The long-term objective of the Rush Memory and Aging Project is to identify the postmortem indices linking genetic and environmental risk factors to the development of Alzheimer’s disease (AD). The overall study design involves a detailed assessment of risk factors for AD in older persons without known dementia who agree to annual clinical evaluation and organ donation at the time of death. In contrast to other clinical-pathologic studies which are conducted on special populations, the Rush Memory and Aging Project enrolled a cohort with much greater diversity in terms of educational attainment, in addition to gender, race, and ethnicity. From September of 1997 through April of 2005, more than 1,000 older persons without known dementia from more than 30 residential facilities across the Chicago metropolitan area agreed to participate. Their mean age was 81 years, about a third had 12 or fewer years of education, a third were men, and about 10% were members of a racial or ethnic minority group. More than 950 already have completed their baseline clinical evaluation.

Objectives To examine any association between social, productive, and physical activity and 13 year survival in older people. Design Prospective cohort study with annual mortality follow up. Activity and other measures were assessed by structured interviews at baseline in the participants' homes. Proportional hazards models were used to model survival from time of initial interview.

Community-Dwelling PopulationElder Self-neglect and Abuse and Mortality Risk in a Correction Contact me if this article is corrected. CitationsContact me when this article is cited. This article has been cited 2 times. Topic collectionsContact me when new articles are published in these topic areas.

Background and Purpose Greater social cohesion is related to lower rates of coronary heart disease, but its relation to stroke risk is unstudied. This study examined whether neighborhood social cohesion was protective against stroke mortality and incidence. Methods Data come from 5,789 participants (60% female; 62% black; mean age, 74.7 years) in a longitudinal study of chronic diseases in the elderly. Stroke mortality, ascertained through 12/31/07, was verified via the National Death Index; 186 stroke deaths were identified in 11 years of follow-up. Stroke incidence was determined in a subset (N=3,816) with linkage to Medicare claims files; 701 first-ever strokes were identified. Cohesion was measured by 6 items assessing frequency of contact and social interactions with neighbors; items were z-scored and averaged. Individual scores were averaged across 82 census block groups, forming a neighborhood-level measure of social cohesion. Marginal Cox proportional hazard models tested the association of neighborhood-level cohesion with stroke mortality and incidence. Results Each one-point increase in cohesion related to a 53% reduced risk of stroke mortality (hazard ratio (HR)=0.47; 95% confidence interval (CI)=0.24, 0.90), adjusting for relevant covariates, including sociodemographics, known stroke risk factors and neighborhood-level socioeconomic status. A race x cohesion interaction (p=0.04) revealed cohesion was protective in whites (HR=0.34, 95% CI=0.17, 0.67) but not blacks (HR=1.17, 95% CI=0.35, 3.86). Cohesion was unrelated to stroke incidence (p>0.5). Conclusion Neighborhood-level social cohesion was independently protective against stroke mortality. Research is needed to further examine observed race differences and pathways by which cohesion is health-protective.

A behavioral intervention in PCI patients has a beneficial effect on feelings of exhaustion. It could not be demonstrated that the intervention reduces the risk of a new coronary event within 2 years.

Data from a community-based sample of 2,812 men and women aged 65 years and over, living in New Haven, Connecticut, were used to examine the associations between blood pressure, smoking, diabetes, anginal chest pain, and relative weight and 6-year incidence (1982-1988) of myocardial infarction and coronary heart disease mortality. Multivariate logistic regression analyses revealed that history of diabetes was associated with increased risk of incident myocardial infarction among women (odds ratio (OR) = 3.20; 95% confidence interval 1.46-7.01), while higher relative weight was a significant risk factor among men (OR = 3.46, 95% confidence interval 1.34-8.95 for middle vs. lowest tertile and OR = 3.24; 95% confidence interval 1.10-9.53 for highest versus lowest tertile). For coronary heart disease mortality, age and diabetes (OR = 4.47, 95% confidence interval 1.85-10.79) were associated with increased risk among women, as was current smoking (OR = 3.96; 95% confidence interval 1.66-9.45). Among men, age, prevalent heart disease, and use of antihypertensive medication (OR = 1.84; 95% confidence interval 1.13-3.00) were risk factors for coronary heart disease mortality. These risk estimates and the relatively high prevalences of these risk factors suggest that attributable risks may be substantial. Observed sex differences as well as differences in patterns of risk factor associations for the two endpoints suggest that there may be different risk profiles for older men and women and for different coronary heart disease endpoints.

Both anemia by WHO criteria and mild reductions in Hb were related to increased risk of mortality in older blacks and whites.

It has been observed that vital exhaustion, a state characterized by unusual tiredness, increased irritability and feelings of demoralization not uncommonly precedes myocardial infarction in apparently healthy individuals. This observation raised the question as to whether vital exhaustion is a marker of subclinical coronary disease. To answer that question the condition was assessed in 105 male patients (mean age 54.8 year) before and 2 weeks after successful percutaneous transluminal coronary angioplasty (PTCA) by the Maastricht questionnaire. Vital exhaustion was found to be significantly correlated with the number of diseased vessels before PTCA and to decrease significantly after PTCA. However, the association was rather modest (R2 = 0.08) and most patients remained exhausted after PTCA. During a follow-up period of 1.5 years, 32 patients (30%) experienced a new cardiac event (cardiac death, myocardial infarction, coronary artery bypass grafting, repeat PTCA, a new coronary lesion or recurrent angina with documented ischaemia). Univariate and multivariate analyses showed that the number of diseased vessels, hypercholesterolaemia, and vital exhaustion were independently associated with future events. The odds ratios were 3.74 (P = 0.02), 3.08 (P = 0.08) and 3.07 (P = 0.04), respectively. It is concluded that the tiredness preceding a cardiac event is only modestly associated with the extent of coronary artery disease and that a state of exhaustion after PTCA increases the risk for a new cardiac event.