Examinando por Autor "Goldman, Noreen"
Mostrando 1 - 5 de 5
Resultados por página
Opciones de ordenación
Ítem Disease and weight loss: a prospective study of middle-aged and older adults in Costa Rica and England(Salud Pública de México; Volumen 57, Número 4, 2015) Blue, Laura; Rosero Bixby, Luis; Goldman, NoreenObjective. To determine whether disease predicts weight loss in population-based studies, as this may confound the relationship between weight and mortality. Materials and methods. We used longitudinal data from the Costa Rican Longevity and Healthy Aging Study (CRELES) and the English Longitudinal Study of Ageing (ELSA). We defined two overlapping outcomes of measured weight loss between waves: >1.0 point of body mass index (BMI) and >2.0 BMI points. Logistic regression models estimated the associations with disease, adjusting for age (range 52-79), sex, smoking, and initial BMI. Results. In ELSA, onset of diabetes, cancer, or lung disease is associated with loss >2.0 points (respectively, OR=2.25 [95%CI: 1.34-3.80]; OR=2.70 [95%CI: 1.49-4.89]; OR=1.82 [95%CI: 1.02-3.26]). In CRELES, disease-onset reprts are not associated with weight loss at 5% significance, but statistical power to detect associations is poor. Conclusion. Although it is known that some diseases cause weight loss, at the population level these associations vary considerably across samples. Objetivo. Determinar si las enfermedades predicen pérdida de peso a partir de encuestas poblacionales, debido a que esto podría confundir la relación entre peso y mortalidad. Material y métodos. Se utilizaron datos longitudinales de Costa Rica: Estudio de Longevidad y Envejecimiento Saludable (CRELES) y Estudio Longitudinal de Envejecimiento en Inglaterra (ELSA, por sus siglas en inglés). Se definieron dos indicadores de resultado no excluyentes de pérdida de peso entre rondas: >1.0 punto de índice de masa corporal (IMC) y >2.0 puntos de IMC. Las asociaciones de interés se estimaron con modelos de regresión logística, con controles para la edad (rango 52-79), sexo, tabaquismo actual e IMC inicial. Resultados. En el ELSA, la incidencia de diabetes, cáncer o enfermedad pulmonar está asociada con pérdida de >2.0 puntos de IMC (respectivamente: OR=2.25 [IC95%: 1.34-3.80]; OR=2.70 [IC95%: 1.49-4.89]; OR=1.82 [IC95%: 1.02-3.26]). En el CRELES, el reprte de diagnóstico de enfermedades no muestra asociación significativa a 5% con pérdida de peso, pero el poder estadístico de la muestra para detectar asociaciones es limitado. Conclusión. Aunque es conocido que ciertas enfermedades causan pérdida de peso, estas asociaciones a nivel poblacional varían considerablemente entre encuestas.Ítem Do biological measures mediate the relationship between education and health : a comparative study(Social Science & Medicine 72 (2011), 2010) Goldman, Noreen; Turra, Cassio M.; Rosero Bixby, Luis; Weir, David; Crimmins, EileenDespite a myriad of studies examining the relationship between socioeconomic status and health outcomes, few have assessed the extent to which biological markers of chronic disease account for social disparities in health. Studies that have examined this issue have generally been based on surveys in wealthy countries that include a small set of clinicalmarkers of cardiovascular disease. The availability of recent data from nationally representative surveys of older adults in Costa Rica and Taiwan that collected a rich set of biomarkers comparable to those in a recent US survey permits us to explore these associations across diverse populations. Similar regression models were estimated on three data setsethe Social Environment and Biomarkers of Aging Study in Taiwan, the Costa Rican Study on Longevity and Healthy Aging, and the Health and Retirement Study in the USA e in order to assess (1) the strength of the associations between educational attainment and a broad range of biomarkers; and (2) the extent to which these biomarkers account for the relationships between education and two measures of health status (self-rated health, functional limitations) in older populations. The estimates suggest non-systematic and weak associations between education and high risk biomarker values in Taiwan and Costa Rica, in contrast to generally negative and significant associations in the US, especially among women. The results also reveal negligible or modest contributions of the biomarkers to educational disparities in the health outcomes. The findings are generally consistent with previous research suggesting stronger associations between socioeconomic status and health in wealthy countries than in middle-income countries and may reflect higher levels of social stratification in the US. With access to an increasing number of longitudinal biosocial surveys, researchers may be better able to distinguish true variations in the relationship between socioeconomic status and health across different settings from methodological differences.Ítem Isolation, integration, and ethnic boundaries in rural Guatemala(The Sociological Quarterly, vol. 46(2), 2005) Pebley, Anne R.; Goldman, Noreen; Robles Soto, ArodysWe investigate two perspectives about the effects of reduced discrimination and greater social and economic opportunities on ethnic identity in rural areas of contemporary Guatemala. Our analysis contrasts the effects of new opportunities in Indigenous communities on language use and dress, using data from the 1995 Encuesta Guatemalteca de Salud Familiar (EGSF). While the use of both dress and language has changed substantially in recent years, language use has changed considerably more than dress. We conclude that, in this context, economic opportunities have not necessarily diminished ethnic solidarity, but may have instead reshaped it.Ítem Predicting survival from telomere length versus conventional predictors: a multinational population-based cohort study(PLOS One; Volumen 11, Número 4, 2016) Glei, Dana; Risques, Rosa Ana; Rehkopf, David H.; Dow, William H.; Rosero Bixby, Luis; Weinstein, Maxine; Goldman, NoreenTelomere length has generated substantial interest as a potential predictor of aging- related diseases and mortality. Some studies have reprted significant associations, but few have tested its ability to discriminate between decedents and survivors compared with a broad range of well-established predictors that include both biomarkers and commonly collected self-reprted data. Our aim here was to quantify the prognostic value of leuko- cyte telomere length relative to age, sex, and 19 other variables for predicting five-year mortality among older persons in three countries. We used data from nationally represen- tative surveys in Costa Rica (N = 923, aged 61+), Taiwan (N = 976, aged 54+), and the U. S. (N = 2672, aged 60+). Our study used a prospective cohort design with all-cause mor- tality during five years post-exam as the outcome. We fit Cox hazards models separately by country, and assessed the discriminatory ability of each predictor. Age was, by far, the single best predictor of all-cause mortality, whereas leukocyte telomere length was only somewhat better than random chance in terms of discriminating between decedents and survivors. After adjustment for age and sex, telomere length ranked between 15th and 17th (out of 20), and its incremental contribution was small; nine self-reprted variables (e.g., mobility, global self-assessed health status, limitations with activities of daily living, smoking status), a cognitive assessment, and three biological markers (C-reactive protein, serum creatinine, and glycosylated hemoglobin) were more powerful predictors of mortality in all three countries. Results were similar for cause-specific models (i.e., mortality from cardiovascular disease, cancer, and all other causes combined). Leukocyte telomere length had a statistically discernible, but weak, association with mortality, but it did not predict survival as well as age or many other self-reprted variables. Although telomere length may eventually help scientists understand aging, more powerful and more easily obtained tools are available for predicting survival.Ítem Self-reported versus performance-based measures of physical function: prognostic value for survival(Demographic Research; Volumen 30, Número 7, 2014) Glei, Dana; Rosero Bixby, Luis; Chiou, Shu-Ti; Weinstein, Maxine; Goldman, NoreenBackground: Although previous studies have indicated that performance assessments strongly predict future survival, few have evaluated the incremental value in the presence of controls for self-reprted activity and mobility limitations. Objective: We assess and compare the added value of four tests -- walking speed, chair stands, grip strength, and peak expiratory flow (PEF) -- for predicting all-cause mortality. Methods: Using population-based samples of older adults in Costa Rica (n = 2290, aged 60+) and Taiwan (n = 1219, aged 53+), we estimate proportional hazards models of mortality for an approximate five-year period. Receiver Operator Characteristic (ROC) curves are used to assess the prognostic value of each performance assessment. Results: Self-reprted measures of physical limitations contribute substantial gains in mortality prediction, whereas performance-based assessments yield modest incremental gains. PEF provides the greatest added value, followed by grip strength. Our results suggest that including more than two performance assessments may provide little improvement in mortality prediction. Conclusions: PEF and grip strength are often simpler to administer in home interview settings, impose less of a burden on some respondents, and, in the presence of self-reprted limitations, appear to be better predictors of mortality than do walking speed or chair stands. Comments: Being unable to perform the test is often a strong predictor of mortality, but these indicators are not well-defined. Exclusion rates vary by the specific task and are likely to depend on the underlying demographic, health, social and cultural characteristics of the sample.