Background-The ability of older persons to function independently is dependent largely on the maintenance of sufficient aerobic capacity and strength to perform daily activities. Although peak aerobic capacity is widely recognized to decline with age, its rate of decline has been estimated primarily from cross-sectional studies that may provide misleading, overly optimistic estimates of aging changes. Methods and Results-To determine longitudinal rate of change in aerobic capacity and the influence of age, gender, and physical activity on these changes, we performed serial measurements of peak treadmill oxygen consumption (peak V O 2 ) in 375 women and 435 men ages 21 to 87 years from the Baltimore Longitudinal Study of Aging, a community-dwelling cohort free of clinical heart disease, over a median follow-up period of 7.9 years. A linear mixed-effects regression model was used to calculate the predicted longitudinal 10-year rate of change in peak V O 2 , expressed in milliliters per minute, for each age decade from the 20s through the 70s after adjustment for self-reported leisure-time physical activity. A longitudinal decline in peak V O 2 was observed in each of the 6 age decades in both sexes; however, the rate of decline accelerated from 3% to 6% per 10 years in the 20s and 30s to Ͼ20% per 10 years in the 70s and beyond. The rate of decline for each decade was larger in men than in women from the 40s onward. Similar longitudinal rates of decline prevailed when peak V O 2 was indexed per kilogram of body weight or per kilogram of fat-free mass and in all quartiles of self-reported leisure-time physical activity. When the components of peak V O 2 were examined, the rate of longitudinal decline of the oxygen pulse (ie, the O 2 utilization per heart beat) mirrored that of peak V O 2 , whereas the longitudinal rate of heart rate decline averaged only 4% to 6% per 10 years, and accelerated only minimally with age. Conclusions-The longitudinal rate of decline in peak V O 2 in healthy adults is not constant across the age span in healthy persons, as assumed by cross-sectional studies, but accelerates markedly with each successive age decade, especially in men, regardless of physical activity habits. The accelerated rate of decline of peak aerobic capacity has substantial implications with regard to functional independence and quality of life, not only in healthy older persons, but particularly when disease-related deficits are superimposed. (Circulation. 2005;112:674-682.)

We examined age trends in the five factors and 30 facets assessed by the Revised NEO Personality Inventory in Baltimore Longitudinal Study of Aging data (N = 1,944; 5,027 assessments) collected between 1989 and 2004. Consistent with cross-sectional results, Hierarchical Linear Modeling analyses showed gradual personality changes in adulthood: a decline up to age 80 in Neuroticism, stability and then decline in Extraversion, decline in Openness, increase in Agreeableness, and increase up to age 70 in Conscientiousness. Some facets showed different curves from the factor they define. Birth cohort effects were modest, and there were no consistent Gender × Age interactions. Significant non-normative changes were found for all five factors; they were not explained by attrition but might be due to genetic factors, disease, or life experience.

Objective-To evaluate longitudinal changes in prostate-specific antigen (PSA) levels in men with and without prostate disease.Design-Case-control study of men with and without prostate disease who were participants in a prospective aging study. Setting-GerontologyResearch Center of the National Institute on Aging; the Baltimore (Md) Longitudinal Study of Aging.Patients-Sixteen men with no prostate disease (control group), 20 men with a histologic diagnosis of benign prostatic hyperplasia (BPH), and 18 men with a histologic diagnosis of prostate cancer.Outcome Measures-Multiple PSA and androgen determinations on serum samples obtained from 7 to 25 years prior to histologic diagnosis or exclusion of prostate disease.Results-Changesin androgen levels with age did not differ between groups. Control subjects did not show a significant change in PSA levels with age. There was a significant difference in the age-adjusted rate of change in PSA levels between groups (prostate cancer>BPH>control; P<.01).At 5 years before diagnosis when PSA levels did not differ between subjects with BPH and prostate cancer, rate of change in PSA levels (0.75 μg/L per year) was significantly greater in subjects with prostate cancer compared with control subjects and subjects with BPH. Also, rate of change in PSA levels distinguished subjects with prostate cancer from subjects with BPH and control subjects with a specificity of 90% and 100%, respectively. Conclusions-The most significant factor affecting serum PSA levels with age is the development of prostate disease. Rate of change in PSA levels may be a sensitive and specific early clinical marker for the development of prostate cancer.PROSTATE-SPECIFIC ANTIGEN (PSA) is a serine protease produced by both benign and malignant prostatic epithelium that can be measured in serum samples by immunoassay. 1 Cross-sectional analysis of serum PSA levels in men with and without prostate discent studies suggest that PSA may be useful in the early detection of prostate cancer, 3,4 it is known that PSA elevations occur in men with BPH 2,5,6 and that men with prostate cancer can have normal PSA levels. [4][5][6] are not specific for prostate cancer, and a normal PSA level does not exclude the presence of cancer.The longitudinal changes in PSA that occur with age in men with and without prostate disease have not been reported previously. In addition, although it is well known that PSA is under the influence of androgen, 7,8 the influence of age-related decreases in androgen levels on PSA has not been studied. To better understand the factors that affect PSA levels and potentially improve the use of this valuable clinical marker in men with prostate disease, we evaluated PSA levels in a longitudinal, casecontrol study. METHODS Study GroupsThree groups of men were identified from subjects participating in the Baltimore Longitudinal Study of Aging (BLSA). The BLSA is an ongoing, long-term,prospective aging study of the National Institute of Aging, Bethesda, Md, which has as its goal the study of ...

To determine the prevalence rates of major depressive disorder and of depressive symptoms and their relationship to mortality in nursing homes, research psychiatrists examined 454 consecutive new admissions and followed them up longitudinally for 1 year. Major depressive disorder occurred in 12.6% and 18.1% had depressive symptoms; the majority of cases were unrecognized by nursing home physicians and were untreated. Major depressive disorder, but not depressive symptoms, was a risk factor for mortality over 1 year independent of selected physical health measures and increased the likelihood of death by 59%. Because depression is a prevalent and treatable condition associated with increased mortality, recognition and treatment in nursing homes is imperative.

Current studies are inconclusive regarding specific patterns of gender differences in age-associated hearing loss. This paper presents results from the largest and longest longitudinal study reported to date of changes in pure-tone hearing thresholds in men and women screened for otological disorders and noise-induced hearing loss. Since 1965, the Baltimore Longitudinal Study of Aging has collected hearing thresholds from 500 to 8000 Hz using a pulsed-tone tracking procedure. Mixed-effects regression models were used to estimate longitudinal patterns of change in hearing thresholds in 681 men and 416 women with no evidence of otological disease, unilateral hearing loss, or noise-induced hearing loss. The results show (1) hearing sensitivity declines more than twice as fast in men as in women at most ages and frequencies, (2) longitudinal declines in hearing sensitivity are detectable at all frequencies among men by age 30, but the age of onset of decline is later in women at most frequencies and varies by frequency in women, (3) women have more sensitive hearing than men at frequencies above 1000 Hz but men have more sensitive hearing than women at lower frequencies, (4) learning effects bias cross-sectional and short-term longitudinal studies, and (5) hearing levels and longitudinal patterns of change are highly variable, even in this highly selected group. These longitudinal findings document gender differences in hearing levels and show that age-associated hearing loss occurs even in a group with relatively low-noise occupations and with no evidence of noise-induced hearing loss.

the Vorarlberg Health Monitoring and Promotion Program Study GroupBackground-There is evidence from recent studies that ␥-glutamyltransferase (GGT) is likely to be associated with cardiovascular disease (CVD). However, few studies to date with sufficient sample size and follow-up investigated the association of GGT with CVD mortality. Methods and Results-The relation of GGT to the risk of death from CVD was examined in a cohort of 163 944 Austrian adults that was monitored for up to 17 years. To evaluate GGT as an independent predictor, Cox proportional hazards models were calculated, which adjusted for established risk factors. In both men and women, high GGT was significantly (PϽ0.001) associated with total mortality from CVD, showing a clear dose-response relationship. Adjusted hazard ratios (95% CI) per log GGT increase were 1.66 (1.40 to 1.98) in men and 1.64 (1.36 to 1.97) in women. In men, subgroup analyses showed that high GGT was positively associated with incident fatal events of chronic forms of coronary heart disease (Pϭ0.009), congestive heart failure (PϽ0.001), and hemorrhagic (Pϭ0.01) and ischemic stroke (PϽ0.001). No significant associations were observed for acute myocardial infarction (Pϭ0.16). In women, hazard ratios suggested associations in all subgroups; however, for hemorrhagic and ischemic stroke they were not statistically significant (Pϭ0.09 and Pϭ0.07, respectively). In addition, subgroup analyses stratified by age revealed a stronger relationship of GGT in younger participants. Hazard ratios for total CVD were 2.

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,6 and the VHM&PP Study Group BACKGROUND: The role of serum uric acid (SUA) as an independent risk factor for cardiovascular disease (CVD) remains controversial, and little is known about its prognostic importance for mortality from congestive heart failure (CHF) and stroke. Few large-scale epidemiologic studies with sufficient follow-up have addressed the association of SUA and CVD mortality in apparently healthy men across a wide age range.