Biomedical subjects

Sharon Tennstedt

Publications and source records attributed to Sharon Tennstedt.

7 recordsLinked to original sources

PubMed2006

Cognitive function in normal-weight, overweight, and obese older adults: an analysis of the Advanced Cognitive Training for Independent and Vital Elderly cohort.

OBJECTIVES: To assess how elevated body mass index (BMI) affects cognitive function in elderly people. DESIGN: Cross-sectional study. SETTING: Data for this cross-sectional study were taken from a multicenter randomized controlled trial, the Advanced Cognitive Training for Independent and Vital Elderly trial. PARTICIPANTS: The analytic sample included 2,684 normal-weight, overweight, or obese subjects aged 65 to 94. MEASUREMENTS: Evaluation of cognitive abilities was performed in several domains: global cognition, memory, reasoning, and speed of processing. Cross-sectional association between body weight status and cognitive functions was analyzed using multiple linear regression. RESULTS: Overweight subjects had better performance on a reasoning task (beta=0.23, standard error (SE)=0.11, P=.04) and the Useful Field of View (UFOV) measure (beta=-39.46, SE=12.95, P=.002), a test of visuospatial speed of processing, after controlling for age, sex, race, years of education, intervention group, study site, and cardiovascular risk factors. Subjects with class I (BMI 30.0-34.9 kg/m2) and class II (BMI>35.0 kg/m2) obesity had better UFOV measure scores (beta=-38.98, SE=14.77, P=.008; beta=-35.75, SE=17.65, and P=.04, respectively) in the multivariate model than normal-weight subjects. The relationships between BMI and individual cognitive domains were nonlinear. CONCLUSION: Overweight participants had better cognitive performance in terms of reasoning and visuospatial speed of processing than normal-weight participants. Obesity was associated with better performance in visuospatial speed of processing than normal weight. The relationship between BMI and cognitive function should be studied prospectively.

Aged↗

PubMed2005

Design of the Stress Incontinence Surgical Treatment Efficacy Trial (SISTEr).

OBJECTIVES: To describe the methods and rationale for the first randomized controlled trial conducted by the Urinary Incontinence Treatment Network. METHODS: The primary objective of this clinical trial is to compare two commonly performed surgical procedures for stress urinary incontinence-the Burch colposuspension and the autologous rectus fascial sling-for overall treatment success for urinary incontinence and stress-type symptoms of incontinence at 24 months after surgery. Secondary aims include a comparison of complications, quality of life, sexual function, patient satisfaction, costs, and the need for additional treatments or surgery; and an evaluation of the prognostic value of preoperative urodynamic studies. The Stress Incontinence Surgical Treatment Efficacy Trial is being conducted on 655 women with predominant stress urinary incontinence, as determined by history and physical examination, urinary stress test with witnessed leakage, and voiding diary. Administration of all questionnaires and performance of examinations, tests, and both surgical procedures are standardized within and across the clinical centers. Assessments occur preoperatively and at 6 weeks and 3, 6, 12, 18, and 24 months postoperatively. A sample of 655 women ensures 80% power to detect a 12% difference (60% versus 72%) at the 5% significance level. The intent-to-treat analysis will use Fisher's exact test and time-to-failure analyses. RESULTS: Enrollment was completed in June 2004 with 24 months of follow-up to end in June 2006. CONCLUSIONS: This is the first large, multicenter randomized clinical trial comparing these two standard-of-care procedures for stress incontinence.

Female↗

PubMed2005

Effect of blood pressure and diabetes mellitus on cognitive and physical functions in older adults: a longitudinal analysis of the advanced cognitive training for independent and vital elderly cohort.

OBJECTIVES: To evaluate the effect of blood pressure (BP) and diabetes mellitus (DM) on cognitive and physical performance in older, independent-living adults. DESIGN: Longitudinal study with secondary data analysis from the Advanced Cognitive Training for Independent and Vital Elderly randomized intervention trial. SETTING: Six field sites in the United States. PARTICIPANTS: Two thousand eight hundred two independent-living subjects aged 65 to 94. MEASUREMENTS: Cognitive functions in different domains and physical functions measured using activities of daily living, instrumental activities of daily living (IADLs), and the physical function subscale from the Medical Outcomes Study Short Form-36 (SF-36) Health Survey. RESULTS: After the first annual examination, hypertension was associated with a faster decline in performance on logical reasoning tasks (ability to solve problems following a serial pattern), whereas DM was associated with accelerated decline on the Digit Symbol Substitution Test (speed of processing). The reasoning and Digit Symbol Substitution test are executive function tasks thought to be related to frontal-lobe function. Hypertension and DM were associated with a significantly faster pace of decline on the SF-36 physical function component score. Individuals with DM had a faster pace of decline in IADL functioning than nondiabetic subjects. There was no evidence for an interaction between BP and DM on cognitive or physical function decline. CONCLUSION: Hypertension and DM are associated with accelerated decline in executive measures and physical function in independent-living elderly subjects. Further research is needed to determine whether cardiovascular risk modification ameliorates cognitive and functional decline in elderly people.

Activities of Daily Living↗

PubMed2004

Pragmatic and internal validity issues in sampling in caregiver studies: a comparison of population-based, registry-based, and ancillary studies.

OBJECTIVES: Studies of caregivers illustrate a classic sampling dilemma: maximizing recruitment without compromising study validity. Because caregivers are defined in relation to a care recipient, sampling methods are often determined by pragmatic decisions such as access, efficiency, and costs. However, overlooking validity may result in selection bias, misclassification of caregiver status, and the confounding of results. Validity and pragmatic concerns were compared in four caregiver studies that used different sampling frames: community based, Alzheimer's disease registry, and ancillary studies to existing epidemiologic studies. METHODS: Systematic comparison of validity and of pragmatic aspects of sampling frames, recruitment methods, and participation rates, with attention to caregiver identification, inclusion criteria, and sample restriction. RESULTS: All studies used task-based inclusion criteria. Caregiver participation rates ranged from 81% to 96%, with higher rates in community-based and registry-based studies than in ancillary studies. The latter studies benefited from unbiased selection of noncaregivers. DISCUSSION: Regardless of sampling frame, standard task-based inclusion criteria to define caregivers may enhance validity.

Aged↗

PubMed2003

Knowledge dissemination and utilization in gerontology: an organizing framework.

PURPOSE: Enabling valuable research findings to be used by the field requires a strategic approach to dissemination and utilization rather than simply making constituencies aware of the information. This article describes a conceptual framework for the dissemination and utilization of information, along with examples of its use by the Boston University Roybal Center for Enhancement of Late Life Function. DESIGN AND METHODS: The framework identifies dissemination/utilization goals of exposure, experience, expertise, and embedding ("4 E") and relates each goal to strategies targeted for specific users. RESULTS AND IMPLICATIONS: The Boston University center exposed the field to information through presentations, print- and Web-based information, provided consumers and family members with new findings through motivational videotapes, developed expertise-level training programs, and embedded the new findings within organizations and systems. The 4 E framework can translate critical research outcomes into useful information to assist the field to better care and support available for individuals in late life.

Aged↗

PubMed2002

Effects of a computer-based, telephone-counseling system on physical activity.

BACKGROUND: There is increasing interest in developing interventions to promote physical activity (PA) that do not involve face-to-face contact with health professionals. We developed a fully automated PA counseling system (telephone-linked communication, TLC-PA) that was delivered via telephone. DESIGN: A randomized, controlled trial with 298 adult, sedentary members (mean age, 45.9 years; 72% women; 45% white; and 45% African American) of a multi-site medical practice. The comparison group (TLC-Eat) received an automated intervention promoting healthy eating, which was also delivered via telephone. INTERVENTION: The TLC-PA promoted moderate-intensity PA (MI-PA) based on the transtheoretical model of behavior change and social cognitive theory. The system was available to participants for 6 months. MAIN OUTCOMES: Energy expenditure in MI-PA, proportion of participants who met recommendations for MI-PA, and motivational readiness for PA. MEASURES: Self-reports of PA behavior and motivational readiness at baseline, 3 months, and 6 months. RESULTS: At 3 months, intention-to-treat analyses showed that the TLC-PA group was more likely to meet recommendations for MI- or vigorous-intensity PA (VI-PA) compared to the TLC-Eat group (TLC-PA=26% vs TLC-Eat=19.6%, p=0.04). Among study completers, TLC-PA subjects reported significantly higher daily kilocalorie energy expenditure in MI-PA (2.3 kcal/kg/d vs 2.0 kcal/kg/d, p=0.02); a larger proportion met recommendations for MI- or VI-PA (31.2% vs 21.3%, p=0.02) and were in more advanced stages of motivational readiness than TLC-Eat subjects (TLC-PA=52.5% vs TLC-Eat=42.2%, p=0.04). Results were not maintained at 6 months. The proportion of TLC-PA users decreased significantly over the intervention period. CONCLUSIONS: A fully automated counseling system had positive short-term effects on PA among sedentary adults. Lack of maintenance of effects may be due to a decrease in the number of participants who continued to use the system.

Chi-Square Distribution↗

PubMed2002

Service utilization among disabled Puerto Rican elders and their caregivers: does acculturation play a role?

OBJECTIVE: This study examined the relationship between language acculturation of disabled Puerto Rican elderly and their caregivers, their length of residence in mainland United States, and the utilization of formal services. METHODS: Language acculturation was measured by language use, understanding, and preferences. The sample of this study consisted of 194 dyads of disabled Puerto Rican elders 60 years and older, and their primary caregivers in an urban center in the northeast. RESULTS: Length of residence in the United States, but not language acculturation, of the disabled Puerto Rican elder and the caregiver was related to elder's use of formal services. Caregivers, whose own children were born in Puerto Rico as opposed to mainland United States, were more likely to use formal services. DISCUSSION: Language acculturation, although a commonly used measure of acculturation, may be of decreasing importance in explaining service utilization, as bilingual services become increasingly available. Practice implications are discussed.

Acculturation↗