The Relationship Between Mentally Unhealthy Days and Depressive Symptoms Among Older Adults Over Time.

This article sought to determine the extent to which the number of self-reported mentally unhealthy days (MUDs) in the past 30 days estimates depressive symptoms in older adults. The sample of 4,321 community-dwelling residents aged 65 and above originated from an ongoing population-based study of older Blacks and Whites. Participants' data from 1993 through 2005 included the single MUD question and questions from the Center for Epidemiologic Studies Short Depression Scale (CES-D).

Relation of cardiac ventricular repolarization and global cognitive performance in a community population.

Atherosclerosis is a risk factor for dementia. However, little is known about the association between cognitive performance and a widely used indicator of coronary heart disease, at rest electrocardiography. We identified 839 older residents (mean age 81 years, 58% black) from a geographically defined biracial community in Chicago, Illinois, who had undergone extensive cognitive performance testing and met the electrocardiographic eligibility criteria, including a QRS duration of < 120 ms.

Upper and lower extremity motor performance and functional impairment in Alzheimer's disease.

This report examines the relation of upper and lower extremity motor performance to functional impairment among 371 persons with probable Alzheimer's disease (AD). Cognitive and motor performance tests were administered at 6-month intervals for up to 4 years. Motor performance was assessed using 3 lower extremity tests and 2 upper extremity tests.

The association of magnetic resonance imaging measures with cognitive function in a biracial population sample.

Background: White matter hyperintensity volume (WMHV), cerebral infarcts, and total brain volume (TBV) are associated with cognitive function, but few studies have examined these associations in the general population or whether they differ by race.

Objective: To examine the association of WMHV, cerebral infarcts, and TBV with global cognition and cognition in 5 separate domains in a biracial population sample.

Setting: A biracial community population of Chicago, Illinois.

Race differences in emotional adaptation of family caregivers.

Objectives: This study compares black and white caregivers of persons with Alzheimer's disease (AD) on two general measures of negative and positive emotion (depressive symptoms, positive mood) and two caregiving specific measures of negative and positive emotion (caregiver burden, caregiver satisfaction). We hypothesized that black caregivers would exhibit lower levels of negative emotion and higher levels of positive emotion over time than whites.

Method: Three hundred ninety-six caregivers were recruited from the Rush Alzheimer's Disease Center in Chicago, Illinois, as part of a longitudinal study of persons with AD.

Biracial population study of mortality in mild cognitive impairment and Alzheimer disease.

Objective: To assess mortality associated with mild cognitive impairment (MCI) and Alzheimer disease (AD) among older African Americans and whites from an urban community.

Design: Longitudinal population-based observational study.

Setting: Four adjacent neighborhoods in Chicago, Illinois.

A hospitalist-run short-stay unit: features that predict length-of-stay and eventual admission to traditional inpatient services.

Background: Short-stay units (SSUs) provide an alternative to traditional inpatient services for patients with short anticipated hospital stays. Yet little is known about which patient types predict SSU success.

Objective: To describe patients admitted to our hospitalist-run SSU and explore predictors of length-of-stay (LOS) and eventual admission to traditional inpatient services.

Hostility and change in cognitive function over time in older blacks and whites.

Objective: To test whether the level of hostility predicted the rate of cognitive decline in a community of older blacks and whites and whether the association varied as a function of race.

Methods: Over 4800 persons from a defined community in Chicago completed up to three structured interviews at approximately 3 year intervals over a period of up to 8.8 years (mean = 4.

Isthmus dependent atrial flutter cycle length correlates with right atrial cross-sectional area.

Background: Right atrial flutter cycle length can prolong in the presence of antiarrhythmic drug therapy. We hypothesized that the cycle length of right atrial isthmus dependent flutter would correlate with right atrial cross-sectional area measurements.

Methods: 60 patients who underwent ablation for electrophysiologically proven isthmus dependent right atrial flutter, who were not on Class I or Class III antiarrhythmic drugs and had recent 2-dimensional echocardiographic data comprised the study group.

Perceived discrimination and blood pressure in older African American and white adults.

Background: The current study was designed to examine the cross-sectional association between perceived discrimination and blood pressure (BP) in a sample of older African American and white adults. We hypothesized that perceived discrimination would be associated with higher levels of BP and that this association would be stronger for older African Americans compared with whites.

Methods: Participants were 4,694 (60% African American, 60% women) community-dwelling older adults.

Repetition priming and change in functional ability in older persons without dementia.

Adverse consequences such as institutionalization and death are associated with compromised activities of daily living in aging, yet there is little known about risk factors for the development and progression of functional disability. Using generalized linear models, the authors examined the association between the ability to benefit from repetition and rate of change in functional ability in 160 nondemented elders participating in the Religious Orders Study. Three single-word repetition priming tasks were administered that varied in the degree to which visual-perceptual or conceptual processing was invoked.

Social engagement and cognitive function in old age.

We examined the association of diverse measures of social engagement with level of function in multiple cognitive domains in 838 persons without dementia who had a mean age of 80.2 (SD = 7.5).

Neighborhood social cohesion and disorder in relation to walking in community-dwelling older adults: a multilevel analysis.

Objectives. To examine the role of neighborhood social conditions and walking in community-dwelling older adults. Methods.

Use of home-based formal services by adult day care clients with Alzheimer's disease.

Objectives: To explore the association between adult day care (ADC) attendance and utilization of home-based formal services among people with Alzheimer's Disease (AD).

Methods: Data for this secondary analysis came from a longitudinal parent study of 457 subjects from 16 ADC programs and an Alzheimer's diagnostic center in metropolitan Chicago. We used the method of Generalized Estimating Equations to model the use of home-based formal services over time.

Change in direct measures of physical performance among persons with Alzheimer's disease.

Objectives: Measures of physical performance were used in intact and community populations. We examined upper and lower extremity physical performance tests among people with Alzheimer's disease.

Method: A total of 367 persons with probable Alzheimer's disease, recruited from an Alzheimer's disease diagnostic center, were given three tests of lower extremity function and two tests of upper extremity function at 6 month intervals for up to 4 years.

Pulmonary function, muscle strength and mortality in old age.

Numerous reports have linked extremity muscle strength with mortality but the mechanism underlying this association is not known. We used data from 960 older persons without dementia participating in the Rush Memory and Aging Project to test two sequential hypotheses: first, that extremity muscle strength is a surrogate for respiratory muscle strength, and second, that the association of respiratory muscle strength with mortality is mediated by pulmonary function. In a series of proportional hazards models, we first demonstrated that the association of extremity muscle strength with mortality was no longer significant after including a term for respiratory muscle strength, controlling for age, sex, education, and body mass index.

Perceived discrimination and mortality in a population-based study of older adults.

Objectives: We examined the relation of individual-level perceived discrimination to mortality in a biracial, population-based sample.

Methods: Participants were 4154 older adults from the Chicago Health and Aging Project who underwent up to 2 interviews over 4.5 years.

Change in depressive symptoms during the prodromal phase of Alzheimer disease.

Context: Prospective studies have established an association between depressive symptoms and risk of dementia, but how depressive symptoms change during the evolution of dementia is uncertain.

Objective: To test the hypothesis that depressive symptoms increase during the prodromal phase of Alzheimer disease (AD).

Design: Prospective cohort study.

Levels of estrogen receptors alpha and beta in frontal cortex of patients with Alzheimer's disease: relationship to Mini-Mental State Examination scores.

Estrogen exerts beneficial effects on the brain throughout life. Studies demonstrate that estrogen is neuroprotective and that reduced brain estrogen activity may influence the clinical course of Alzheimer's disease (AD). Changes in levels of estrogen receptors have been detected in postmortem brain tissue of AD patients.

Anti-inflammatory agents and cognitive decline in a bi-racial population.

In a prospective study among 4,409 subjects aged 65+ years, we assessed the relation of nonsteroidal anti-inflammatory agents (NSAIDs) to cognition. The main outcome was decline in global cognitive function, determined by average performance across four cognitive tests, over up to four interviews. We found similar rates of cognitive decline among recent users of aspirin and of other NSAIDs (largely ibuprofen) compared to those who did not use these NSAIDs.

Confounding in the Estimation of Mediation Effects.

A mediation effect explains the relationship of a risk factor and an outcome through a mediator variable which is a step in their pathway. Under the assumption of no cycling in the causal relationship, we consider various situations in which a fourth variable may interfere the estimation of a mediation effect as a confounding factor. Our asymptotic results, which are supported by a Monte Carlo study, show that adjusting for confounding factors under certain conditions might lead to biased estimates.

Grip strength and the risk of incident Alzheimer's disease.

Decline in strength is common in older persons but little data are available about its association with Alzheimer's disease (AD). We studied the association of level of and rate of change in strength in 877 older persons without dementia at baseline and risk of AD. In a proportional hazards model adjusted for age, sex and education, each 1-lb decrease in grip strength at baseline was associated with about a 1.

Conscientiousness and the incidence of Alzheimer disease and mild cognitive impairment.

Context: The personality trait of conscientiousness has been related to morbidity and mortality in old age, but its association with the development of Alzheimer disease is not known.

Objective: To test the hypothesis that a higher level of conscientiousness is associated with decreased risk of Alzheimer disease.

Design: Longitudinal clinicopathologic cohort study with up to 12 years of annual follow-up.

Visuoperceptual repetition priming and progression of parkinsonian signs in aging.

Parkinsonian signs in older persons are associated with numerous adverse health outcomes, however there is limited information about factors which predict progression of these signs. Using generalized linear models, we examined the association between efficiency in visuoperceptual and conceptual processing, measured by repetition priming, and rate of change in parkinsonian signs in a large sample of older persons without cognitive impairment or Parkinson's disease. Subjects with better visuoperceptual priming, measured by threshold word-identification and word-stem completion, at study baseline, progressed more slowly during follow-up of up to 11 years.

Efficacy of behavioral interventions for dementia caregivers.

Behavioral symptoms of Alzheimer's disease, particularly agitation, appear to be a major contributing factor to the emotional distress exhibited by family caregivers. Psychosocial interventions have been shown to reduce caregiver emotional distress, but few studies have examined the efficacy of these interventions with caregivers exposed to high levels of dementia-related behavioral symptoms. The purpose of this study is to test the efficacy of a caregiver skill building intervention in reducing emotional distress to agitated behaviors of care recipients.