10 % CR at 12 mo) were obtained from the NIA AgingResearchBiobank. Glycomic investigations using UPLC or LC-MS analyses were conducted on samples from baseline (BL), mid-intervention (12 mo) and post-intervention (24 mo), and changes resulting from the 2y CR intervention were examined.

View Article and Find Full Text PDF

Older adults with Alzheimer's disease (AD), in addition to significant cognitive disability, have twice the risk of fracture compared to those with normal cognition. Fractures among older adults with AD are associated with substantial morbidity, loss of physical function, and significant mortality. Prior studies have shown a decreased risk of fracture among those taking acetylcholinesterase inhibitors, such as donepezil.

View Article and Find Full Text PDF

Objective: Caloric restriction (CR) is known to enhance insulin sensitivity and reduce the risk of metabolic disorders; however, its molecular mechanisms are not fully understood. This study aims to elucidate specific proteins and pathways responsible for these benefits.

Methods: We examined adipose tissue from participants in the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy Phase 2 (CALERIE 2) study, comparing proteomic profiles from individuals after 12 and 24 months of CR with baseline and an ad libitum group.

View Article and Find Full Text PDF
Article Synopsis
  • The study examines the effects of prescribing multiple psychoactive medications, specifically gabapentinoids alongside other potentially inappropriate medications (PPIMs), in patients undergoing dialysis.
  • It found that coprescribing these medications significantly increases the risk of altered mental status (AMS) and falls, especially in patients with varying levels of frailty.
  • Results indicate that frailty influences the severity of these risks, with the highest hazard for AMS and falls observed in patients with severe frailty receiving multiple psychoactive prescriptions.
View Article and Find Full Text PDF

Background: Predicting individual weight loss (WL) responses to lifestyle interventions is challenging but might help practitioners and clinicians select the most promising approach for each individual.

Objective: The primary aim of this study was to develop machine learning (ML) models to predict individual WL responses using only variables known before starting the intervention. In addition, we used ML to identify pre-intervention variables influencing the individual WL response.

View Article and Find Full Text PDF

Context: Hypogonadism may be caused by Cushing syndrome (CS) and may intensify its adverse consequences.

Objective: To determine the frequency of male hypogonadism before and after curative surgery for CS, and its cause.

Design: Post-hoc analyses of prospective cohort studies.

View Article and Find Full Text PDF

Background: Resident physicians experience personal and professional stressors throughout training. These experiences may increase levels of burnout, depression, and grief. Understanding how these stressors impact trainees is essential for improving wellbeing during residency.

View Article and Find Full Text PDF

Background: Central nervous system (CNS) medication use is common among older adults, yet the impact of hospitalizations on use remains unclear. This study details CNS medication use, discontinuations, and user profiles during hospitalization periods.

Methods: Retrospective cohort study using electronic health records on patients ≥65 years, from three hospitals (2018-2020), and prescribed a CNS medication around hospitalization (90 days prior to 90 days after).

View Article and Find Full Text PDF

Background: Multimorbidity research has focused on the prevalence and consequences of multimorbidity in older populations. Less is known about the accumulation of chronic conditions earlier in the life course.

Methods: We identified patterns of longitudinal multimorbidity accumulation using 30 years of data from in-person exams, annual follow-ups, and adjudicated end-points among 4,945 participants of the Coronary Artery Risk Development in Young Adults (CARDIA) study.

View Article and Find Full Text PDF

Introduction: No prior study has assessed grief and bereavement curriculum in Hospice and Palliative Medicine (HPM) fellowship programs in the United States.

Methods: A 14-item survey was created and distributed to Accreditation Council for Graduate Medical Education (ACGME)-accredited HPM fellowship Program Directors to assess program demographics, curriculum emphasis, grief and bereavement programming, and attitudes toward grief and bereavement training for HPM fellows.

Results: The overall survey response rate was 63%.

View Article and Find Full Text PDF
Article Synopsis
  • A study compared the effects of a remotely supervised weight loss and exercise program (SWET) with lifestyle counseling (CHAT) on older patients with rheumatoid arthritis (RA) and obesity over 16 weeks.
  • Both groups showed improvements in metabolic syndrome scores, but the SWET group had greater benefits in weight loss, fat mass, disease activity, and various patient-reported health outcomes.
  • The findings suggest that structured weight loss and exercise are more effective than general lifestyle counseling in enhancing overall health and managing RA symptoms in older adults.
View Article and Find Full Text PDF

Purpose: Cardiac rehabilitation (CR) is endorsed for coronary artery disease (CAD), but studies report inconsistent findings regarding efficacy. The objective of this study was to determine whether confounding factors, potentially contributing to these heterogeneous findings, impact the effect of CR on all-cause readmission and mortality.

Methods: Patients (n = 2641) with CAD, CR eligible, and physically able were identified.

View Article and Find Full Text PDF

High rates of maternal and neonatal morbidity and mortality in Kenya may be influenced by provider training and knowledge in emergency obstetric and neonatal care in addition to availability of supplies necessary for this care. While post-abortion care is a key aspect of life-saving maternal health care, no validated questionnaires have been published on provider clinical knowledge in this arena. Our aim was to determine provider knowledge of maternal-child health (MCH) emergencies (post-abortion care, pre-eclampsia, postpartum hemorrhage, neonatal resuscitation) and determine factors associated with clinical knowledge.

View Article and Find Full Text PDF

Study Objective: Shiftwork increases risk for numerous chronic diseases, which is hypothesized to be linked to disruption of circadian timing of lifestyle behaviors. However, empirical data on timing of lifestyle behaviors in real-world shift workers are lacking. To address this, we characterized the regularity of timing of lifestyle behaviors in shift-working police trainees.

View Article and Find Full Text PDF

Many studies identified factors associated with vaccination intention and hesitancy, but factors associated with vaccination promptness and the effect of vaccination intention on vaccination promptness are unknown. This study identified factors associated with COVID-19 vaccination promptness and evaluated the role of vaccination intention on vaccination promptness in 1223 participants in a community-based longitudinal cohort study (June 2020 to December 2021). Participants answered questions regarding COVID-19 vaccination intention, vaccination status, and reasons for not receiving a vaccine.

View Article and Find Full Text PDF

Background: Physical resilience, or the ability to recover after a physical stressor, declines with aging. Efforts to preserve physical resilience in the older dialysis population are critically needed; however, validated, patient-centered measures that are sensitive to change are also needed. Our objective was to assess accelerometer-derived step count variability, or a measure of intra-individual variation in physical activity, as a potential measure of physical resilience among older adults receiving hemodialysis.

View Article and Find Full Text PDF
Article Synopsis
  • Traumatic brain injuries (TBIs) are linked to a higher risk of dementia, and this study investigates how a lifetime of TBIs impacts cognitive decline in aging individuals, particularly using twin data to control for genetic and environmental factors.
  • The research involved male World War II veterans from a twin registry, who reported TBIs and underwent cognitive assessments over 12 years, revealing that TBIs, especially those with loss of consciousness or experienced at older ages, are associated with lower cognitive scores and faster decline.
  • Key findings showed that 25% of participants had TBIs, and those with multiple TBIs or TBIs at older ages experienced significant cognitive decline, highlighting the need for targeted cognitive interventions for TBI sufferers.
View Article and Find Full Text PDF

Objectives: The prevalence of hearing loss increases with age. Untreated hearing loss is associated with poorer communication abilities and negative health consequences, such as increased risk of dementia, increased odds of falling, and depression. Nonetheless, evidence is insufficient to support the benefits of universal hearing screening in asymptomatic older adults.

View Article and Find Full Text PDF

The present prospective randomized study was designed to investigate whether the development of Post Operative Cognitive Decline (POCD) is related to anesthesia type in older adults. All patients were screened for delirium and mental status, received baseline neuropsychological assessment, and evaluation of activities of daily living (ADLs). Follow-up assessments were performed at 3-6 months and 12-18 months.

View Article and Find Full Text PDF

Study Objective: Shiftwork increases risk for numerous chronic diseases, which is hypothesized to be linked to disruption of circadian timing of lifestyle behaviors. However, empirical data on timing of lifestyle behaviors in real-world shift workers are lacking. To address this, we characterized the regularity of timing of lifestyle behaviors in shift-working police trainees.

View Article and Find Full Text PDF

Introduction: We developed demographically-adjusted normative data for Spanish- and English-speaking Latinos on the Version 3.0 of the National Alzheimer's Coordinating Center Uniform Data Set Neuropsychological Battery (UDS3-NB).

Methods: Healthy Latino adults (N = 437) age 50-94 (191 Spanish- and 246 English-speaking) enrolled in Alzheimer's Disease Research Centers completed the UDS3-NB in their preferred language.

View Article and Find Full Text PDF

Importance: Major depressive disorder (MDD) is a leading cause of global distress and disability. Earlier studies have indicated that antidepressant therapy confers a modest reduction in depressive symptoms on average, but the distribution of this reduction requires more research.

Objective: To estimate the distribution of antidepressant response by depression severity.

View Article and Find Full Text PDF

Background: The risk of dysphagia increases with age, affecting up to 33% of adults over the age of 65. Older adults with dysphagia are at increased risk for negative physical health outcomes such as aspiration pneumonia and death. However, the relationship between dysphagia and psychosocial health is uncertain in this population.

View Article and Find Full Text PDF

Our aim was to evaluate relationships between swallowing difficulty (dysphagia) and social determinants of health (SDOH) in older adults ≥65 years. Cross-sectional analyses were performed in community-dwelling Medicare beneficiaries from the National Health & Aging Trends Study (NHATS). The primary exposure was self-reported difficulty chewing/swallowing in the prior month.

View Article and Find Full Text PDF