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Biomedical subjects

G R Andrews

Publications and source records attributed to G R Andrews.

At least 19 recordsLinked to original sources
PubMed2006

Relative androgen deficiency in relation to obesity and metabolic status in older men.

BACKGROUND: Although androgen deficiency in men has been linked with obesity and the metabolic syndrome, whether it predisposes to, or is a consequence of, type 2 diabetes mellitus (T2DM) is still unclear. OBJECTIVE: To determine the relationship between plasma androgen levels, obesity, metabolic status and T2DM in men of 70 years or older. DESIGN AND METHODS: A sample of 195 men from the Australian Longitudinal Study of Ageing with a mean age of 76.2 +/- 0.3 years were followed up for 8 years. Total testosterone (TT), fasting plasma glucose (FPG), urate, serum creatinine, total cholesterol (TC), HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), triglycerides (TG), blood pressure (BP), body mass index (BMI), waist circumference (WC) and diabetic status were assessed at baseline. Self-reported diabetic status was obtained after 8 years. Metabolic syndrome was diagnosed based on the Third National Cholesterol Education Program Adult Treatment Panel clinical criteria. RESULTS: TT levels were lower in diabetic men compared with non-diabetic men (12.1 +/- 0.7 vs. 14.2 +/- 0.4 nmol/l, p = 0.026). TT levels in healthy, non-diabetic men over 80 years of age were lower (11.9 +/- 0.8 vs. 15.0 +/- 0.5 nmol/l, p = 0.002) than TT levels in those aged 70-79 years, inversely related to BMI (r = -0.26, p = 0.001), WC (r = -0.30, p < 0.001) and TG (r = -0.22, p = 0.005) and positively related to LDL-C (r = 0.25, p = 0.002). Men with the metabolic syndrome had significantly lower levels of TT and HDL-C, and higher values of BP, FPG, TG, BMI and WC, compared with those without. However, no significant difference in plasma TT levels was noted between men with incident T2Dm and healthy men. Stepwise linear regression analysis revealed that only LDL-C and WC related significantly to the variance of TT. Multiple logistic regression revealed FPG to be the only independent predictor of incident diabetes (odds ratio = 60.2, p = 0.003). CONCLUSIONS: Testosterone levels continue to decline even in healthy men over the age of 80 years. Although TT levels were inversely related to visceral obesity and several components of the metabolic syndrome, our data do not support a predictive or causative role for decreasing TT levels in the development of incident T2Dm. Androgen deficiency is consequent upon, rather than a cause of, poor metabolic status.

Aged↗
PubMed2001

The priority of basic research on ageing vulnerability in a comprehensive research agenda on ageing for the 21st century.

The prospects for individual and population ageing as we enter a new century pose some of the greatest social, economic and humanitarian challenges humankind as a whole has ever faced. The basic biological mechanisms that control human ageing remain ill understood but it is clear that for many individuals exhibiting predisposition to risk factors for certain chronic diseases, such as coronary heart disease, diabetes, osteoporosis, certain cancers and Alzheimer's disease, such predisposition is mediated through genetic processes that operate at a most fundamental biomolecular level interacting with nongenetic attributes. The prospect of improved understanding of the fundamental processes underlying the pathogenesis of common age-related diseases that may lead to identification of interventions that are effective in preventing, delaying or ameliorating the diseases and their consequences is compelling. It is this prospect that provides the prime justification for giving high priority to research on ageing vulnerability in a comprehensive research agenda on ageing for the 21st century.

Aged↗
PubMed2001

Demographic, health, cognitive, and sensory variables as predictors of mortality in very old adults.

Cognitive and sensorimotor predictors of mortality were examined in the Australian Longitudinal Study of Ageing, controlling for demographic and health variables. A stratified random sample of 1,947 males and females aged 70 and older were interviewed, and 1,500 were assessed on measures of health, memory. verbal ability, processing speed, vision, hearing, and grip strength in 1992 and 1994. Analyses of incident rate ratios for mortality over 4- and 6-year periods were conducted using Cox hierarchical regression analyses. Results showed that poor performance on nearly all cognitive variables was associated with mortality, but many of these effects were explained by measures of self-rated health and disease. Significant decline in hearing and cognitive performance also predicted mortality as did incomplete data at Wave 1. Results suggest that poor cognitive performance and cognitive decline in very old adults reflect both biological aging and disease processes.

Aged↗
PubMed2001

Demographic and health issues in rural aging: a global perspective.

The world is witnessing unprecedented changes in population structure, so that both the absolute number and proportion of older people are increasing worldwide. For many developing countries, rapid population aging and the phenomenon of a "double burden" of both infectious disease and emerging chronic diseases represent a major challenge. Many of those who will contribute to these extraordinary transitions will live in rural areas. Many countries, especially the poorest, still have a huge burden of infectious diseases, including increasing rates of HIV/AIDS along with a growing problem of chronic diseases. A number of critical policy considerations come to the fore in examining issues associated with rural aging, including: the need for rural development policies that take account of population aging and the needs of older people; improved coordination and integration of public health and care services in rural areas; support for nongovernmental organizations and community group efforts; and greater use of new technologies for communication. The year 1999 was pivotal for aging in terms of perceptions, attitudes, public action, better research and knowledge, and improved policy decisions that will benefit all of society into this new century. The Second United Nations World Assembly to be held in Madrid in April 2002 will provide further opportunity to build upon this progress and in the formulation of a new International Plan of Action on Aging to point the way for decisive action on positive policy and program initiatives for the future.

Aged↗
PubMed1997

The effectiveness of exercise training in lowering blood pressure: a meta-analysis of randomised controlled trials of 4 weeks or longer.

OBJECTIVE: To identify the features of an optimal exercise programme in terms of type of exercise, intensity and frequency that would maximise the training induced decrease in blood pressure (BP). DATA IDENTIFICATION: Trials were identified by a systematic search of Medline, Embase and Science Citation Index (SCI), previous review articles and the references of relevant trials, from 1980 until 1996, including only English language studies. STUDY SELECTION: The inclusion criteria were limited to randomised controlled trials of aerobic or resistance exercise training conducted over a minimum of 4 weeks where systolic and diastolic BP was measured. RESULTS: A total of 29 studies (1533 hypertensive and normotensive participants) were included, 26 used aerobic exercise training, two trials used resistance training and one study had both resistance and aerobic training groups. Aerobic exercise training reduced systolic BP by 4.7 mm Hg (95% CI: 4.4, 5.0) and diastolic BP by 3.1 mm Hg (95% CI: 3.0, 3.3) as compared to a non-exercising control group, however, significant heterogeneity was observed between trials in the analysis. The BP reduction seen with aerobic exercise training was independent of the intensity of exercise and the number of exercise sessions per week. The evidence for the effect of resistance exercise training was inconclusive. CONCLUSIONS: Aerobic exercise training had a small but clinically significant effect in reducing systolic and diastolic BP. Increasing exercise intensity above 70% VO2 max or increasing exercise frequency to more than three sessions per week did not have any additional impact on reducing BP.

Adolescent↗
PubMed1997

Exercise profile and subsequent mortality in an elderly Australian population.

Although the importance of exercise as a public health issue is increasingly recognised, little attention has been paid to exercise in very old people. We examined exercise patterns in 1788 subjects aged 70 years and over who were participating in the Australian Longitudinal Study of Ageing. In the two weeks before interview, 39 per cent of subjects had taken no exercise and only four per cent had exercised vigorously. When compared with those who took no exercise, exercisers were more likely to be male and younger, to self-report better health, to be former smokers and regular alcohol users. Mortality rates at two years follow-up were inversely related to the level of exercise at baseline. This research indicates that exercise is important for the very old as well as younger groups.

Aged↗
PubMed1997

Factors associated with falling in older Adelaide residents.

The aim of this study was to identify characteristics that predispose older residents of Adelaide to falling. Information collected in the baseline phase of the Australian Longitudinal Study of Ageing was used to draw cross-sectional comparisons between participants who reported having fallen on at least one occasion in the previous 12 months and those participants who reported not having fallen. The baseline cohort consisted of 1947 participants aged 70 years or more, of whom 550 (28 per cent) reported having fallen at least once in the previous year. Independent risk factors for falling were: age; having left school at an early age; a worsening of vision in recent years; and histories of Parkinson's disease, fractured hip, glaucoma, stroke (including transient ischaemic attack), corns or bunions, or arthritis. The findings regarding medical histories suggest some possible opportunities for reducing the risk of falls in the elderly by managing the symptoms and risk factors of underlying conditions such as stroke and loss of vision.

Accidental Falls↗
PubMed1992

Gerontological education in Australia.

Courses in Gerontology and Geriatric medicine are now provided in most undergraduate training programs for medical, allied health and social work professionals in Australian Universities. The depth and coverage varies between schools but almost all undergraduate social workers, nurses, medical practitioners and allied health professionals will receive some training and in several cases more extensive optional programs are offered.

Australia↗
PubMed1992

The circumstances and contributions of older persons in three Asian countries: preliminary results of a cross-national study.

"This article examines some of the findings from surveys carried out in Indonesia, Sri Lanka and Thailand as part of a cross-national study of ageing sponsored by the World Health Organization. It finds that the majority of elderly in these countries live in households with their children and in many cases also with their grandchildren. The elderly also contribute significantly to household activities. In the future, the special needs of very old women will have to be addressed as it will be difficult for their children to meet those needs without assistance."

Adult↗
PubMed1988

Health and ageing in the developing world.

Although ageing is not yet a high priority tissue for health planners, policy makers and clinicians in most developing countries there will be a growing need in coming years to pay more attention to the important health issues associated with population ageing in the developing world. This paper reports some of the relevant findings of a cross-national study (sponsored by the World Health Organization) of the health and social aspects of ageing in four developing countries--Republic of Korea, the Philippines, Fiji and Malaysia. The key findings are compared and contrasted with those of a similar eleven-country WHO study in Europe. In very broad terms, the overall demographic, physical, mental health and social patterns and trends associated with ageing as demonstrated by age-group and sex differences were consistent throughout the four countries studied. Comparisons with European findings in other similar studies underlined the fundamental universality of age-related changes in biophysical, behavioural and social characteristics. The importance of the family in developing countries was evident, with about three-quarters of those aged 60 and over in the four countries living with children, often in extended family situations. Levels of adverse health-related behaviour and the prospect of changing patterns of morbidity with further increases in the total and proportional numbers of aged persons point to a need for emphasis on preventive health measures and programmes directed to the maintenance of the physical and mental health of the ageing population.

Activities of Daily Living↗
PubMed1987

An evaluation of planned early postnatal transfer home with nursing support.

A community-based programme of planned early postnatal transfer home with the continuity of hospital nursing care was instituted in a defined geographic area of the western suburbs of Sydney in 1983. Mothers were offered the option of discharge in 24-48 hours after delivery, with home visits by a hospital midwife, subject to certain medical and social criteria. An evaluation of the programme in terms of morbidity, psychosocial impact on the family and costs was undertaken. For evaluation, a quasi-experimental study of parallel groups was designed in preference to randomized selection as it was believed that the personal choice would be fundamental to the success of the scheme. A contemporary control group was achieved with volunteer mothers who opted for the traditional five- to seven-day hospital stay. Studies of maternal response and the partner's response and adjustment were undertaken, including the administration of questionnaires that were designed to detect the presence of mild postnatal depression. No increased morbidity occurred in the early discharge group. The early discharge group performed more favourably on the questionnaire that was designed to measure their postpartum adjustment. Continued postnatal domiciliary surveillance reduces the risk that early neonatal pathological changes, especially jaundice, may be overlooked.

Adaptation, Psychological↗