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L F Berkman

Publications and source records attributed to L F Berkman.

95 records · Page 6Linked to original sources
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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↗
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Is educational attainment associated with shared determinants of health in the elderly? Findings from the MacArthur Studies of Successful Aging.

OBJECTIVE: To investigate the association of educational attainment with an array of risk factors for poor health among high-functioning older men and women. METHODS: Cross-sectional analyses of psychosocial, behavioral, and biological factors and educational attainment were conducted using data from a population-based cohort study of older men and women. Participants consisted of 70- to 79-year-old residents of communities of East Boston, MA; New Haven, CT; and Durham County, NC (N = 1192) participating in the Established Populations for Epidemiologic Studies of the Elderly programs, a three-site longitudinal study of community-dwelling men and women. Participants were selected on the basis of high physical and cognitive function, representing approximately the top third of their peers in terms of functional ability in 1988. In-home interviews were conducted. Associations among education and behavioral (e.g., cigarette smoking and physical activity), biological (e.g., pulmonary function, serum cholesterol), psychological (e.g., self-efficacy, anxiety), and social (e.g., networks and support) factors were examined. RESULTS: Low levels of education were associated with poorer psychological function (less mastery, efficacy, happiness), less optimal health behaviors (increased tobacco consumption and decreased levels of physical activity), poorer biological conditions (decreased pulmonary function, increased body mass index and waist-to-hip ratio), and larger social networks (increased number of contacts, decreased negative support). Several factors (alcohol consumption, high-density lipoprotein cholesterol) were nonlinearly related to educational attainment. CONCLUSIONS: Educational attainment is associated with a broad array of psychosocial and biological conditions among the elderly. That an education gradient functions over an array of factors that structure daily life, even in later life in a healthy population, may suggest how socioeconomic status influences health.

Aged↗
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A prospective study of medical care utilization and morbidity in preschool children belonging to a prepaid group practice: background and methods.

The purpose of this paper is to describe the background and methods of a prospective study of medical care utilization and morbidity in a fixed cohort of over 500 preschool children whose families belonged to a prepaid group practice affiliated with Yale University. Following baseline interviews with their mothers, study children were followed for 12 months between 1981 and 1982. Information concerning the subjects' contacts with the health care facility serving members of the group practice was collected from accompanying adults, attending clinicians, and medical records. Using these data, we were able to identify episodes of care, linking all clinical visits and phone calls for single occurrences of an illness or injury. The major aim of the study is to identify psychosocial determinants of pediatric utilization (for both acute and preventive care) and of childhood morbidity. The possible predictors of principal interest are factors associated with the family environment, such as social stress and strain, family structure, and different aspects of the mother's social network. The dual emphasis on both illness and behavior outcomes is based on the important interrelationship between epidemiologic and health services research, especially when examining psychosocial effects.

Attitude to Health↗
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Health indices as predictors of cognition among older African Americans: MacArthur studies of successful aging.

Using cross-sectional and longitudinal data from the MacArthur Successful Aging Study, this paper examines associations between cognition and indices of health in 224 elderly African Americans 70 to 79 years of age at initial interview. The results indicated that greater average peak expiratory flow was predictive of better cognitive performance at the first interview. One longitudinal analysis showed that gender was the only significant predictor of change (change as a continuous variable) with women tending to slightly improve their cognitive performance over time. When change was treated as a dichotomous variable (e.g., a decline of 6 or more points), lower levels of average peak expiratory flow and education were predictive of decline, and positive self-ratings of current health and changes in health in the past year were important factors in the improvement of cognitive performance. The results indicate that, in addition to education, health is an important predictor of the status and course of cognitive functioning in older African Americans.

Black or African American↗