OBJECTIVES: This study assesses the relationship of body mass index to 5-year mortality in a cohort of 4317 nonsmoking men and women aged 65 to 100 years. METHODS: Logistic regression analyses were conducted to predict mortality as a function of baseline body mass index, adjusting for demographic, clinical, and laboratory covariates. RESULTS: There was an inverse relationship between body mass index and mortality; death rates were higher for those who weighed the least. Inclusion of covariates had trivial effects on these results. People who had lost 10% or more of their body weight since age 50 had a relatively high death rate. When that group was excluded, there was no remaining relationship between body mass index and mortality. CONCLUSIONS: The association between higher body mass index and mortality often found in middle-aged populations was not observed in this large cohort of older adults. Over-weight does not seem to be a risk factor for 5-year mortality in this age group. Rather, the risks associated with significant weight loss should be the primary concern.

Studies and clinical procedures related to patients with Alzheimer disease (AD) largely have ignored the hearing ability of either the patient or caregiver. Yet the majority of treatment and investigation depends on or presupposes communication ability. Further, caregiver complaints often center around communication-based issues. Hearing deficits may be the most frequently unrecognized condition in patients with AD because patients either communicate adequately in quiet or the impairment is masked by other behavioral symptoms of AD. The current investigation identified individuals with AD with perceived and measured hearing impairment, provided amplification management, and evaluated the impact of treatment on caregiver-identified problem behaviors believed to be related to hearing status. Specifically, treatment compliance (hearing-aid use) and treatment efficacy (reduction in perceived hearing handicap and problem behaviors) were measured in the current investigation. A multiple-baseline design across individuals with multiple dependent variables was used to evaluate the reduction of problem behaviors post-hearing-aid treatment. Eight participants were included and 1 to 4 problem behaviors were significantly reduced for each patient after hearing-aid treatment. All participants were able to complete the necessary evaluation for hearing-aid fitting and wore their hearing aids between 5 and 15 hours per day by the end of the study. This investigation employed novel methodology in the areas of on-site hearing evaluation and hearing-aid selection, advanced hearing-aid technology, and primary data recording of caregiver-identified problem behaviors by caregivers.

We report data on abdominal pain and depression from a survey of Hispanic Americans by the United States National Center for Health Statistics. The point prevalence rates of chronic abdominal pain were 4.6% in Mexican Americans and 5.8% in Cuban Americans in a total of 4175 subjects. The rate was 8.3% among 1323 Puerto Ricans. In 53% the abdominal pain came in waves. Using the Depression scale of the Center for Epidemiologic Studies (CES-D), 18.7% of Mexican and Cuban Americans with pain were found to be depressed to an extent likely to require intervention, and 40.8% of Puerto Ricans were so affected. The Diagnostic Interview Schedule (DIS) gave more conservative figures for major depression in terms of DSM-III, viz., 6.8% for Mexican and Cuban Americans with chronic pain, and 12.6% for Puerto Ricans with chronic pain. Logistic regression analyses demonstrated links between depression and female sex, the single state, low education and income, and chronic abdominal pain. The most consistent relationships for depression were with chronic pain, female sex and the single state. The results confirm the strong relationships between chronic pain, mood and female gender, and other socio-demographic variables.

Within the context of a hospital-based newborn hearing screening program, we have studied the application of two OAE protocols (TEOAE and DPOAE) on a group of 250 well babies. The main goal of this study was to evaluate the performance of DPOAE protocol in a relatively large population sample. using a preset number of five tested frequencies, in comparison with a default TEOAE screening protocol. The data were collected on the second day of life and during spontaneous sleep. The TEOAE recordings were acquired with linear protocols using click stimuli of 70-75 dB SPL and were used as indicators of normal cochlear function. The cubic distortion product DPOAE responses were evoked by an asymmetrical 75-65 dB SPL protocol, with a frequency ratio of 1.22. Five frequencies (referring to F2) were tested at 1.5, 2.0, 3.0, 4.0 and 5.0 kHz. The data from the DPOAE responses show a similar pass rate (similarity = 0.98) to the linear TEOAE protocol. The data presented suggest that a DPOAE cochlear evaluation, at 5 pre-selected frequencies, has clinical potential.

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