Metabolomics analysis identifies a lipidomic profile in treatment-naïve juvenile dermatomyositis patients vs healthy control subjects.

Objectives: To perform an exploratory study to identify a JDM serum metabolic profile that differs from healthy controls (HCs) and responds to immunosuppressive treatment.

Methods: Blood was collected from 9 HCs and 10 patients diagnosed with probable (n = 4) or definite (n = 6) JDM based on the criteria of Bohan and Peter for myositis, with 7 of the 10 providing longitudinal samples following initiation of treatment; these patients comprised the treatment-naïve cohort. Sera underwent mass spectroscopy-based measurements of targeted metabolic intermediates, including 15 amino acids, 45 acylcarnitines (ACs), 15 ceramides and 29 sphingomyelins.

Teleassessment of Gait and Gait Aids: Validity and Interrater Reliability.

Background: Gait and mobility aid assessments are important components of rehabilitation. Given the increasing use of telehealth to meet rehabilitation needs, it is important to examine the feasibility of such assessments within the constraints of telerehabilitation.

Objective: The objective of this study was to examine the reliability and validity of the Tinetti Performance-Oriented Mobility Assessment gait scale (POMA-G) and cane height assessment under various video and transmission settings to demonstrate the feasibility of teleassessment.

Relations of established aging biomarkers (IL-6, D-dimer, s-VCAM) to glomerular filtration rate and mortality in community-dwelling elderly adults.

Background: Biomarkers improving risk prediction for elderly populations with chronic kidney disease (CKD), an independent predictor of mortality, could be particularly useful. We previously observed that interleukin-6 (IL-6), D-dimer and soluble vascular adhesion molecule (s-VCAM) were independent biomarkers of mortality in elderly individuals. Therefore, we investigated whether these established biomarkers were independently associated with both estimated glomerular filtration rate (eGFR) and mortality.

Testing fine motor coordination via telehealth: Effects of video characteristics on reliability and validity.

Background There is limited research about the effects of video quality on the accuracy of assessments of physical function. Methods A repeated measures study design was used to assess reliability and validity of the finger-nose test (FNT) and the finger-tapping test (FTT) carried out with 50 veterans who had impairment in gross and/or fine motor coordination. Videos were scored by expert raters under eight differing conditions, including in-person, high definition video with slow motion review and standard speed videos with varying bit rates and frame rates.

Tele-Assessment of the Berg Balance Scale: Effects of Transmission Characteristics.

Objective: To compare Berg Balance Scale (BBS) rating using videos with differing transmission characteristics with direct in-person rating.

Design: Repeated-measures study for the assessment of the BBS in 8 configurations: in person, high-definition video with slow motion review, standard-definition videos with varying bandwidths and frame rates (768 kilobytes per second [kbps] videos at 8, 15, and 30 frames per second [fps], 30 fps videos at 128, 384, and 768 kbps).

Setting: Medical center.

Identifying Patterns of Multimorbidity in Older Americans: Application of Latent Class Analysis.

Objectives: To define multimorbidity "classes" empirically based on patterns of disease co-occurrence in older Americans and to examine how class membership predicts healthcare use.

Design: Retrospective cohort study.

Setting: Nationally representative sample of Medicare beneficiaries in file years 1999-2007.

Trends in decayed teeth among middle-aged and older adults in the United States: socioeconomic disparities persist over time.

Objectives: While trends in tooth loss among older adults have been well documented and show a decline over the last few decades, little is known about trends in tooth decay which may lead to tooth loss. The study aim was to examine trends in tooth decay among adults ages 50 years and older in the United States and determine whether these trends were consistent across demographic and socioeconomic subgroups of middle-aged and older adults.

Methods: Secondary analysis of data collected through detailed oral health examinations in the National Health and Nutrition Examination (NHANES) surveys 1988-1994 and 1999-2004.

Trajectories of depressive symptoms and oral health outcomes in a community sample of older adults.

Objective: Adverse outcomes associated with chronic depressive symptoms are of clinical importance. The objective was to identify subgroups of older adults based on their trajectories of depressive symptoms over a 10-year period and determine if these subgroups predicted oral health outcomes.

Methods: The sample was 944 adults aged 65+ who participated in the oral health module of the the Health and Retirement Survey in 2008.

Chronic kidney disease and recurrent falls in nursing home residents: a retrospective cohort study.

This study examined whether chronic kidney disease (CKD) is associated with recurrent falls in older adults in nursing homes (NHs). We used data abstracted over a six month period from 510 NH residents with a history of falls. Thirty-five percent of the NH residents had CKD.

One size does not fit all-mobility device type affects speed, collisions, fatigue, and pain.

Objective: To determine whether differences could be detected in mobility outcomes during community mobility and home mobility tasks according to type of mobility assistive device.

Design: Randomized, repeated measures.

Setting: Community mobility task: traversing 341.

Social stratification and tooth loss among middle-aged and older Americans from 1988 to 2004.

Objectives: Tooth retention has improved over the past few decades, but it is not known whether these trends have been observed across all demographic/socioeconomic subgroups. We examined number of missing teeth among dentate individuals (n = 9,113) as well as edentulism and systematically modeled their trends over time by using clinical examination data.

Methods: We investigated the association between social stratification and trends in tooth retention among adults ages 50+ from 1988 to 2004, using four waves of the National Health and Nutrition Examination Surveys (NHANES) (n = 11,812).

Vascular lesions and functional limitations among older adults: does depression make a difference?

Background: The association between disability and depression is complex, with disability well established as a correlate and consequence of late life depression. Studies in community samples report that greater volumes of cerebral white matter hyperintensities (WMHs) seen on brain imaging are linked with functional impairment. These vascular changes are also associated with late life depression, but it is not known if depression is a modifier in the relationship between cerebrovascular changes and functional impairment.

Using the past to predict the future: latent class analysis of patterns of health service use of older adults in the emergency department.

Objectives: To classify older adults in the emergency department (ED) according to healthcare use and to examine associations between group membership and future ED visits and hospital admissions.

Design: Secondary analysis.

Setting: Medicare Current Beneficiary Survey.

Participation in decision making as a property of complex adaptive systems: developing and testing a measure.

Objectives. To (1) describe participation in decision-making as a systems-level property of complex adaptive systems and (2) present empirical evidence of reliability and validity of a corresponding measure. Method.

CONNECT for better fall prevention in nursing homes: results from a pilot intervention study.

Objectives: To determine whether an intervention that improves nursing home (NH) staff connections, communication, and problem solving (CONNECT) would improve implementation of a falls reduction education program (FALLS).

Design: Cluster randomized trial.

Setting: Community (n=4) and Veterans Affairs (VA) NHs (n=4).

Interactive behaviors of American Indian mothers and their premature infants.

The interactive behaviors of 17 American Indian mothers and their premature infants and selected maternal and infant factors affecting those behaviors were measured using naturalistic observation and the Home Observation for Measurement of the Environment (HOME) Inventory at 3, 6, and 12 months corrected infant age. The frequency of some maternal behaviors changed over the first 12 months. Mothers spent less time holding, looking at, touching, and interacting with their premature infants and more time uninvolved as the infant aged.

Trends of edentulism among middle-aged and older Asian Americans.

Objectives: We estimated national trends of the prevalence of edentulism (complete tooth loss) for Asian American subgroups in the United States and investigated factors that could contribute to improvements in edentulism across populations over time.

Methods: We used 10 waves of the National Health Interview Survey data collected from 1999 to 2008. Eligible respondents were those aged 50 years and older who completed the question on tooth loss.

Latent subtypes of depression in a community sample of older adults: can depression clusters predict future depression trajectories?

Identifying sources of heterogeneity in late life depression remains an important focus of psychiatric investigation. Community samples are particularly informative since many older adults have clinically significant depressive symptoms but fail to meet criteria for major depression and older adults generally do not seek treatment for their depressive symptoms. The primary data used for these analyses were those collected in a community-based survey of over 3000 adults age 65 or older followed for up to ten years.

Interactive behaviors of ethnic minority mothers and their premature infants.

Objective: To compare the interactive behaviors of American Indian mothers and their premature infants with those of African American mothers and their premature infants.

Design: Descriptive, comparative study.

Setting: Three neonatal intensive care units and two pediatric clinics in the southeast.

A quality assurance study on the accuracy of measuring physical function under current conditions for use of clinical video telehealth.

Objective: To determine whether conditions for use of clinical video telehealth technology might affect the accuracy of measures of physical function.

Design: Repeated measures.

Setting: Veterans Administration Medical Center.

Memory deficit associated with worse functional trajectories in older adults in low-vision rehabilitation for macular disease.

Objectives: To examine whether performance on a brief memory test is related to functional outcomes in older individuals undergoing low-vision rehabilitation (LVR) for macular disease.

Design: Observational cohort study of individuals receiving outpatient LVR.

Setting: Academic center.

Comorbid cognitive impairment and functional trajectories in low vision rehabilitation for macular disease.

Background And Aims: Comorbid cognitive impairment is common among visually impaired older adults. This study investigated whether baseline cognitive status predicts functional trajectories among older adults in low vision rehabilitation (LVR) for macular disease.

Methods: The Telephone Interview for Cognitive Status - modified (TICS-m) was administered to macular disease patients aged ≥ 65 years receiving outpatient LVR.

Caloric restriction alters the metabolic response to a mixed-meal: results from a randomized, controlled trial.

Objectives: To determine if caloric restriction (CR) would cause changes in plasma metabolic intermediates in response to a mixed meal, suggestive of changes in the capacity to adapt fuel oxidation to fuel availability or metabolic flexibility, and to determine how any such changes relate to insulin sensitivity (S(I)).

Methods: Forty-six volunteers were randomized to a weight maintenance diet (Control), 25% CR, or 12.5% CR plus 12.

MODELING REPEATED MEASURES OF DICHOTOMOUS DATA: Testing Whether the Within-Person Trajectory of Change Varies Across Levels of Between-Person Factors.

In this paper, we consider the following question for the analysis of data obtained in longitudinal panel designs: How should repeated-measures data be modeled and interpreted when the outcome or dependent variable is dichotomous and the objective is to determine whether the within-person rate of change over time varies across levels of one or more between-person factors? Standard approaches address this issue by means of generalized estimating equations or generalized linear mixed models with logistic links. Using an empirical example and simulated data, we show (1) that cross-level product terms from these models can produce misleading results with respect to whether the within-person rate of change varies across levels of a dichotomous between-person factor; and (2) that subgroup differences in the rate of change should be assessed on an additive scale (using group differences in the effects of predictors on the of disease) rather than on a multiplicative scale (using group differences in the effects of predictors on the of disease). Because usual approaches do not provide a significance test for whether the rate of change varies across levels of a between-person factor, sample differences in the rate of additive change may be due to sampling error.