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Studies have found both gender- and age-related differences in rates of forced expiratory volume at one second (FEV1). FEV1 decline was found to be slower in women than in men, but not at a statistically significant rate. Variability between subjects is also lower in women than in men, and rises with age.

Cross-sectional and longitudinal age-associated reductions in power and isometric strength are described for the upper extremities. Over a 25-year period, repeated measures were taken approximately every 2 years from men and women in the Baltimore Longitudinal Study of Aging (BLSA). The longitudinal measures covered an average 9.6 years, range 1-25 years for men and an average 4.6 years, range 1-8 years for women. Strength and power declined beginning by age 40 in both women and men. Thereafter, power declined about 10% more than strength in men, while no significant differences were found in women. Age had a statistically independent influence on strength and power measures after adjusting for gender, height, weight, caloric expenditure, and muscle mass. Twenty-five-year longitudinal analyses in men confirmed the declines observed cross-sectionally, while no changes were observed in women over the 4-5 years of longitudinal data available. Further longitudinal studies are needed to understand the relationships between strength and power losses with age in women. The differences between power and strength changes with age in men argue for the importance of factors other than strength affecting power.

Background. Cross-sectional studies have demonstrated that olfactory function diminishes with increasing age, which may impact on the safety and quality of life of older persons. To date, however, there have been no published longitudinal studies on olfaction. The purpose of this study was to examine the influence of age and gender on smell identification over a 3-year period in a group of generally healthy men and women. Methods. Males (n = 85) and females (n = 76) between the ages of 19 and 95 years were administered the University of Pennsylvania Smell Identification Test (SIT) over a 3-year span as part of the oral physiology component of the Baltimore Longitudinal Study of Aging. A linear mixed-effects regression model was used to determine how longitudinal changes in SIT scores differ with respect to gender, history of medical problems and use of prescription medications. Results. Over the 3-year period, SIT scores diminished progressively with increased age. Women and men in the eighth decade of life experienced a decline of greater than one SIT print per year. Females consistently performed better than males in smell identification. Similar results were obtained regardless of medical problems or medication usage. Conclusions. These results extend the conclusions of previous cross-sectional olfactory studies and indicate that smell identification deteriorates progressively with greater age. Furthermore, age-related declines in olfaction occur even in the absence of overt medical problems.

Increased blood levels of prostate-specific antigen (PSA) as men age may indicate greater risk for developing prostate cancer and other prostate diseases than in men with lower blood levels of PSA. Of 54 men whose blood levels of androgen and PSA were measured over seven to 25 years, 16 did not develop prostate disease, 20 developed benign prostatic hyperplasia (enlargement) (BPH), and 18 developed prostate cancer. Men who developed prostate cancer had a more rapid increase in PSA levels with age than men who developed BPH. Men who developed BPH had a more rapid increase in PSA levels with age than men who did not develop prostate disease. Five years before diagnosis, changes in PSA levels among men who developed BPH were approximately the same as those of men who did not develop prostate disease. The PSA levels of men who developed prostate cancer increased at a much more rapid rate compared to the other two groups, however.

There is a fundamental disagreement among those who study language disorders. One school of thought holds to a unitary, holistic, or nonsyndrome approach, which notes the similarities among aphasic patients. This approach is supported by the inability to predict aphasic symptoms from information about the site of the injury, indicating that there is no strict localization of language function. The other school of thought is that multiple and distinct aphasic syndromes exist, which can be observed in the clinical differences among patients. Also, damage to distinct brain regions produces specific dysfunctions. Various areas of the brain are associated with different language functions, with no single region being critical. Part of the problem in determining which view is correct is that it is possible to specify where the brain has been injured, but the functional consequences cannot be so easily measured. Positron emission tomographic (PET) examination of glucose metabolism in the temporoparietal region of the brain can locate areas of abnormal functioning, and help to provide a solution to this puzzle. The authors searched for a constant glucose metabolic abnormality across all major types of chronic aphasia in 44 patients. The results support the concept of a single location of functional abnormality in aphasia. The type and the extent of language dysfunction seem dependent on a complex relationship between the regions of structural damage, their effects on temporoparietal function, and the effects of these two on the rest of the brain. The data support a two-compartment model of aphasia, in which the temporoparietal region regulates the linguistic process, and the frontal lobe controls motor and planning processes that allow the task of speaking to be carried out. (Consumer Summary produced by Reliance Medical Information, Inc.)

Background and Purpose: Ischemic stroke (IS), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) patients often require endotracheal intubation (EI) and mechanical ventilation (MV). Predicting the need for prolonged EI and timing of tracheostomy (TR) is challenging. While TR is performed for about 10-15% of patients in the general intensive care unit (ICU), the rate in the neurological ICU and for stroke patients ranges between 15 and 35%. Thus, we performed an external validation of the recently published SETscore.Methods: This is a retrospective review for all patients with IS, non-traumatic ICH, and SAH who required intubation within 48 h of admission to the neurological ICU. We compared the SETscore between tracheostomized versus successfully extubated patients, and early TR (within 7 days) versus late TR (after 7 days).Results: Out of 511 intubated patients, 140 tracheostomized and 105 extubated were included. The sensitivity for a SETscore > 10 to predict the need for TR was 81% (95% CI 74-87%) with a specificity of 57% (95% CI 48-67%). The score had moderate accuracy in correctly identifying those requiring TR and those successfully extubated: 71% (95% CI 65-76%). The AUC of the score was 0.74 (95% CI 0.68-0.81). Multivariable logistic regression models were used to identify other independent predictors of TR. After including body mass index (BMI), African American (AA) race, ICH and a positive sputum culture in the SETscore, sensitivity, specificity, overall accuracy, and AUC improved to 90%, 78%, 85%, and 0.89 (95% CI 0.85-0.93), respectively. In our cohort, performing early TR was associated with improvement in the ICU median length of stay (LOS) (15 vs 20.5 days; p = 0.002) and mean ventilator duration (VD) (13.4 vs 18.2 days; p = 0.005) in comparison to late TR.Conclusions: SETscore is a simple score with a moderate accuracy and with a fair AUC used to predict the need for TR after MV for IS, ICH, and SAH patients. Our study also demonstrates that early TR was associated with a lower ICU LOS and VD in our cohort. The utility of this score may be improved when including additional variables such as BMI, AA race, ICH, and positive sputum cultures. [ABSTRACT FROM AUTHOR]

We examined the effects of age and gender on the relationship between knee strength and walking time during a walk-turn-walk test in 176 male and 168 female generally healthy participants of the Baltimore Longitudinal Study of Aging who were aged 21-89 years. Subjects were timed as they walked 50 ft (15.24 m), turned around, and walked back to the starting point, both at a comfortable pace and as fast as possible. Isokinetic concentric knee extensor strength was measured at 30[degrees]/s by using a Kin-Com dynamometer. Both comfortable and fast gait times increased with increasing age for both women and men, starting in middle age. An interaction was found between gender and age showing that older women are slower than older men at both paces. Gait time decreased linearly with increasing knee extensor strength, plateauing at higher strength levels ([is greater than] 130 N m for comfortable gait, and 190 N m for fast gait). Most women occupied the linear part of the curve below the plateau. Adjustment for body size, age, physical activity, and particularly number of steps to complete the task removed the relationship between strength and gait time for the comfortable gait. Women took longer to complete the walk-turn-walk test than men at older ages, were on the linear part of the strength--gait time relationship, and used more steps to complete the task, all of which may contribute to their greater likelihood of frailty in later years.

Background. Because of the scarcity of data available from direct comparisons of age and gender groups using the same relative training stimulus, it is unknown whether older individuals can increase their muscle mass as much as young individuals and whether women can increase as much as men in response to strength training (ST). In addition, little is known about whether the hypertrophic response to ST is affected by myostatin genotype, a candidate gene for muscle hypertrophy. Methods. Eleven young men (25 [+ or -] 3 years, range 21-29 years), 11 young women (26 [+ or -] 2 years, range 23-28 years), 12 older men (69 [+ or -] 3 years, range 65-75 years), and 11 older women (68 [+ or -] 2 years, range 65-73 years) had bilateral quadriceps muscle volume measurements performed using magnetic resonance imaging (MRI) before and after ST and detraining. Training consisted of knee extension exercises of the dominant leg three times per week for 9 weeks. The contralateral limb was left untrained throughout the ST program. Following the unilateral training period, the subjects underwent 31 weeks of detraining during which no regular exercise was performed. Myostatin genotype was determined in a subgroup of 32 subjects, of which five female subjects were carriers of a myostatin gene variant. Results. A significantly greater absolute increase in muscle volume was observed in men than in women (204 [+ or -] 20 vs 101 [+ or -] 13 [cm.sup.3], p [is less than].01), but there was no significant difference in muscle volume response to ST between young and older individuals. The gender effect remained after adjusting for baseline muscle volume. In addition, there was a significantly greater loss of absolute muscle volume after 31 weeks of detraining in men than in women (151 [+ or -] 13 vs 88 [+ or -] 7 [cm.sup.3], p [is less than] .05), but no significant difference between young and older individuals. Myostatin genotype did not explain the hypertrophic response to ST when all 32 subjects were assessed. However, when only women were analyzed, those with the less common myostatin allele exhibited a 68% larger increase in muscle volume in response to ST (p = .056). Conclusions. Aging does not affect the muscle mass response to either ST or detraining, whereas gender does, as men increased their muscle volume about twice as much in response to ST as did women and experienced larger losses in response to detraining than women. Young men were the only group that maintained muscle volume adaptation after 31 weeks of detraining. Although myostatin genotype may not explain the observed gender difference in the hypertrophic response to ST, a role for myostatin genotype may be indicated in this regard for women, but future studies are needed with larger subject numbers in each genotype group to confirm this observation.