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Biomedical subjects

M A Robbins

Publications and source records attributed to M A Robbins.

At least 37 records · Page 2Linked to original sources
PubMed1993

The influence of gender and age on Halstead-Reitan neuropsychological test performance.

Age-cohort differences for seven tests from the Halstead-Reitan Neuropsychological Battery, for overall performance on the Impairment Index, and for a multivariate composite of the seven scores, were examined for 427 subjects falling into six age groups (15-24, 25-34, 35-44, 45-54, 55-64, and 65 years and over). Univariate and multivariate-discriminant analyses were performed. Poorer performance was observed across age-cohorts (linear trend) for all tests and the Impairment Index. A very modest Age-Cohort (linear trend) x Gender interaction was observed only for the Category Test. Decline in Category Test performance across age-cohorts was more pronounced for women than for men. For women, the best discrimination among age groups was observed for the Category Test. For men, Tactile Performance Localization Test discriminated best. The poorest discrimination among age groups was seen for Finger-Tapping for men and Tactile Performance Test--Total (time score) for women. Results were consistent with a model of specific nested within general decline. Although linear-trend across age groups was observed for all tests, the strongest discriminations were associated with neuropsychological tests of abstraction and complex problem-solving performance.

Adolescent↗
PubMed1991

Structural modeling of mixed longitudinal and cross-sectional data.

In this paper we describe some mathematical and statistical models for dealing with changes over age. We concentrate specifically on the use of a structural equation modeling (SEM) approach (using computer programs like LISREL) to deal with issues of: (1) group differences in regression parameters, (2) differences in longitudinal and cross-sectional results, (3) differences due to longitudinal attrition, and (4) mixtures of these problems. To illustrate these ideas we use data from a previous study of hypertension and intellectual abilities (from Schultz, Elias, Robbins, Streeten, and Blakeman, 1986).

Adult↗
PubMed1990

The effects of age, blood pressure, and knowledge of hypertensive diagnosis on anxiety and depression.

Recent studies have indicated that heightened anxiety and depression in hypertensives, relative to normotensives, is particular to hypertensives' knowledge of their diagnosis. We tested the hypothesis that knowledge of hypertensive diagnosis (KHD) has a stronger association with anxiety and depression for younger than for older individuals. Samples were 239 subjects referred to a hypertension clinic with KHD and 90 subjects, never diagnosed as hypertensive, recruited as a normotensive comparison group. Two age groups, 21-39 and 45-65, were employed. Regression analyses indicated that higher unmedicated blood pressure (BP) values were associated with higher state anxiety but not trait anxiety or depression, after age, education, and sex were entered into the equations. Knowledge of hypertension diagnosis was related to higher scores on all anxiety and depression measures. However, evidence that BP values and KHD had stronger associations with anxiety and depression for a younger than for an older cohort was not obtained. Regression analyses performed within the hypertension clinic referrals indicated that the severity of hypertension as reflected by unmedicated BP values was unrelated to anxiety and depression, and that a history of treatment with anti-hypertensive medications was related only to higher somatic depression.

Adult↗
PubMed1990

Determining neuropsychological cut scores for older, healthy adults.

Three age groups (20-31, 37-49, and 55-67 years) of healthy men and women were compared on tests from the Halstead-Reitan neuropsychological test battery. Age-cohort differences in performance were observed for every measure (except Finger Tapping) and for overall indices of cognitive functioning, the Average Impairment Rating (AIR) and the Halstead-Reitan Impairment Index (HR II). When traditional cut scores (developed with age-heterogeneous samples) were used, alarmingly high percentages of subjects in the oldest group were defined as brain damaged. These findings were not attributable to higher levels of psychometrically-assessed anxiety and depression in the older groups or for the impaired subjects. Slightly more conservative criteria (fewer diagnoses of brain impairment) were then employed. The first, AIR greater than or equal to 2.00, resulted in a low and more reasonable base rate of brain impairment for the oldest group. The second, AIR greater than 2.00, resulted in age-parity in incidence of brain impairment. The heuristic value of more conservative AIR scores was discussed as were possible uses in applied clinical research settings. The limitations of this approach were noted with regard to its exclusive focus on the problem of false positive diagnoses. It was emphasized that, from a neuropsychological diagnostic perspective, cut scores based on healthy aging samples must ultimately be tested in the context of traditional neuropsychological studies in which external validation with neurosurgical and neurological criteria is employed.

Adult↗
PubMed1990

Is blood pressure an important variable in research on aging and neuropsychological test performance?

Regression analyses using Blood Pressure, Age, and the multiplicative effect of Blood Pressure and Age as predictors of performance (on selected tests from the Halstead-Reitan neuropsychological test battery) were done. Three hypotheses were tested with subjects ranging in age from 20 to 72 years of age: (1) blood pressure values predict neuropsychological test performance over a wide range of hypertensive and normotensive blood pressure values; (2) blood pressure predicts performance within the narrower range of normal and borderline values; (3) blood pressure X age interactions, when observed over this age and education range, are such that negative blood pressure effects on performance are larger for younger than older subjects. Regression analyses confirmed each of these hypotheses and indicated that strength of prediction was not reduced when participants free from hypertension-related complications and medication were tested. Blood pressure X age interactions were seen for Trailmaking-B Test and the Tactile Performance Test-Localization for the primary sample. However, only Blood Pressure main effects were observed for the Average Impairment Rating, the Categories Test, TPT-Memory and TPT-Localization when age, sex, and education were controlled. Implications of these findings for the role of blood pressure in aging research and for longitudinal studies with subjects free from the need for treatment with antihypertensive medications are discussed.

Adult↗
PubMed1989

A longitudinal study of the performance of hypertensive and normotensive subjects on the Wechsler Adult Intelligence Scale.

Performance on the Wechsler Adult Intelligence Scale was followed over two 5- to 6-year intervals for essential hypertensive Ss (EH; n = 22) free from medical complications and for normotensive Ss (N; n = 20). EH were treated with adrenergic beta-blocking drugs, diuretics, or both. Mean age was 46 years (SD = 12.6 years), initially (Time 1). Results were unaltered by adjustment for initial age. N improved modestly on the Verbal scale, from Time 1 to Time 2 only. EH neither improved nor declined on the Verbal scale. Scores remained unchanged for both EH and N Ss for the Performance scale. Overall, and at Times 2 and 3, Verbal scores were lower for the EH group. It was concluded that neither decline nor improvement in cognitive function over time are necessary outcomes of modest, carefully treated, uncomplicated hypertension in the middle years.

Female↗
PubMed1989

A longitudinal study of neuropsychological performance by hypertensives and normotensives: a third measurement point.

The neuropsychological test performance of hypertensive and normotensive subjects was compared at three times of measurement over a 10-year period. The tests used were among those that are most sensitive to brain impairment in the Halstead-Reitan battery. In addition to individual test measures, a widely used clinical index of battery-wide performance--the Average Impairment Rating (AIR)--was used. Hypertensives exhibited lower mean levels of performance on the AIR at all times of measurement. However, the Blood Pressure Group x Time of Measurement interactions were not statistically significant, indicating that hypertensives and normotensives did not exhibit a differential rate of change (decline or improvement) over time. Hypertensives also performed more poorly for a measure of learning set formation (categories test) and two tests of memory for forms experienced by touch only (tactile perception memory and localization tests). However, Blood Pressure x Time of Measurement interactions were not observed for these measures.

Adult↗
PubMed1987

Acquisition of word-processing skills by younger, middle-age, and older adults.

A total of 45 subjects in three age groups (younger, middle-age, older) were trained to word process on microcomputers using a commercial training program and an experimenter-designed test and evaluation protocol. Although all of the subjects mastered the essentials of word processing, the older group took significantly longer to complete the training and evaluation procedures and performed more poorly on a review examination that tested their knowledge of the word-processing commands and techniques. The results are discussed in relation to requirements for trainer assistance, motivational factors, and the need to design training protocols that meet the needs of older adults.

Achievement↗
PubMed1987

Clinical significance of cognitive performance by hypertensive patients.

Fifty-four subjects with uncomplicated essential hypertension and 54 normotensive subjects were compared with regard to a widely employed clinical index of cognitive dysfunction (the Average Impairment Rating) calculated from neuropsychological tests that discriminate between brain-damaged and neurologically normal persons. Hypertensive subjects exhibited lower mean scores on this index when education was ignored, but results were not the same for highly educated and less well educated groups. There were no differences between exceptionally well educated hypertensive and normotensive subjects, but in the less well educated group, hypertensive subjects performed more poorly than normotensive subjects. The percentages of hypertensive and normotensive subjects scoring in a cognitively impaired range on the Average Impairment Rating were low and did not differ for either education group. These data indicate the important role of subtle differences in education level with respect to positive or negative findings for studies comparing hypertensive and normotensive subjects and illustrate the important role of clinical neuropsychological indices of cognitive dysfunction when one wishes to make meaningful inferences regarding cerebral cortical function in hypertensive subjects.

Adult↗
PubMed1986

A longitudinal comparison of hypertensives and normotensives on the Wechsler Adult Intelligence Scale: initial findings.

This study was designed to compare changes in performance on the Wechsler Adult Intelligence Scale over a 5- to 6-year test interval for normotensives and medically treated, uncomplicated essential hypertensives. The results indicated that normotensives improved from Time 1 to Time 2 on the Verbal scale but not on the Performance scale. Hypertensives exhibited no significant improvement or decline on either scale, although they performed less well on the Verbal scale at Time 2 than did normotensives. They also performed more poorly on the Performance scale when Time 1 and Time 2 scores were averaged. Participants who returned for Time 2 testing and those who participated only at Time 1 were compared. Verbal scaled scores at Time 1 were higher for returning than for nonreturning hypertensives, but, for normotensives, no differences were observed for those who returned for Time 2 testing and those who did not.

Adult↗
PubMed1986

A longitudinal study of neuropsychological test performance for hypertensive and normotensive adults: initial findings.

This study was designed to compare changes in performance on selected measures from the Halstead-Reitan neuropsychological test battery over a 5 to 6 year interval for normotensive and medically treated, uncomplicated essential hypertensive adults. Mean performance level was poorer for hypertensive than for normotensive groups on an average impairment index and a number of the individual impairment rating scores, but no Time of measurement X Blood pressure interactions were observed. There was no evidence of improvement or decline for normotensive or hypertensive adults and no evidence suggesting that the hypertensive group could be characterized as "cognitively impaired" in an absolute or clinical sense.

Blood Pressure↗
PubMed1983

Resting and exercise hemodynamics in constrictive pericarditis and a case of cardiac amyloidosis mimicking constriction.

The resting and exercise hemodynamics in seven patients with pericardial constriction and in one patient with cardiac amyloidosis are described. Equalization of left and right heart diastolic filling pressures was observed in all cases, both at rest and during exercise. This hemodynamic response, although typical, should not be considered pathognomonic of pericardial constriction.

Adult↗
PubMed1976

Extratesticular lipoma: report of 2 cases and a new classification.

We report 2 cases of intrascrotal extratesticular lipoma and propose a new classification. If the possible anatomic sites of origin and the histology of this neoplasm are considered during dissection the tumor can be excised without unnecessary orchiectomy when the blood supply of the testicle can be preserved.

Adult↗