The Johns Hopkins Academic Nursing Home (JHANH) represents both a specific program project directed toward phenomena and problems related to the interaction between excess adiposity and aging in the human and also a mechanism for encouraging, reviewing, coordinating, and facilitating additional research on problems relevant to human aging. While centered in the institutions on the Baltimore City Hospitals (BCH) campus (the Mason F. Lord [MFL] chronic hospital and skilled nursing facility, the Baltimore City Hospital, and the Gerontology Research Center of the National Institute on Aging), the JHANH will capitalize upon the extensive human and non-human resources of the Johns Hopkins Medical Institutions at large, notably the School of Medicine, the School and Hygiene and Public Health, and (when re-activated in 1984) the School of Nursing. The core facility will provide administration, scientific advisory and review functions, and a patient registry with biostatistical consultative expertise and the mechanism to enroll all study subjects in the aging-adiposity projects, patients in the practices of key BCH primary care physicians, patients in MFL, and subjects enrolled in an epidemiologic survey of elderly residents of the Southeast Baltimore community. Pilot studies promoted by the core include those directed toward detailing the natural history of life in the MFL and rehabilitation of patients newly admitted to that facility. The four specific projects represent a tightly-integrated approach to the complex phenomena of metabolic regulation, cardiopulmonary physiology (emphasizing exercise and heat regulation), sleep physiology, and neuropsychological function. In this multi-faceted project non-smoking obese male subjects of three age groups (45-49, 60-74, and 75 and older) will receive baseline evaluations in these four spheres, following which they will be randomly assigned to observation-control, weight loss through hypocaloric therapy, or endurance aerobic exercise training. After twelve months these assessments will be repeated, the subject re-assigned to observational status, and assessment repeated once again 36 months after initial entry into the study. Thus this research will address problems related both to the quantity (via the central effects of obesity upon cardiovascular risk profiles) and quality (via sleep and related neuropsychological disturbances) of life of aging man in Occidental society in which excess adiposity is so prevalent.
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