Biomedical subjects

E M Simonsick

Publications and source records attributed to E M Simonsick.

42 records · Page 3Linked to original sources

PubMed1989

Survival experience of aged hip fracture patients.

Hip fracture has long been considered a major threat to survival in aged populations. This report describes the survival experience of 814 aged, community dwelling hip fracture patients treated in seven Baltimore hospitals between 1984 and 1986: 4.3 per cent died during hospitalization; 8.2, 12.6, and 17.4 per cent died within three, six, and 12 months after fracture, respectively. The mortality rate for the entire population approaches expected mortality approximately six months post-fracture, but varies by age and sex. The most important factors predicting mortality are presence of serious concomitant illness and marked delirium (in the absence of dementia) at the time of hospital admission. The authors suggest that medical factors that may contribute to patient disorientation be investigated and treated, when possible, in an effort to improve the survival status of hip fracture patients.

Age Factors↗

PubMed1988

Patient-proxy response comparability on measures of patient health and functional status.

The present study evaluates the response comparability between 361 elderly hip fracture patients admitted from the community to seven Baltimore area hospitals between 1984 and 1986 and interviewer selected proxies on items pertaining to patients' pre-fracture health and functional status. Agreement across items ranges from very poor to good and varies with respect to the health or functional area assessed. Proxies tend to overestimate patient disability relative to the patients themselves, especially with regard to capacity to perform instrumental activities of daily living. Although proxies who report the greatest contact with patients respond most comparably to the patients, when they do disagree, proxies with the greatest patient contact tend to overestimate patient disability. The authors suggest that attention to item construction and phrasing may improve response comparability.

Activities of Daily Living↗

PubMedDate not supplied

Association of muscle strength with maximum walking speed in disabled older women.

Our aim was to study the association of lower limb strength with maximum walking speed in disabled older women and to try to detect the reserve capacity threshold for maximum walking speed and the minimum strength required for walking at a speed of 1.22 m x s(-1), which is required in crossing signaled intersections. The data are from the baseline of Women's Health and Aging Study, a population-based study on causes and course of disability. Altogether, 1,002 disabled women participated in the tests, which took place at their homes. Maximum isometric hip flexion and knee extension forces were measured on both sides using a handheld dynamometer. For analytic purposes, knee extension torque/body mass ratio (KET/BM) was calculated. Maximum walking speed was measured with a stopwatch during a 4-m walk. KET/BM had a significant effect on walking speed after controlling for number of chronic conditions, balance, use of walking aid, joint pain, age, and body height and mass. A total of 42.3% of the variation in maximum walking speed was explained by these variables. The cumulative percentage distribution of KET/BM of those able to attain a maximum walking speed of 1.22 m x s(-1) (n = 148) was flat to the level of 1.1 N x m x kg(-1), after which it turned upward, indicating that the probability of attaining 1.22 m x s(-1) started to increase after that level. By using segmented linear regression analysis, 2.3 N x m x kg(-1) was found to be the cutoff point beyond which an increase in KET/BM did not correspond to an increase in maximum walking speed. Muscle strength was positively but not linearly associated with maximum walking speed. Strength testing may help to identify people close to functional thresholds and, thus, at risk of impaired walking, who would benefit most from strengthening exercises.

Activities of Daily Living↗

PubMedDate not supplied

Depressive symptomatology and hypertension-associated morbidity and mortality in older adults.

This study determines, in a population of older adults with diagnosed hypertension, the concurrent association between depressive symptomatology and blood pressure control and the longitudinal association between depressive symptomatology and blood pressure control, stroke, and cardiovascular-related mortality. Data are from the East Boston, Massachusetts; New Haven, Connecticut; and Iowa sites of the Established Populations for Epidemiologic Studies of the Elderly, conducted between 1982 and 1988. Age-adjusted site-and gender-specific analyses were conducted, unadjusted and adjusted for baseline health status. There was no consistent association, cross-sectionally or longitudinally, between depressive symptoms and blood pressure control. Rates of stroke were 2.3 to 2.7 times higher in most subgroups with high depressive symptomatology in contrast to their nondepressed counterparts. Rates of cardiovascular disease-related death were also elevated in most subgroups, achieving statistical significance in women from New Haven and Iowa. This study presents evidence that high depressive symptoms in older adults with diagnosed hypertension may place them at increased risk of stroke and possibly cardiovascular-related death relative to other elderly persons with diagnosed hypertension. Because the rate of stroke in this subpopulation was exceptionally high, further evaluation of the role of depressive symptoms in the progression of hypertensive disease seems warranted.

Aged↗

PubMedDate not supplied

Glycemia and cognitive function in older adults using glucose-lowering drugs.

OBJECTIVES: In experimental studies, both high and low levels of plasma glucose are associated with cognitive impairment. In populations, less is known about the relationship between glycemia and cognitive function, especially in persons using glucose-lowering drugs. DESIGN: A cross-sectional study of 378 high-functioning black and white men and women aged 70 to 79 participating in the Health, Aging, and Body Composition Study (Health ABC) who used glucose-lowering medications. Glycemic measures included fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c). Cognitive function was assessed using the Modified Mini-Mental State Examination (3MS) and the Digit Symbol Substitution Test (DSS) at the same examination visit in which the glycemic measures were determined. SETTING: Memphis, Tennessee and Pittsburgh, Pennsylvania. RESULTS: We observed an "inverted-U" relationship (p =.0025 for 3MS, p=.0277 for DSS) between FPG (range 47 - 366 mg/dl) and performance on these two tests. The fasting plasma glucose levels associated with the highest score on the 3MS was 180 mg/dl and 135 mg/dl for the DSS. There was a monotonic inverse relationship between HbA1c and performance on 3MS and DSS without evidence of a threshold effect. CONCLUSION: Our findings suggest that older adults who are treated for diabetes may experience a small degree of cognitive impairment within the recommended fasting glucose levels, yet measures of long-term glycemic control support tight glycemic control. Given the high prevalence of diabetes and the common use of glucose-lowering drugs in older adults, further studies are needed to elucidate these relationships.

Aged↗

PubMedDate not supplied

Personal health habits and mental health in a national probability sample.

This investigation examined the relationship between six of seven Alameda County health habits and four dietary practices and three indices of mental health in a probability sample of 2,436 adults 20 to 64 years of age, residing in the coterminous United States. The sample consisted of all respondents to Wave 2 of the National Survey of Personal Health Practices and Consequences conducted in 1980. I found a strong relationship between poor health habits and risk of depressed mood and "nervous breakdown." The magnitude and direction of the association varied by sex, age group, the specific habit examined, and the measure of mental health used. For women, infrequent participation in active sports consistently predicted mental health problems, but was not important for men. In young men, I found no association between health habits and mental health. Dietary practices and mental health generally showed a negative association, especially among men, for whom those reporting good practices had a significantly higher risk of nervous breakdown than those reporting poor practices.

Adult↗