Suzanne Satterfield

The University of Tennessee Health Science Center, Memphis, Tennessee, United States

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Publications (164)977.9 Total impact

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    ABSTRACT: Poor peripheral nerve function is common in older adults and may be a risk factor for strength decline, although this has not been assessed longitudinally.
    The Journals of Gerontology Series A Biological Sciences and Medical Sciences 10/2014; · 4.31 Impact Factor
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    ABSTRACT: We sought to determine which systolic blood pressure (SBP) characteristics are associated with reduced brain integrity and whether these associations are stronger for white or gray matter. We hypothesized that exposure to higher and variable SBP will be associated with lower structural integrity of both gray and white matter.
    American journal of hypertension. 08/2014;
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    ABSTRACT: Hearing impairment (HI) is highly prevalent in older adults and is associated with social isolation, depression, and risk of dementia. Whether HI is associated with broader downstream outcomes is unclear. We undertook this study to determine whether audiometric HI is associated with mortality in older adults.
    The Journals of Gerontology Series A Biological Sciences and Medical Sciences 07/2014; · 4.31 Impact Factor
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    ABSTRACT: Results from numerous studies suggest protective effects of the Mediterranean diet for cardiovascular disease, cancer, and mortality. Evidence for an association with a decreased risk of cognitive decline is less consistent and studies are limited by a lack of diversity in their populations.
    The Journals of Gerontology Series A Biological Sciences and Medical Sciences 07/2014; · 4.31 Impact Factor
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    ABSTRACT: We aimed to examine trajectories of inflammatory markers and cognitive decline over 10 years. Cox proportional hazards models were used to examine the association between interleukin-6 and C-reactive protein (CRP) trajectory components (slope, variability, and baseline level) and cognitive decline among 1323 adults, aged 70-79 years in the Health, Aging, and Body Composition Study. We tested for interactions by sex and apolipoprotein E (APOE) genotype. In models adjusted for multiple covariates and comorbidities, extreme CRP variability was significantly associated with cognitive decline (hazard ratio [HR] 1.6, 95% confidence interval [CI]: 1.1-2.3). This association was modified by sex and APOE e4 (p < 0.001 for both), such that the association remained among women (HR = 1.8; 95% CI: 1.1, 3.0) and among those with no APOE e4 allele (HR = 1.6; 95% CI: 1.1, 2.5). There were no significant associations between slope or baseline level of CRP and cognitive decline nor between interleukin-6 and cognitive decline. We believe CRP variability likely reflects poor control of or greater changes in vascular or metabolic disease over time, which in turn is associated with cognitive decline.
    Neurobiology of aging. 06/2014;
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    ABSTRACT: Whether apolipoprotein E (APOE) E4 allele status which is associated with an increased risk of cognitive decline is also associated with hearing impairment is unknown.
    American journal of Alzheimer's disease and other dementias. 06/2014;
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    ABSTRACT: Background The ability to walk for short and prolonged periods of time is often measured with separate walking tests. It is unclear whether decline in the two-minute walk coincides with decline in a shorter 20-meter walk among older adults.Objective To describe patterns of change in the 20-meter walk and two-minute walk over 8 years among a large cohort of older adults. Should change be similar between tests of walking ability, separate re-testing of prolonged walking may need to be reconsidered.DesignLongitudinal Observational CohortMethods Data were from 1,893 well-functioning older adults (≥ 70 years). The 20-meter walk and two-minute walk were repeatedly measured over 8 years to measure change in short- and prolonged-walking, respectively. Change was examined using a dual group-based trajectory model (dual model) and agreement between walking trajectories was quantified with a Weighted Kappa statistic.ResultsThree trajectory groups for the 20-meter walk and two-minute walk were identified. Over 86% of subjects were in similar trajectory groups for both tests from the dual model. There was high chance corrected agreement (Kappa = 0.84, 95%CI [0.81, 0.86]) between 20-meter walk and two-minute walk trajectory groups.LimitationsOne-third of the original Health ABC cohort was excluded from analysis due to missing clinic visits followed by being excluded for health reasons for performing the two-minute walk, limiting generalizability to healthy older adults.Conclusions Patterns of change in the two-minute walk are similar to the 20-meter walk. Thus, separate re-testing of the two-minute walk may need to be reconsidered to gauge change in prolonged walking.
    Physical Therapy 05/2014; · 2.78 Impact Factor
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    ABSTRACT: Obesity is a risk factor for disability, but risk of specific adipose depots is not completely understood. We investigated associations between mobility limitation, performance, and the following adipose measures: body mass index (BMI) and areas and densities of visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and intermuscular adipose tissue (IMAT) in older adults. This was a prospective population-based study of men (n = 1459) and women (n = 1552) initially aged 70-79 y and free from mobility limitation. BMI was determined from measured height and weight. Adipose tissue area and density in Hounsfield units were measured in the thigh and abdomen by using computed tomography. Mobility limitation was defined as 2 consecutive reports of difficulty walking one-quarter mile or climbing 10 steps during semiannual assessments over 13 y. Poor performance was defined as a gait speed <1 m/s after 9 y of follow-up (n = 1542). In models adjusted for disability risk factors, BMI, and areas of VAT, abdominal SAT, and IMAT were positively associated with mobility limitation in men and women. In women, thigh SAT area was positively associated with mobility limitation risk, whereas VAT density was inversely associated. Associations were similar for poor performance. BMI and thigh IMAT area (independent of BMI) were particularly strong indicators of incident mobility limitation and poor performance. For example, in women, the HR (95% CI) and OR (95% CI) associated with an SD increment in BMI for mobility limitation and poor performance were 1.31 (1.21, 1.42) and 1.41 (1.13, 1.76), respectively. In men, the HR (95% CI) and OR (95% CI) associated with an SD increment in thigh IMAT for mobility limitation and poor performance were 1.37 (1.27, 1.47) and 1.54 (1.18, 2.02), respectively. Even into old age, higher BMI is associated with mobility limitation and poor performance. The amount of adipose tissue in abdominal and thigh depots may also convey risk beyond BMI.
    American Journal of Clinical Nutrition 02/2014; · 6.50 Impact Factor
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    ABSTRACT: Kidney damage is a common sequela of several chronic pathologic conditions. Whether biomarkers of kidney damage are prognostic for more severe outcomes is unknown. We measured three urinary biomarkers (kidney injury molecule-1 [KIM-1], IL-18, and albumin) in 3010 individuals enrolled in the Health, Aging and Body Composition (Health ABC) study and used Cox proportional hazards models to investigate the associations of urinary KIM-1/creatinine (cr), IL-18/cr, and albumin/cr (ACR) with all-cause mortality and cardiovascular disease (CVD). Multivariable models adjusted for demographics, traditional CVD risk factors, and eGFR. Mean age of participants was 74 years, 49% of participants were men, and 41% of participants were black. During the median 12.4 years of follow-up, 1450 deaths and 797 CVD outcomes occurred. Compared with the lowest quartile, successive quartiles had the following adjusted hazard ratios (HRs; 95% confidence intervals [95% CIs]) for mortality: KIM-1/cr: (1.21; 1.03 to 1.41), (1.13; 0.96 to 1.34), and (1.28; 1.08 to 1.52); IL-18/cr: (1.02; 0.88 to 1.19), (1.16; 0.99 to 1.35), and (1.06; 0.90 to 1.25); ACR: (1.08; 0.91 to 1.27), (1.24; 1.06 to 1.46), and (1.63; 1.39 to 1.91). In similar analyses, only ACR quartiles associated with CVD: (1.19; 0.95 to 1.48), (1.35; 1.08 to 1.67), and (1.54; 1.24 to 1.91). Urinary KIM-1 had a modest association with all-cause mortality but did not associate with CVD, and urinary IL-18 did not associate with either outcome. In contrast, albuminuria strongly associated with all-cause mortality and CVD. Future studies should evaluate reasons for these differences in the prognostic importance of individual kidney injury markers.
    Journal of the American Society of Nephrology 02/2014; · 8.99 Impact Factor
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    ABSTRACT: the xanthophylls lutein (L) and zeaxanthin (Z) exist in relatively high concentration in multiple central nervous tissues (e.g. cortex and neural retina). L + Z in macula (i.e. macular pigment, MP) are thought to serve multiple functions, including protection and improvement of visual performance. Also, L + Z in the macula are related to L + Z in the cortex. to determine whether macular pigment optical density (MPOD, L + Z in the macula) is related to cognitive function in older adults. participants were older adults (n = 108, 77.6 ± 2.7 years) sampled from the age-related maculopathy ancillary study of the Health Aging and Body Composition Study (Memphis, TN, USA). Serum carotenoids were measured using high performance liquid chromatography. MPOD was assessed using heterochromatic flicker chromatography. Eight cognitive tests designed to evaluate several cognitive domains including memory and processing speed were administered. Partial correlation coefficients were computed to determine whether cognitive measures were related to serum L + Z and MPOD. MPOD levels were significantly associated with better global cognition, verbal learning and fluency, recall, processing speed and perceptual speed, whereas serum L + Z was significantly related to only verbal fluency. MPOD is related to cognitive function in older people. Its role as a potential biomarker of cognitive function deserves further study.
    Age and Ageing 01/2014; · 3.82 Impact Factor
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    ABSTRACT: Background Unless effective preventive strategies are implemented, aging of the population will result in a significant worsening of the heart failure (HF) epidemic. Few data exist on whether baseline ECG abnormalities can refine risk prediction for HF. Methods We examined a prospective cohort of 2915 participants aged 70-79 years without preexisting HF, enrolled between April 1997-June 1998 in the Health Aging and Body Composition (Health ABC) study. Minnesota Code was used to define major and minor ECG abnormalities at baseline and at year 4 follow-up. Using Cox models, we assessed (1) the association between ECG abnormalities and incident HF and (2) the incremental value of adding ECG to the Health ABC HF Risk Score using the net reclassification index (NRI). Results At baseline, 380 participants (13.0%) had minor and 620 (21.3%) had major ECG abnormalities. During a median follow-up of 11.4 years, 485 (16.6%) participants developed incident HF. After adjusting for the Health ABC HF Risk Score variables, the hazard ratio (HR) was 1.27 (95% confidence interval [CI] 0.96-1.68) for minor and 1.99 (95% CI 1.61-2.44) for major ECG abnormalities. At year 4, 263 participants developed new and 549 had persistent abnormalities; both were associated with increased subsequent HF risk (HR = 1.94, 95% CI 1.38-2.72 for new and HR = 2.35, 95% CI 1.82-3.02 for persistent ECG abnormalities). Baseline ECG correctly reclassified 10.5% of patients with HF events, 0.8% of those without HF events and 1.4% of the overall population. The NRI across the Health ABC HF risk categories was 0.11 (95% CI 0.03-0.19). Conclusions Among older adults, baseline and new ECG abnormalities are independently associated with increased risk for HF. The contribution of ECG screening for targeted prevention of HF should be evaluated in clinical trials.
    American Heart Journal. 01/2014;
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    ABSTRACT: Step length variability (SLV) increases with age in those without overt neurologic disease, is higher in neurologic patients, is associated with falls, and predicts dementia. Whether higher SLV in older adults without neurologic disease indicates presence of neurologic abnormalities is unknown. Our objective was to identify whether SLV in older adults without overt disease is associated with findings from multimodal neuroimaging. A well-characterized cohort of 265 adults (79-90 years) was concurrently assessed by gait mat, magnetic resonance imaging with diffusion tensor, and neurological exam. Linear regression models adjusted for gait speed, demographic, health, and functional covariates assessed associations of MRI measures (grey matter volume, white matter hyperintensity volume, mean diffusivity, fractional anisotropy) with SLV. Regional distribution of associations was assessed by sparse partial least squares analyses. Higher SLV (mean: 8.4, SD: 3.3) was significantly associated with older age, slower gait speed, and poorer executive function and also with lower grey matter integrity measured by mean diffusivity (standardized beta = 0.16; p = 0.02). Associations between SLV and grey matter integrity were strongest for the hippocampus and anterior cingulate gyrus (both β = 0.18) as compared to other regions. Associations of SLV with other neuroimaging markers were not significant. Lower integrity of normal-appearing grey matter may underlie higher SLV in older adults. Our results highlighted the hippocampus and anterior cingulate gyrus, regions involved in memory and executive function. These findings support previous research indicating a role for cognitive function in motor control. Higher SLV may indicate focal neuropathology in those without diagnosed neurologic disease.
    Gait & posture 01/2014; · 2.58 Impact Factor
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    ABSTRACT: Brain-derived neurotrophic factor (BDNF) plays a role in the maintenance and function of neurons. Although persons with Alzheimer's disease have lower cortical levels of BDNF, evidence regarding the association between circulating BDNF and cognitive function is conflicting. We sought to determine the correlates of BDNF level and whether BDNF level was prospectively associated with cognitive decline in healthy older adults. We measured serum BDNF near baseline in 912 individuals. Cognitive status was assessed repeatedly with the modified Mini-Mental Status Examination and the Digit Symbol Substitution test over the next 10 years. We evaluated the association between BDNF and cognitive decline with longitudinal models. We also assessed the association between BDNF level and demographics, comorbidities and health behaviors. We found an association between serum BDNF and several characteristics that are also associated with dementia (race and depression), suggesting that future studies should control for these potential confounders. We did not find evidence of a longitudinal association between serum BDNF and subsequent cognitive test trajectories in older adults, although we did identify a potential trend toward a cross-sectional association. Our results suggest that serum BDNF may have limited utility as a biomarker of prospective cognitive decline.
    PLoS ONE 01/2014; 9(3):e91339. · 3.53 Impact Factor
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    ABSTRACT: Obesity is associated with increased risk of many types of cancer. Less is known regarding associations between adipose depots and cancer risk. We aimed to explore relationships between adipose depots, risk of cancer, and obesity-related cancer (per NCI definition) in participants initially aged 70-79 years without prevalent cancer (1179 men, 1340 women), and followed for incident cancer for 13 years. Measures included body mass index (BMI), total adipose tissue from dual-energy X-ray absorptiometry, and computed tomography measures of visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue, thigh intermuscular adipose tissue, and thigh muscle attenuation (Hounsfield unit, HU), where low HU indicates fatty infiltration. Hazard ratios (HR) and 95% confidence intervals (CIs) were estimated by Cox proportional hazards models adjusted for demographics, lifestyle variables, and medical conditions. During follow-up, 617 participants developed cancer of which 224 were obesity-related cancers. Total adipose tissue and VAT were positively associated with cancer risk among women (HR 1.14, 95% CI 1.01-1.30 per SD increase; HR 1.15, 95% CI 1.02-1.30 per SD increase). There were no associations with cancer risk among men. Total adipose tissue was positively associated with obesity-related cancer risk among women (HR 1.23, 95% CI 1.03-1.46 per SD increase). VAT was positively associated with obesity-related cancer risk among men (HR 1.30, 95% CI 1.06-1.60 per SD increase) and remained associated even with adjustment for BMI (HR 1.40, 95% CI 1.08-1.82 per SD increase). These findings provide insight into relationships between specific adipose depots and cancer risk and suggest differential relationships among men and women.
    Applied Physiology Nutrition and Metabolism 12/2013; · 2.01 Impact Factor
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    ABSTRACT: The cerebellum plays an important role in mobility and cognition. However, it is unclear which regions of the cerebellum are associated with gait speed and information-processing ability in older adults without overt brain damage. Cross-sectional associations between cerebellar gray matter volumes (GMV), gait speed, and information-processing ability were explored in 231 community-dwelling adults (mean age: 83 years, 48% black, 58% female). We measured gait speed on an automated walkway and information-processing ability on the Digit Symbol Substitution test (DSST). Total and regional cerebellar GMV was measured on 3T-magnetic resonance imaging. Lobar GMV of the cerebellum, obtained by an automated parcellation process, were aggregated based on the cognitive (lobules VI, VII, VIII and crus I, II), sensorimotor (lobules II, IV, V), and vestibular (lobules IX and X) functions ascribed to the cerebellar regions. Larger cerebellar GMV correlated with faster gait speed and superior DSST scores (both p < .001) independent of age, gender, atrophy, and small vessel disease. After adjusting for age, gender, and atrophy, larger cognitive cerebellar GMV correlated with both faster gait speed (p = .04) and higher DSST scores (p < .001), larger sensorimotor cerebellar GMV correlated significantly with DSST alone (p = .02), and the vestibular cerebellar GMV with neither. The association between cognitive cerebellar GMV and gait speed was no longer significant after adjusting for DSST score in the linear regression models. The relationship between gait speed and cerebellar GMV is influenced by information-processing ability, and this relationship is stronger in subregions ascribed to cognitive than vestibular or sensorimotor functions.
    The Journals of Gerontology Series A Biological Sciences and Medical Sciences 10/2013; · 4.31 Impact Factor
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    ABSTRACT: Low literacy is common among the elderly and possibly more reflective of educational attainment than years of school completed. We examined the association between literacy and risk of likely dementia in older adults. Participants were 2,458 black and white elders (aged 71-82) from the Health, Aging and Body Composition study, who completed the Rapid Estimate of Adult Literacy in Medicine and were followed for 8 years. Participants were free of dementia at baseline; incidence of likely dementia was defined by hospital records, prescription for dementia medication, or decline in Modified Mini-Mental State Examination score. We conducted Cox proportional hazard models to evaluate the association between literacy and incidence of likely dementia. Demographics, education, income, comorbidities, lifestyle variables, and apolipoprotein E (APOE) ε4 status were included in adjusted analyses. Twenty-three percent of participants had limited literacy (<9th-grade level). Limited literacy, as opposed to adequate literacy (≥9th-grade level), was associated with greater incidence of likely dementia (25.5% vs17.0%; unadjusted hazard ratio [HR] = 1.75, 95% confidence interval 1.44-2.13); this association remained significant after adjustment. There was a trend for an interaction between literacy and APOE ε4 status (p = .07); the association between limited literacy and greater incidence of likely dementia was strong among ε4 noncarriers (unadjusted HR = 1.85) but nonsignificant among ε4 carriers (unadjusted HR = 1.25). Limited literacy is an important risk factor for likely dementia, especially among APOE ε4-negative older adults, and may prove fruitful to target in interventions aimed at reducing dementia risk.
    The Journals of Gerontology Series A Biological Sciences and Medical Sciences 10/2013; · 4.31 Impact Factor
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    ABSTRACT: To evaluate race-related differences in depression onset and recovery in older persons, overall and by sex, and examine race-related differences in mortality according to depression. Prospective cohort study. General community in pre-designated zip code areas in Memphis, Tennessee, and Pittsburgh, Pennsylvania. 3,075 persons aged 70-79 years at baseline in the Health, Aging, and Body Composition study. Depression was assessed at eight time points over 10 years using the 10-item Center for Epidemiologic Studies-Depression scale; patients were categorized as nondepressed (score less than 8) or depressed (score of 8 or higher). We created variables for transitions across each 18-month time interval, namely, from nondepressed or depressed to nondepressed, depressed, or death, and determined the association between race and the average likelihood of these transitions over time. A higher percentage of blacks than whites were depressed at nearly all time points. Adjusting for demographics, common chronic conditions, and body mass index, blacks had a higher likelihood of experiencing depression onset than whites (odds ratio [OR]: 1.22; 95% confidence interval [CI]: 1.03-1.43); among men, blacks were more likely to experience depression onset than whites (OR: 1.44; 95% CI: 1.24-2.89). Blacks also had a higher likelihood of transitioning from nondepressed to death (OR: 1.79; 95% CI: 1.30-2.46). Overall and in sex-stratified analyses, race was not associated with recovery from depression or with the transition from depression to death. Our findings highlight race differences in depression in older persons and encourage further research on the course of depression in older black patients.
    The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry 10/2013; · 3.35 Impact Factor
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    ABSTRACT: To determine whether anemia is associated with incident dementia in older adults. We studied 2,552 older adults (mean age 76.1 years; 38.9% black; 51.8% female) participating in the Health, Aging, and Body Composition study and free of dementia at baseline. We defined anemia using WHO criteria (hemoglobin concentration <13 g/dL for men and <12 g/dL for women). Dementia diagnosis was determined by dementia medication use, hospital records, or a change in Modified Mini-Mental State (3MS) score of more than 1.5 SD from mean. Discrete time Cox proportional hazard regression models were used to examine the hazard for developing dementia associated with anemia. Of 2,552 participants, 392 (15.4%) older adults had anemia at baseline. Over 11 years of follow-up, 455 (17.8%) participants developed dementia. In the unadjusted model, those with baseline anemia had an increased risk of dementia (23% vs 17%, hazard ratio = 1.64; 95% confidence interval 1.30, 2.07) compared to those without anemia. The association remained significant after adjusting for demographics, APOE ε4, baseline 3MS score, comorbidities, and renal function. Additional adjustment for other anemia measures (mean corpuscular volume, red cell distribution width), erythropoietin, and C-reactive protein did not appreciably change the results. There was no interaction by sex and race on risk of developing dementia. Among older adults, anemia is associated with an increased risk of developing dementia. Findings suggest that further study of anemia as a risk factor for dementia and a target for intervention for cognitive health is warranted.
    Neurology 07/2013; · 8.25 Impact Factor
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    ABSTRACT: Abnormal atrial repolarization is important in the development of atrial fibrillation (AF), but no direct measurement is available in clinical medicine. To determine whether the QT interval, a marker of ventricular repolarization, could be used to predict incident AF. We examined a prolonged QT corrected by the Framingham formula (QTFram) as a predictor of incident AF in the Atherosclerosis Risk in Communities (ARIC) study. The Cardiovascular Health Study (CHS) and Health, Aging, and Body Composition (Health ABC) study were used for validation. Secondary predictors included QT duration as a continuous variable, a short QT interval, and QT intervals corrected by other formulae. Among 14,538 ARIC participants, a prolonged QTFram predicted a roughly two-fold increased risk of AF (hazard ratio [HR] 2.05, 95% confidence interval [CI] 1.42-2.96, p<0.001). No substantive attenuation was observed after adjustment for age, race, sex, study center, body mass index, hypertension, diabetes, coronary disease, and heart failure. The findings were validated in CHS and Health ABC and were similar across various QT correction methods. Also in ARIC, each 10-ms increase in QTFram was associated with an increased unadjusted (HR 1.14, 95%CI 1.10-1.17, p<0.001) and adjusted (HR 1.11, 95%CI 1.07-1.14, p<0.001) risk of AF. Findings regarding a short QT were inconsistent across cohorts. A prolonged QT interval is associated with an increased risk of incident AF.
    Heart rhythm: the official journal of the Heart Rhythm Society 07/2013; · 4.56 Impact Factor
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    ABSTRACT: BACKGROUND:The impact of evidence-based guidelines and controlled trial data on use of cholesterol-lowering medications in older adults is unclear.OBJECTIVE:To examine whether utilization patterns of cholesterol-lowering medications in community-dwelling older adults changed following the release of the National Cholesterol Education Program Adult Treatment Panel III guidelines and RESULTS: Community-dwelling elderly individuals who were enrolled in the Health, Aging and Body Composition Study in 1997-1998 were followed for up to 11 years. An interrupted time series analysis with multivariable generalized estimating equations (GEEs) was used to examine changes in level and trend in cholesterol-lowering medication use before and after 2002, adjusting for sociodemographics, health-related behaviors, and health status.RESULTS:Cholesterol-lowering medication use increased nearly 3-fold from 14.9% in 1997-1998 to 42.6% in 2007-2008, with statins representing the most common class used (87-94%). Multivariable GEE results revealed no significant difference in the level of cholesterol-lowering medication use after 2002 (adjusted OR 0.95; 95% CI 0.89-1.02). Multivariable GEE results revealed that trend changes in the rate of increase in cholesterol-lowering medication declined after 2002 (adjusted ratio of ORs 0.92; 95% CI 0.89-0.95).CONCLUSIONS:The use of cholesterol-lowering medication increased substantially over a decade in community-dwelling elderly individuals but was not related to a change in level or trend following the release of the guidelines and evidence-based data.
    Annals of Pharmacotherapy 06/2013; · 2.57 Impact Factor

Publication Stats

5k Citations
977.90 Total Impact Points


  • 2007–2014
    • The University of Tennessee Health Science Center
      • • Department of Preventive Medicine
      • • Department of Medicine
      Memphis, Tennessee, United States
    • University of Utah
      • Division of Pulmonary Medicine
      Salt Lake City, UT, United States
  • 1999–2014
    • University of Tennessee
      • Department of Preventive Medicine
      Knoxville, Tennessee, United States
  • 2013
    • King's College London
      • Institute of Psychiatry
      London, ENG, United Kingdom
    • Oregon State University
      • School of Biological and Population Health Sciences
      Corvallis, OR, United States
    • University of Connecticut
      • UConn Center on Aging
      Storrs, Connecticut, United States
  • 2012–2013
    • San Francisco VA Medical Center
      San Francisco, California, United States
    • University of Missouri - St. Louis
      Saint Louis, Michigan, United States
    • Inselspital, Universitätsspital Bern
      • Department of General Internal Medicine
      Bern, BE, Switzerland
  • 2010–2013
    • National Institute on Aging
      • Laboratory of Epidemiology, Demography and Biometry (LEDB)
      Baltimore, Maryland, United States
    • University of Lausanne
      • Faculté de biologie et de médecine (FBM)
      Lausanne, VD, Switzerland
  • 2009–2013
    • The University of Tennessee Medical Center at Knoxville
      Knoxville, Tennessee, United States
    • University of South Carolina
      Columbia, South Carolina, United States
  • 2003–2013
    • University of California, San Francisco
      • • Division of Hospital Medicine
      • • Department of Psychiatry
      • • Department of Epidemiology and Biostatistics
      • • Division of Geriatrics
      San Francisco, CA, United States
  • 2005–2012
    • University of Pittsburgh
      • • Department of Epidemiology
      • • UPMC - Comprehensive Lung Center
      • • Physical Therapy
      Pittsburgh, PA, United States
    • Maastricht University
      Maestricht, Limburg, Netherlands
  • 2011
    • State University of New York Downstate Medical Center
      • Department of Epidemiology and Biostatistics (EPID, BIOS)
      Brooklyn, NY, United States
    • Johns Hopkins Bloomberg School of Public Health
      • Department of Health Policy and Management
      Baltimore, MD, United States
  • 2009–2011
    • California Pacific Medical Center Research Institute
      • Research Institute
      San Francisco, CA, United States
  • 2007–2011
    • The University of Memphis
      Memphis, Tennessee, United States
  • 2009–2010
    • Duke University
      Durham, North Carolina, United States
  • 2008–2009
    • Emory University
      • • Division of Endocrinology
      • • Division of Cardiology
      Atlanta, GA, United States
    • University of Louisville
      • Department of Psychological and Brain Sciences
      Louisville, KY, United States
    • Boston University
      • Department of Epidemiology
      Boston, MA, United States
  • 2007–2009
    • VU University Medical Center
      • Department of Psychiatry
      Amsterdam, North Holland, Netherlands
  • 2005–2009
    • University of Florida
      • Department of Aging and Geriatric Research
      Gainesville, FL, United States
    • Wake Forest School of Medicine
      • • Sticht Center on Aging
      • • Department of Internal Medicine
      Winston-Salem, NC, United States
  • 2006–2008
    • Vanderbilt University
      • • Department of Neurology
      • • Division of Cardiovascular Medicine
      Nashville, MI, United States
    • Johns Hopkins Medicine
      • Department of Medicine
      Baltimore, MD, United States
  • 1991–1999
    • Brigham and Women's Hospital
      • • Division of Preventive Medicine
      • • Center for Brain Mind Medicine
      • • Department of Medicine
      Boston, MA, United States
    • Harvard Medical School
      • Department of Medicine
      Boston, Massachusetts, United States
  • 1993
    • University of Washington Seattle
      Seattle, Washington, United States