Carl Eisdorfer

Changes in the Sleep and Waking EEGs of Nondemented and Demented Elderly Subjects

Sleep and waking EEGs from 11 healthy nondemented elderly men and from ten inpatients for whom the diagnosis was probable senile dementia of Alzheimers type (SDAT), were monitored in the subjects typical home or ward environments or in the sleep laboratory, according to their customary sleep schedules. Aged normal subjects (age range, 56–85 years) had less Stage 3 and Stage 4 sleep, less REM sleep, and more wakefulness than normally observed in young adults. Patients with SDAT (age range, 56–88 years) had even less Stage 3 sleep, no Stage 4 sleep, and very little REM sleep, and experienced fragmentation of their sleep, with frequent awakenings. These sleep variables were significantly different in the SDAT and control groups (MANOVA). Examination of the 24‐hour plots of sleep/waking patterns revealed prominent fragmentation of the diurnal sleep/waking rhythm in SDAT patients, with frequent daytime napping and nighttime periods of wakefulness. In addition, significant group differences were observed for the EEG variable, dominant occipital frequency. More qualitative EEG variables (diffuse slowing, spindle activity, and paroxysmal discharges) also differed between groups. It is suggested that correlative neuropathologic data might provide an understanding of the basis for the sleep, EEG, and mental‐function factors that undergo change in SDAT.

Active coping style is associated with natural killer cell cytotoxicity in asymptomatic HIV-1 seropositive homosexual men

The aim of this study was to examine the hypothesis that a psychosocial model was associated with natural killer cell cytotoxicity (NKCC) in HIV-1 infection. A sample of 62 HIV-1 seropositive homosexual men at CDC stages II and III were given a psychosocial battery assessing life stressors, social support, and coping style. A regression model quantifying these variables along with control variables for alcohol use, substance use and nutritional status was estimated. Active coping style was directly and positively associated with NKCC, and trends toward a negative relationship of life stressors and a buffering effect of social support on lives stressors were also observed. The results suggest that (1) control variables should be included with psychosocial models and that (2) psychosocial factors, especially active coping, may have a deterrent effect on loss of NK cell function. Active coping style may merit a specific focus in future research of life stressors and the immune system.

A stress-moderator model of distress in early HIV-1 infection: Concurrent analysis of life events, hardiness and social support

A stress moderator framework was employed to investigate the relationship of negative life events, hardiness and social support to psychological distress among 67 asymptomatic HIV-1 seropositive gay males. Both main effects and stress moderator (interaction) models were evaluated. Main effects were found for negative life events and social support but not hardiness (either as commitment or overall hardiness); no moderator effects emerged. Results were the same whether events were quantified as negative impact or as number of events, and were in the predicted direction--life events associated with greater distress, social support with less distress. The present study replicates for early HIV-1 infection findings obtained in non-HIV-infected samples about the influence on psychological distress of negative life events and social support. Methodological limitations, possible explanations for the absence of stress moderator effects, and clinical implications of the findings are discussed.

Alzheimer's Disease and Maternal Age

Findings from several studies suggest a relationship between Alzheimers disease and0020Downs syndrome. It has long been known that advanced maternal age is a risk factor for Downs syndrome, and that mothers who give birth to a child with this syndrome have characteristics consistent with accelerated aging. Little is known about risk factors for Alzheimers disease, other than age. In this study, documentation is supplied for a hypothesis concerning a relationship between Alzheimers disease and advanced maternal age.

A psychosocial model of distress over time in early hiv-1 infection: The role of life stressors, social support and coping

Abstract This study tested whether a psychosocial model-consisting of life event stressors, social support and coping strategy-was associated with distress over time in 40 homosexual men with asymptomatic HIV-1 infection. With prior distress controlled, changes in distress were associated with changes in negatively rated life events and social support (replicating our cross-sectional findings) and with coping strategy (disengagement/denial, venting emotions and religion). Stringent tests that ruled out spurious moderator effects yielded significant stress moderator interactions for social support and active coping, as well as evidence for nonlinear relationships for both main effects and interactions. These findings confirm that the psychosocial model is associated with distress over time during asymptomatic HIV-1 infection. The model thus provides a framework for screening to identify patients who would benefit from clinical interventions while simultaneously identifying the areas most needing intervention.

Memory and blood pressure in the aged

Memory loss, as measured by the Wechsler Memory scale was examined as a function of diastolic blood pressure during a 6.5-year follow-up period among individuals initially tested in their 60s. On the initial testing, memory was not related to blood pressure. At the end of the follow-up period, the hypertensives showed greater impairment in memory for nonverbal material involving time limits and a psychomotor component than did their age peers with normotensive and borderline elevations of blood pressure. The hypertensives poor performance, however, was found only on specific sub-task items and appeared not to be influenced by item difficulty alone but rather by other performance factors such as difficulty in deciding what to do, understanding test instructions, or state anxiety associated with the testing situation. Memory for highly meaningful verbal material was not related to blood pressure.

Psychopharmacology and aging

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Dementia and other competing risks for mortality in the institutionalized aged

ABSTRACT: The relative importance of dementia, gender, age and functional status (FS) was examined for relationships to mortality within five years after admission of the subjects to a New York City nursing home for the aged. Using a random sample of 212 of the nursing homes patients, a statistical model was developed to estimate the relative risk of mortality. When this model was cross‐validated on an independent sample of 118 residents, it failed to show significant lack of fit. Given these results, an international model was developed by combining the New York City samples (N = 330) and comparing them to a sample (N = 363) from a nursing home in Tokyo, Japan. In the New York model, gender was the most important predictor, with age and dementia next in importance; FS was not a significant predictor. Despite the apparent differences in the types of dementia in the New York and Tokyo nursing homes, the mortality patterns were similar.

Care of the Aged: The Barriers of Traditions

The growing population of older persons in our society will require increased attention. It is contended that the current pattern of third-party reimbursement for hospitalization and technical procedures focuses upon acute care and cure. The philosophy underlying medical education and practice is a barrier to the provision of quality care to older persons with chronic disorders. A changing emphasis for future practice is indicated.

Electrodermal Reactivity: An Analysis by Age and Sex

Resting electrodermal levels and electrodermal response to Valsalva maneuver were measured in males and females of three age groups (young, middle-aged, old). Significant sex and age effects were observed. Young and middle-aged females had lower electrodermal resting levels than males. These differences were reversed for the young age group during a Valsalva maneuver, where the females larger specific responses. With old age, sex differences diminished, resting state conductance levels decreased, but the specific conductance responses to Valsalva remained relatively unchanged. Results demonstrate interactive age and sex effects on the electrodermal measure. Possible relevance of the data to sex differences in adaptation and stress response are discussed.