Health perceptions and lifestyles of the elderly.

Adoption of a healthy lifestyle can slow physical decline and improve well being of the elderly. The purpose of this study was to examine the relationship of six aspects of a healthy lifestyle (nutrition, exercise, stress management, self actualization, health responsibility, and interpersonal support) with selected demographic variables, perceived health status, and health locus of control in the well elderly. The sample consisted of 297 volunteers. Person product-moment correlations and stepwise multiple regression procedures revealed that perceived health status and health locus of control were significant predictors of healthy lifestyles. Demographic variables, posited as modifying factors, were found to be associated with perceived health and locus of control but were not predictive of lifestyle practices.

[The health status and biochemical parameters of 98 long-surviving persons]. / Gesundheitliche Situation und biochemische Parameter bei 98 langlebigen Personen.

During 8 years authors examined 98 persons of the age ranging from 90 to 99 years. The results of the longevity phenomenon analysis suggest its relationship to hereditary factor, female sex, occupation in agriculture and absence of the life shortening diseases in anamnesis. Clinical diagnoses of all the longaged have been analyzed to confirm the multimorbidity and the so called senile polypathy which is frequent in this age. All the longaged were divided into 3 groups according to their vitality degree. Erythrocyte sedimentation, basic biochemical and haematological tests were carried out and the values obtained were analyzed following the 3 vitality degrees mentioned. The authors' aim is to point out some problems especially the difficulty of interpretation of some laboratory tests results in this longaged patient category and thus contribute to a certain extent to the description of the longevity phenomenon from the modern clinical gerontology viewpoint.

Theory of adequate function of cells and the organism--the theoretical basis for contemporary medicine.

The theory of adequate function of the cells and the organism is introduced as the theoretical basis for contemporary medicine. In accordance with this theory, the organism tends to function adequately to the needs directed toward the maintenance of life under various conditions. Mechanisms responsible for adequate function include those of regulation, compensation and defense. Their interactions provide for adequate function in both steady and transient physiological conditions, as well as in pathological conditions. Examples of adequate function under various conditions are discussed. The notion of optimal adequate function of cells and the organism is introduced, which implies the complete satisfaction of the needs of the cells and the demands imposed upon these cells by the organism. The dual character of the cell's adequate function contributes to the possibilities for disease. Imbalance between the needs of the cell and the needs of the organism is proposed to be the general mechanism of chronic diseases. Maintenance of the optimal balance of adequate function throughout the life of an individual is considered to be the major objective through which the prophylaxis and early treatment of chronic diseases can be achieved.

General mechanism of chronic diseases.

In a human, the cells function adequately to the needs of the organism, and to their own needs. Consequently, adequate cell function is comprised of the organism-oriented, and cell-oriented functions. It is suggested that an independent stage in the pathogenesis of a chronic disease exists which so far has not been considered. This is the disturbance of the cell-oriented function of the cells involved. This initial stage may last for years and decades, whereas function of the organ remains preserved. Organism-oriented cellular function appears to become involved in the pathologic process long after the disease has actually started. At this time the cells themselves are severely impaired, and as a result a disease acquires its progressive, irreversible course. Pathogenesis of atherosclerosis is considered as an example of the above-mentioned developments.

The Western diet: an examination of its relationship with chronic disease.

Diet is a component in the etiology of the two major causes of death in the United States, namely, cardiovascular disease and cancer. During the last decade, various organizations have suggested that we alter the "typical" American diet in order to decrease the incidence of these diseases even though both diseases are indisputably of multiple etiology. An implication behind these recommendations is that individuals will increase their longevity by changing their diets. The burden of proof falls on those proposing changes to the diet that such alterations will be safe and effective. In spite of our often indicted diet, mortality from heart disease and stroke continue to fall and deaths from diet-related cancers are static or dropping. Longevity in the U.S. is exceeded by only five countries, whose populations consume a diet similar to ours in four, and that in the fifth is approaching ours. While low-fat high-fiber diets probably have some beneficial effect vis-a-vis chronic diseases, it is likely that other risk factors contribute more to the total risk of disease. Therefore, it is illogical to expect dietary manipulation to offset significantly other concurrent risks such as heredity, tobacco use, hypertension, and obesity. Individuals who are at high risk for specific diseases should modify their diets to minimize this particular risk factor. Most Americans can safely reduce their intake of total calories, fat, sugar, and salt. Although this can be achieved most readily on a population basis by following a form of "prudent" diet, it is premature to promise medical benefits to individuals.(ABSTRACT TRUNCATED AT 250 WORDS)

Critical issues in air pollution epidemiology.

The epidemiological studies which have had significant impact on the setting of National Ambient Air Quality Standards (NAAQSs) were performed more than twenty years ago. Most of the more recent studies have been seriously flawed in their design and/or execution because they neglected to account for important variables such as: pollutant exposures other than those from ambient air; the influence of personal activity on pollutant uptake; host responsiveness; and the separate contributions of recent transient peak exposures and long-term chronic exposures on the effects endpoints. For particulate pollutants, the influence of composition and size distribution has also received too little consideration. In order to address these deficiencies, research and methods development are needed on: indices for particulate exposures; identification of exposures relevant to the effects; improved indices of effects; acquisition of response data; identification of exposed populations; and identification of susceptible subgroups. Approaches to these needs are discussed, along with brief reviews of several recent studies that have focused on critical issues of concern, made the necessary efforts to characterize the relevant exposures of the populations being studied, and demonstrated human responses to ambient pollutants at current exposure levels.

The genesis of chronic illness: narrative re-construction.

In this paper I demonstrate the way in which people's beliefs about the aetiology of their particular affliction (arthritis) need to be understood as part of a more comprehensive imaginative enterprise which I refer to as narrative reconstruction. The intrinsically teleological form of this enterprise means that identified 'causes' represent only putative efficient connexions between the disease and antecedent factors but also narrative reference points between the individual and society in an unfolding process which has become profoundly disrupted. Through the presentation of case material taken from lengthy interviews I illustrate the way in which my question to the subjects about the cause of their disease: 'Why do you think you got arthritis?' was translated by them into a narrative reconstruction of their changing relationship to the world in which they live and the genesis of illness within it.

Psychosocial processes and general susceptibility to chronic disease.

The concept of general susceptibility to disease has developed as a unifying explanation for the findings that a variety of diseases are associated with certain social and cultural situations. This hypothesis was tested in a prospective study of 4251 men of Japanese ancestry in Hawaii who answered a psychosocial questionnaire in 1971. The seven-year incidence rates of coronary heart disease, stroke, cancer, and all deaths during the period December 1971-January 1979 were analyzed for association with individual questions and five summary scores measuring geographic and generational mobility, sociocultural and spousal inconsistency, and social networks. Among all questions and summary scores measuring mobility and inconsistency, there was only one statistically significant association with any disease, and this association was in the opposite direction to that predicted by the hypothesis. The measures of social networks were not associated with either the incidence of stroke, cancer, or all diseases combined, but were associated with coronary heart disease, as reported in detail earlier. The authors examined the joint interaction of the postulated stressful processes of mobility and inconsistency with the protective effects of social networks, with special attention to the men in the highest levels of mobility and inconsistency. They found no significant associations, and thus there was no support for the hypothesis that social networks are especially protective among persons in the highest levels of mobility and inconsistency. The inclusion of known health hazards, cigarette smoking, and high systolic blood pressure levels did not alter these findings.

Conceptual/operational criteria of causality: relevance to systematic epidemiologic theory.

Emphasis has recently been placed on the possibility of developing "unified" criteria of causality applicable to both the infectious and chronic, non-infectious diseases. Yet, contemporary efforts are essentially compilations of criteria established over the past 140 years, without provision of the conceptual basis allowing such a unification. From hierarchical views of the natural history of infectious and neoplastic (i.e., chronic non-infectious) disease, it is possible to identify discipline and natural history-related concepts of causation from which it is possible to derive conceptual criteria of causality and complementary operational criteria of causality. These criteria are entirely relevant to the comprehension of disease as both product and process and applicable to both the infectious and neoplastic diseases.

The South African window.

Southern Africa presents some fine opportunities to examine the relation of lifestyle to chronic disease. A cross-cultural comparison of disease is the only feasible way to study many of the chronic diseases. Biomedical scientists have an obligation to undertake this. If they do not, there is the dreadful expectation that the rising cultures will soon suffer the same diseases which the members of the highest socio-economic classes must now endure.

Proportion of disease attributable to the combined effect of two factors.

This paper presents a technique for the analysis of interaction which is based upon the additivity of attributable risks. Such an approach is justified when the purpose is to provide a basis for making decisions about personal risk or public health intervention.