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Biomedical subjects

Ilene C Siegler

Publications and source records attributed to Ilene C Siegler.

30 records · Page 2Linked to original sources
PubMed2002

Alcoholic beverage preference, diet, and health habits in the UNC Alumni Heart Study.

BACKGROUND: Moderate alcohol intake is related to better health, and additional benefits may be associated with wine. However, beverage preference may be confounded by lifestyle factors related to health. OBJECTIVE: The goal was to describe the associations between alcoholic-beverage preferences and indicators of a healthy diet and other health habits. DESIGN: This cross-sectional study included data from 2864 men and 1571 women enrolled in the UNC Alumni Heart Study. Self-reports of drinking habits were used as predictors of health behaviors and of intakes of nutrients and food groups. RESULTS: Subjects who preferred wine had healthier diets than did those who preferred beer or spirits or had no preference. Wine drinkers reported eating more servings of fruit and vegetables and fewer servings of red or fried meats. The diets of wine drinkers contained less cholesterol, saturated fat, and alcohol and more fiber. Wine drinkers were less likely to smoke. Compared with all drinkers, those who drank no alcohol consumed fewer vegetables but more fiber. Nondrinkers were less likely to exercise regularly and had a higher mean body mass index. Controlling for income and education had little effect on these associations. CONCLUSIONS: The apparent health benefits of wine compared with other alcoholic beverages, as described by others, may be a result of confounding by dietary habits and other lifestyle factors. Confounding by lifestyle variables could also be a factor in the previously observed health differences between drinkers and nondrinkers, although the evidence for this association is not as strong.

Beer↗
PubMed2002

Hostility, race, and glucose metabolism in nondiabetic individuals.

OBJECTIVE: The present study was designed to determine whether hostility is differentially related to measures of glucose metabolism in African-Americans and Caucasians. RESEARCH DESIGN AND METHODS: The relationship of hostility, as measured by a subset of the Cook-Medley hostility scale (CMHOST) inventory items, to various parameters of glucose metabolism were examined in a young, healthy sample of male and female African-American and Caucasian volunteers. Fasting blood samples were collected during an inpatient admission, at which time the CMHOST was also administered. RESULTS: In the entire sample, the CMHOST was found to be significantly correlated with fasting glucose and insulin sensitivity, as measured by the homeostatic model assessment (HOMA). However, the relationship of hostility to these parameters of glucose metabolism was different in African-American and Caucasian subjects. Hostility was significantly related to fasting glucose in African-Americans and to insulin sensitivity and fasting insulin in Caucasian subjects. The relationship of hostility to insulin sensitivity and fasting insulin was partially dependent on BMI in Caucasians, but the relationship of hostility to fasting glucose was unrelated to BMI in African-Americans. CONCLUSIONS: Our data suggest that the relationship of hostility to measures of glucose metabolism is mediated differently in these two ethnic groups. Therefore, hostility seems to be part of a constellation of risk-related behaviors related to BMI in Caucasians but independently related to fasting glucose in African-Americans.

Adult↗
PubMedDate not supplied

Coping styles and personality domains related to menopausal stress.

PURPOSE: Examine the role of coping styles and personality domains in relationship to stress associated with menopause. DATA/INFORMATION: Data are from 170 women ages 45 to 54 who completed a mailed questionnaire and a telephone interview that assessed women's stress associated with menopause, coping style, personality, menopausal symptoms, depressive symptoms, and use of hormone replacement therapy. RESULTS: Rating menopause as stressful was associated with higher levels of neuroticism, seeking social support, and avoidance, and lower levels of agreeableness in unadjusted analyses. In a multivariate model, menopausal symptoms, seeking social support, and neuroticism accounted for 21% of the variance in rating menopause as stressful. CONCLUSIONS: Health care providers treating women going through menopause should be aware that the stress response to the menopause transition is multifactorial and is associated with women's individual personalities and coping styles.

Adaptation, Psychological↗
PubMedDate not supplied

Terminal change in cognitive function: an updated review of longitudinal studies.

We provide an update to Siegler's (1975) review of the terminal change literature. Articles identified through MEDLINE, CANCERLIT, PUBMED, and PSYCINFO from 1975 to 2000 were examined. Lower levels of cognitive function are related to increased risk of mortality; however, the relationship between rate of cognitive change and mortality is less clear. Although there has been an increase in the number of studies since our last review, prior studies have been limited by a lack of medical data, consideration of dementia, small sample sizes, and poor cognitive measures. The emphasis on Alzheimer's disease and the growth of epidemiology of aging in the past 25 years have provided well-characterized population studies with serial cognitive measures that provide an opportunity to test the theory of terminal change.

Cognition↗
PubMedDate not supplied

A path model of chronic stress, the metabolic syndrome, and coronary heart disease.

OBJECTIVE: We tested a theoretical stress model cross-sectionally and prospectively that examined whether relationships of chronic stress, psychophysiology, and coronary heart disease (CHD) varied in older adult men (N = 47), older adult women not using hormone replacement therapy (HRT) (N = 64), and older adult women using HRT (N = 41). METHOD: Structural equations examined relationships of CHD with 1) chronic stress (caring for a spouse with Alzheimer's disease and patient functioning), 2) vulnerability (anger and hostility), 3) social resources (supports), 4) psychological distress (burden, sleep problems, and low uplifts), 5) poor health habits (high-caloric, high-fat diet and limited exercise), and 6) the metabolic syndrome (MS) (blood pressure, obesity, insulin, glucose, and lipids). RESULTS: Caregiver men had a greater prevalence of CHD (13/24) than did noncaregiver men (6/23) (p <.05) 27 to 30 months after study entry. This was influenced by pathways from caregiving to distress, distress to the MS, and the MS to CHD. In men, poor health habits predicted the MS 15 to 18 months later, and the MS predicted new CHD cases over 27 to 30 months. In women, no "caregiving-CHD" relationship occurred; however, 15 to 18 months after study entry women not using HRT showed "distress-MS" and "MS-CHD" relationships. In women using HRT, associations did not occur among distress, the MS, and CHD, but poor health habits and the MS were related. CONCLUSIONS: In older men, pathways occurred from chronic stress to distress to the metabolic syndrome, which in turn predicted CHD. Older women not using HRT showed fewer pathways than men; however, over time, distress, the MS, and CHD were related. No psychophysiological pathways occurred in older women using HRT.

Aged↗
PubMedDate not supplied

Predictors of smoking cessation in patients with a diagnosis of coronary artery disease.

PURPOSE: This study aimed to examine demographic, psychosocial, and clinical variables as predictors of smoking cessation in patients with coronary artery disease. METHODS: Smoking status and psychosocial variables were obtained at baseline. Participants were followed up at 3 months then annually up to 6 years for smoking status. Participants were recruited from the population of patients undergoing coronary angiography from 1986 through 1990. Patients were included in the study if they reported smoking at baseline and had valid data for demographic and clinical measures of interest. Depending on the psychosocial measure analyzed, sample size ranged from 525 to 303. Age, gender, education, marital status, disease severity, cardiac procedure, hostility, and four ratings of distress were evaluated as predictors of smoking cessation. RESULTS: Of the full sample, 40% (n = 210) quit smoking without relapse. Education (odds ratio [OR] 0.61; 95% confidence interval [CI] 0.44-0.84; P <.003), disease severity (OR 0.58; 95% CI 0.40-0.84; P <.004), and coronary artery bypass surgery (OR 0.60; 95% CI 0.43-0.85; P <.004) were associated with a lower likelihood of relapse. Higher levels of hostility (OR 2.36; 95% CI 1.46-3.84; P <.001), concern about health (OR 1.90; 95% CI 1.33-2.74; P <.001), tension (OR 1.60; 95% CI 1.12-2.30; P <.012), and depressive feelings (OR 1.60; 95% CI 1.12-2.27; P <.010) were associated with a higher risk of continuing to smoke. CONCLUSIONS: These findings describe demographic, clinical, and psychological mechanisms that might underlie successful smoking cessation and also may guide the identification of patients in need of special intervention.

Adult↗
PubMedDate not supplied

Patterns of change in hostility from college to midlife in the UNC Alumni Heart Study predict high-risk status.

OBJECTIVE: To examine hostility measured in college and patterns of change in hostility from college to midlife as predictors of high health-related risk later in midlife. METHODS: Logistic regression models were used to test hostility/risk associations. RESULTS: College hostility predicted being a current smoker, consuming more than two drinks of alcohol, low social support, achieving less than expected in career and in relationships, risk for depression, and appraisal of life changing for the worse in terms of family events at midlife. Change in hostility did not predict smoking and drinking; however, it did significantly predict social isolation, lower income (only for women), obesity, avoidance of exercise, high-fat diet, and negative changes in economic life, work life, and physical health events-all risk indicators measured during the next decade. Appraisals of social support, lowered expectations, risk for depression, and reports of family life changing for the worse were predicted at both time periods. When change in hostility was modeled with college hostility, all risk indicators were significantly predicted by college hostility. CONCLUSIONS: High hostility in college and change in hostility from college to midlife predicts a full range of health risk indicators. When compared with the average population decline in hostility, gains in hostility at midlife are related to increased risk while declines in hostility are related to reduced risk. Higher midlife hostility is associated with increased odds of being in the higher risk group. Future research should focus on developing interventions to reduce hostility.

Achievement↗
PubMedDate not supplied

Hostility as a predictor of survival in patients with coronary artery disease.

OBJECTIVE: This article presents a reanalysis of an earlier study that reported a nonsignificant relation between the 50-item Cook-Medley Hostility Scale (CMHS) and survival in a sample of coronary patients. Since publication of those results, there have been significant developments in the measurement of hostility that suggest that an abbreviated scale may be a better predictor of health outcomes. This study examined the ability of the total CMHS and an abbreviated form of the CMHS (ACM) to predict survival in a sample of patients with documented coronary artery disease (CAD) with increased statistical power. METHODS: Nine hundred thirty-six patients (83% were male; mean age = 51.48) with CAD who were followed for an average of 14.9 years. The ACM consisted of the combination of the cynicism, hostile attribution, hostile affect, and aggressive responding subscales that were identified in an earlier study (Barefoot et al. [1989]) by a rational analysis of the item content. The relation between hostility and survival was examined with Cox proportional hazard models (hazard ratios [HRs] based on a two standard deviation difference). RESULTS: Controlling for disease severity, the ACM was a significant predictor for both CHD mortality (HR = 1.33, p <.009) and total mortality (HR = 1.28, p <.02). The total CMHS was only a marginally significant predictor of either outcome (p values < 0.06). CONCLUSION: The results of this study suggest that hostility is associated with poorer survival in CAD patients, and it may be possible to refine measures of hostility in order to improve prediction of health outcomes.

Cause of Death↗
PubMedDate not supplied

Perceived social support as a predictor of mortality in coronary patients: effects of smoking, sedentary behavior, and depressive symptoms.

OBJECTIVE: Numerous studies have shown network assessments of social contact predict mortality in patients with coronary artery disease (CAD). Fewer studies have demonstrated an association between perceived social support and longevity in patient samples. It has been suggested that 1 of the mechanisms linking social support with elevated risk for mortality is the association between social support and other risk factors associated with decreased longevity such as smoking, failure to exercise, and depressive symptoms. The present study examined an assessment of perceived support as a predictor of all-cause and CAD mortality and examined the hypothesis that smoking, sedentary behavior, and depressive symptoms may mediate and/or moderate this association. METHODS: Ratings of social support and the risk factors of smoking, sedentary behavior, and depressive symptoms were examined as predictors of survival in 2711 patients with CAD, and associations between support and these risk factors were assessed. Smoking, sedentary behavior, and depressive symptoms were examined as mediators and/or moderators of the association between social support and mortality. RESULTS: Social support, smoking, sedentary behavior, and depressive symptoms were predictors of mortality (p's <.01). Results also indicated that sedentary behavior, but not smoking status or depressive symptoms, may substantially mediate the relationship between support and mortality. No evidence for moderation was found. CONCLUSIONS: The relation between social support and longevity may be partially accounted for by the association between support and sedentary behavior.

Cause of Death↗
PubMedDate not supplied

Neighborhood characteristics moderate effects of caregiving on glucose functioning.

OBJECTIVE: Adverse neighborhood environments and caregiving for a relative with dementia are both stressors that have been associated with poor health. The present study examined the extent to which three self-report measures of neighborhood characteristics interact with caregiving status (caregiver versus noncaregiver) to modify an important stress related health outcome: plasma glucose. METHODS: The study sample consisted of 147 community recruited caregivers and 147 participants who did not have caregiving responsibilities. We hypothesized that negative neighborhood characteristics would magnify effects of caregiving on plasma glucose levels. Regression analyses were conducted to examine the interaction of three neighborhood characteristic measures with caregiving status in predicting fasting plasma glucose (FPG) and glycosylated hemoglobin concentration (HbA1c), with control for age, race, gender, relation to care recipient (spouse or relative), body mass index, income, and education. RESULTS: Of the three neighborhood measures, the one reflecting crime concerns significantly moderated the effect of caregiving on FPG (p < .002) and HbA1c (p < .001). For participants with better neighborhood characteristics, caregivers and noncaregivers were similar with respect to indicators of glucose metabolism; however, for participants with worse neighborhood characteristics, caregivers had higher levels of FPG and HbA1c, as compared with noncaregivers. CONCLUSIONS: Poor health outcomes, such as impaired glucose control, may be found among caregivers who fear neighborhood crime.

Blood Glucose↗
PubMedDate not supplied

Allelic differences in the serotonin transporter-linked polymorphic region in geriatric depression.

Previous studies have examined the role of genetic variations in the serotonin transporter-linked polymorphic region (5HTTLPR) in affective disorders. The authors studied 182 older depressed subjects and 107 elderly control subjects and obtained DNA for genotyping at the 5HTTLPR. There were no significant differences in allele frequencies generally or for number of short alleles for the group as a whole, but interesting gender effects emerged. Among men, 23% of depressed men had two short alleles, compared with only 5% of control subjects. Among women, 67% of depressed women with more than one episode had at least one short allele, compared with 41% of single-episode female patients. Also, 74% of women with a positive family history of psychiatric illness in any female relative had at least one short allele, whereas 53% had at least one short allele who did not have such a family history. Our results add to the literature linking this gene to affective illness. The negative association of allele frequency and depression may be related to the relatively small sample size. The findings raise the possibility that this genetic locus may exert differential effects based on gender, increasing risk in men, and increasing risk of recurrence in women.

Aged↗