Development and validation of a geriatric depression screening scale: A preliminary report

OBJECTIVE — To systematically review the incidence of posttransplantation diabetes (PTD), risk factors for its development, prognostic implications, and optimal management. RESEARCH DESIGN AND METHODS — We searched databases (MEDLINE, EMBASE, the Cochrane Library, and others) from inception to September 2000, reviewed bibliographies in reports retrieved, contacted transplantation experts, and reviewed specialty journals. Two reviewers independently determined report inclusion (original studies, in all languages, of PTD in adults with no history of diabetes before transplantation), assessed study methods, and extracted data using a standardized form. Meta-regression was used to explain between-study differences in incidence. RESULTS — Nineteen studies with 3,611 patients were included. The 12-month cumulative incidence of PTD is lower (10% in most studies) than it was 3 decades ago. The type of immunosuppression explained 74% of the variability in incidence (P 0.0004). Risk factors were patient age, nonwhite ethnicity, glucocorticoid treatment for rejection, and immunosuppression with high-dose cyclosporine and tacrolimus. PTD was associated with decreased graft and patient survival in earlier studies; later studies showed improved outcomes. Randomized trials of treatment regimens have not been conducted. CONCLUSIONS — Physicians should consider modification of immunosuppressive regimens to decrease the risk of PTD in high-risk transplant recipients. Randomized trials are needed to evaluate the use of oral glucose-lowering agents in transplant recipients, paying particular attention to interactions with immunosuppressive drugs. Diabetes Care 25:583–592, 2002

A systematic review of the literature

Background Although disuse of skeletal muscle and undernutrition are often cited as potentially reversible causes of frailty in elderly people, the efficacy of interventions targeted specifically at these deficits has not been carefully studied. Methods We conducted a randomized, placebo-controlled trial comparing progressive resistance exercise training, multinutrient supplementation, both interventions, and neither in 100 frail nursing home residents over a 10-week period. Results The mean (±SE) age of the 63 women and 37 men enrolled in the study was 87.1 ±0.6 years (range, 72 to 98); 94 percent of the subjects completed the study. Muscle strength increased by 113 ±8 percent in the subjects who underwent exercise training, as compared with 3 ±9 percent in the nonexercising subjects (P<0.001). Gait velocity increased by 11.8 ±3.8 percent in the exercisers but declined by 1.0 ±3.8 percent in the nonexercisers (P = 0.02). Stair-climbing power also improved in the exercisers as compared with the nonexercis...

https://www.nejm.org/doi/pdf/10.1056/NEJM199406233302501

Exercise training and nutritional supplementation for physical frailty in very elderly people

Trail Making Test A and B: Normative data stratified by age and education

Normative data for the Trail Making Test (TMT) A and B are presented for 911 community-dwelling individuals aged 18-89 years. Performance on the TMT decreased with increasing age and lower levels of education. Based on these results, the norms were stratified for both age (11 groups) and education (2 levels). The current norms represent a more comprehensive set of norms than previously available and will increase the ability of neuropsychologists to determine more precisely the degree to which scores on the TMT reflect impaired performance for varying ages and education.

Trail making test A and B : normative date stratified by age and education

Contends that the diagnosis of depression in aged patients is the responsibility of both psychologists, and non-psychologists, for it is the latter that is most likely to make initial contact with ...

Screening tests for geriatric depression

Aging and Life Course Transitions: An Interdisciplinary Perspective

Metaphor as Data in the Study of Organizations

Does obesity lead to discrimination in hiring and promotion decisions? Business Week ( 1 ) reported a study in which male MBA's who were more than 20% overweight earned an average of $4,000 a year less than their peers of normal weight. The same source reported that obese women were rarely found in management and speculated that those making the hiring and promotion decisions view obesity as a symptom of laziness or inability to control oneself. The purpose of the present study was to confirm the discriminatory tendency and the rationale behind it. In the first experiment, subjecrs were students ( N = 4 2 ) in an undergraduate industrial psychology class. Ages ranged from 2 0 to 43 yr. (with 21-30 yr. being the modal and median category). Most of the students were part-time, working fulltime i n local high-tech or service firms. N o more than one or two in the entire sample could have been described as obese themselves. Subjects were asked to evaluate (on a I-to-10 scale of acceptability for the job) each of six candidates for the position of psychology professor. Half of the students had candidare A described as a man, half as a woman; half had candidate B described as age 33, half as age 63; half had candidate C described as married, half as divorced; half had candidate D described as a woman with two children; half had her described as having eight children; half had candidate E described as black, half had him described as white; half had candidate F described as 165 Ib., half as 425 Ib. There was no significant discrimination as to sex, age, race, marital status, or number of children. Although Mr. F had a mean rating of 7.3 ( S D = 2.3) when he was described as weighing 165 Ib., his rating was only 5.2 ( S D = 2.5) when he was described as weighing 425 Ib. ( t = 3.09, p < .01). In the second experiment, subjects were students ( N = 31) in an undergraduate human relations in business course. Ages ranged from 1 9 to 44 yr. (with 21-29 yr. being the modal and median category). Most of the students were part-time, working full-time in local high-tech or service firms. N o mote than one or two in the entire sample could have been described as obese. Subjects were asked to assess a sales worker for promotion ( o n a 1-to-10 scale) and then describe the worker on an adjective checklist. Again, those subjects Gho thought that the worker weighed 365 Ib. rated his promotion prospects much lower compared to when he was described as weighing 165 Ib. (Ms 7.4, S D = 2.0; vs 5.6, S D = 2.5; r = 2.58, f l < .02) . Nevertheless, weight had no significant ( p = . l o ) relationship with ascribed personality traits such as "hard working," "friendly," "intelligent," "conscientious," "serious," or "persistent." The condusion is that there is job discrimination against the severely obese, but this probably reflects the discriminator's cultural and aesthetic value system more than stereotypes about the personalities of obese persons, and the general advantage enjoyed by the physically attractive (2 , 3 ) .

T. L. Brink

Papers

Development and validation of a geriatric depression screening scale: A preliminary report

Screening tests for geriatric depression

Aging and Life Course Transitions: An Interdisciplinary Perspective

Metaphor as Data in the Study of Organizations

Obesity and Job Discrimination: Mediation via Personality Stereotypes?: