Identifying key targets for interventions to improve psychological wellbeing: replicable results from four UK cohorts.

BACKGROUND: An increasing importance is being placed on mental health and wellbeing at individual and population levels. While there are several interventions that have been proposed to improve wellbeing, more evidence is needed to understand which aspects of wellbeing are most influential. This study aimed to identify key items that signal improvement of mental health and wellbeing. METHODS: Using network analysis, we identified the most central items in the graph network estimated from the well-established Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Results were compared across four major UK cohorts comprising a total of 47,578 individuals: the Neuroscience in Psychiatry Network, the Scottish Schools Adolescent Lifestyle and Substance Use Survey, the Northern Ireland Health Survey, and the National Child Development Study. RESULTS: Regardless of gender, the three items most central in the network were related to positive self-perception and mood: 'I have been feeling good about myself'; 'I have been feeling confident'; and 'I have been feeling cheerful'. Results were consistent across all four cohorts. CONCLUSIONS: Positive self-perception and positive mood are central to psychological wellbeing. Psychotherapeutic and public mental health interventions might best promote psychological wellbeing by prioritising the improvement of self-esteem, self-confidence and cheerfulness. However, empirical testing of interventions using these key targets is needed.

Prognostic models for identifying adults with intellectual disabilities and mealtime support needs who are at greatest risk of respiratory infection and emergency hospitalisation.

BACKGROUND: Among adults with intellectual disabilities (ID), problems with eating, drinking and swallowing (EDS), and an associated need for mealtime support, are common, with an estimated 15% of adults known to specialist ID services requiring mealtime support. We set out to identify which adults with ID who receive mealtime support are at an increased risk of respiratory infections and emergency hospitalisation related to EDS problems. METHOD: An exploratory, prospective cohort study was undertaken in the East of England. At baseline, structured interviews with the caregivers of 142 adults with ID and any type of mealtime support needs were used to gather information on health and support needs over the previous 12 months. These interviews were repeated at follow-up, 12 months later. The resulting dataset, covering a 24-month period, was analysed with logistic regression, using model averaging to perform sensitivity analysis, and backwards step-wise variable selection to identify the most important predictors. RESULTS: Individuals with a history of respiratory infections (in the first year of study), those who had epilepsy and those with caregiver-reported difficulty swallowing were most likely to have respiratory infections in the second year. Adults with increasing mealtime support needs, epilepsy and/or full mealtime support needs (fed mainly or entirely by a caregiver or enterally) were at increased risk of emergency hospitalisation for EDS-related problems. CONCLUSIONS: Our findings highlight the importance of carefully monitoring health issues experienced by adults with ID and EDS problems, as well as their eating, drinking and swallowing skills. However, the models developed in this exploratory research require validation through future studies addressing the EDS problems commonly experienced by adults with ID and their implications for health outcomes and quality of life. Further research into the relationship between epilepsy and EDS problems would provide much-needed insight into the complex relationship between the two areas.

'What vision?': experiences of Team members in a community service for adults with intellectual disabilities.

BACKGROUND: In the UK, the closure of 'long-stay' hospitals was accompanied by the development of community teams (CTs) to support people with intellectual disabilities (IDs) to live in community settings. The self-reported experiences of staff working in such teams have been neglected. METHODS: Focusing on a single county-wide service, comprising five multi-disciplinary and inter-agency CTs, we measured perceptions among the health care and care management Team members of (1) their personal well-being; (2) the functioning of their team; and (3) the organisation's commitment to quality, and culture. RESULTS: Almost three-quarters of the questionnaires were returned (73/101; 72%). The scores of health care practitioners and care managers were very similar: (1) the MBI scores of more than half the respondents were 'of concern'; (2) similarly, almost four in ten respondents' scores on the Vision scale of the TCI were 'of concern'; (3) the perceived commitment to quality (QIIS-II Part 2) was uncertain; and (4) the organisational culture (QIIS-II, Part 1) was viewed as primarily hierarchical. DISCUSSION: The perceived absence of a vision for the service, combined with a dominant culture viewed by its members as strongly focussed on bureaucracy and process, potentially compromises the ability of these CTs to respond proactively to the needs of people with IDs. Given the changes in legislation, policy and practice that have taken place since CTs were established, it would be timely to revisit their role and purpose.

The incidence of healthcare use, ill health and mortality in adults with intellectual disabilities and mealtime support needs.

BACKGROUND: Adults with intellectual disabilities (ID) experience a wide range of eating, drinking and/or swallowing (EDS) problems, for which they receive diverse mealtime support interventions. Previous research has estimated that dysphagia (difficulty swallowing) affects 8% of all adults with ID and that 15% require some form of mealtime support. People with ID (whether they require mealtime support or not) also experience a greater burden of ill health and die younger than their peers in the general population with no ID. METHODS: Using an exploratory, population-based cohort study design, we set out to examine health-related outcomes in adults with ID who receive mealtime support for any eating, drinking or swallowing problem, by establishing the annual incidence of healthcare use, EDS-related ill health, and all-cause mortality. This study was conducted in two counties in the East of England. RESULTS: In 2009, 142 adults with mild to profound ID and a need for any type of mealtime support were recruited for a baseline survey. At follow-up 1 year later, 127 individuals were alive, eight had died and seven could not be contacted. Almost all participants had one or more consultations with a general practitioner (GP) each year (85-95%) and, in the first year, 20% reportedly had one or more emergency hospitalizations. Although their annual number of GP visits was broadly comparable with that of the general population, one-fifth of this population's primary healthcare use was directly attributable to EDS-related ill health. Respiratory infections were the most common cause of morbidity, and the immediate cause of all eight deaths, while concerns about nutrition and dehydration were surprisingly minor. Our participants had a high annual incidence of death (5%) and, with a standardized mortality ratio of 267, their observed mortality was more than twice that expected in the general population of adults with ID (not selected because of mealtime support for EDS problems). CONCLUSIONS: All Annual Health Checks now offered to adults with ID should include questions about respiratory infections and EDS functioning, in order to focus attention on EDS problems in this population. This has the potential to reduce life-threatening illness.

Investigating the widely held belief that men and women with learning disabilities receive poor quality healthcare when admitted to hospital: a single-site study of 30-day readmission rates.

BACKGROUND: This study aims to use 30-day readmission rates to investigate the presumption that men and women with learning disabilities (LDs, known internationally as intellectual disabilities) receive poorer quality hospital care than their non-disabled peers. METHOD: A 12-month retrospective audit was conducted using Hospital Episode Statistics (HES) at a single acute hospital in the East of England. This identified all in-patient admissions; admissions where the person concerned was recognised as having a LD; and all emergency readmissions within 30 days of discharge. Additionally, the healthcare records of all patients identified as having a LD and readmitted within 30 days as a medical emergency were examined in order to determine whether or not these readmissions were potentially preventable. RESULTS: Over the study period, a total of 66 870 adults were admitted as in-patients, among whom 7408 were readmitted as medical emergencies within 30 days of discharge: a readmission rate of 11%. Of these 66 870 patients, 256 were identified as having a LD, with 32 of them experiencing at least one emergency readmission within 30 days: a readmission rate of 13%. When examined, the healthcare records pertaining to these 32 patients who had a total of 39 unique 30-day readmissions revealed that 69% (n = 26) of these readmissions were potentially preventable. CONCLUSION: Although overall readmission rates were similar for patients with LDs and those from the general population, patients with LDs had a much higher rate of potentially preventable readmissions when compared to a general population estimate from van Walraven et al. This suggests that there is still work to be done to ensure that this patient population receives hospital care that is both safe and of high quality.

Automated mortality monitoring in Scotland from 2009.

Mortality monitoring systems are important for gauging the effect of influenza and other wide ranging health threats. We present the daily all-cause mortality monitoring system routinely used in Scotland, which differs from others by using two different statistical models for calculating expected mortality. The first model is an extended Serfling model, which captures annual seasonality in mortality using sine and cosine terms, and is frequently seen in other systems. Serfling models fit to summer seasonality well, but not to the winter peak. Thus, during the winter, there are frequent 'excesses', higher than expected mortality, making it harder to directly judge if winter mortality is higher than in previous years. The second model, a Generalised Additive Model, resolves this by allowing a more flexible seasonal pattern that includes the winter peak. Thus, excesses under the second model directly indicate if winter mortality is higher than in previous years, useful, for example, in judging if a new strain of seasonal influenza is more likely to produce death than previous ones. As common in all-cause mortality monitoring systems, the Scottish system uses a reporting delay correction: we discuss the difficulties of interpretation when such a correction is used and possible avenues for future work that may address these difficulties.

Whole systems approach to diet and healthy weight: a longitudinal process evaluation in East Scotland.

AIMS: Obesity contributes to morbidity and early mortality, affecting people of all ages and sociodemographic backgrounds. Despite attempts to address obesity, efforts to date have only had limited success. Adopting a whole systems approach (WSA) may potentially address obesity and emphasise complex inter-relating factors beyond individual choice. This study aimed to assess implementation of WSA to diet and healthy weight in two council areas of Scotland, longitudinally exploring enablers and barriers. One area followed a Leeds Beckett WSA model (LBM) of implementation, while the other used a hybrid model incorporating existing working systems. METHODS: To assess the process of implementing a WSA, interviews and focus groups were conducted after initiation and 1 year later. RESULTS: Main enablers included: belief in WSA effectiveness; positive relationships between key personnel; buy-in at community and national levels; funding availability; the working group responsible for coordinating the system development comprising individuals with diverse expertise; good communication; and existing governance structures. Barriers included: insufficient funding; high staff turnover; inadequate training in WSA methodology; engaging all relevant stakeholders and reverting to 'old ways' of non-WSA working. The LBM provided a framework for system setup and generating an action plan. CONCLUSION: This study provides the first independent longitudinal process evaluation of WSAs that have incorporated Leeds Beckett methodology, and offers insights into how a WSA can be implemented to address diet and healthy weight.

Review of health economic models exploring and evaluating treatment and management of hospital-acquired pneumonia and ventilator-associated pneumonia.

BACKGROUND: Hospital-acquired pneumonia (HAP) is pneumonia that occurs ≥48 h after hospital admission; it is the most common hospital-acquired infection contributing to death. Ventilator-associated pneumonia (VAP) arises ≥48-72 h after intubation. Opinions differ on whether VAP is a subset of HAP; the same pathogens predominate in both. Compared with VAP-free controls, patients developing VAP are twice as likely to die and have significantly longer stays in intensive care units. Guidelines recommend that microbiological cultures should guide antibiotic treatment, but these lack sensitivity and take 48-72 h to process, meaning that initial therapy must be empiric, generally with broad-spectrum agents. Given increasing pressure to improve both antibiotic stewardship and patient outcomes, the National Institute for Health and Care Excellence and the Infectious Diseases Society of America recommend research into rapid molecular diagnostic tests to identify causative organisms and their antibiotic resistances. Ideally, these would supersede culture, being quicker and more sensitive. In the UK, the INHALE research programme, funded by the National Institute for Health Research, is exploring rapid molecular diagnostics to inform treatment of HAP/VAP and, given resource implications, incorporates a health economic component. AIM: To identify previous economic modelling of HAP/VAP costs to inform this component. METHODS: Literature review of HAP/VAP studies with economic modelling identified from three databases. FINDINGS: Twenty studies were identified. Only one study specifically evaluated strategies to improve diagnosis; the remaining 19 studies omitted this important aspect. CONCLUSION: HAP/VAP modelling would be improved by better awareness of long-term outcomes and treatment complexity. To the authors' knowledge, no similar literature reviews of economic modelling for HAP/VAP have been published.

Vibratory stimulation enhances thyroid epithelial cell function.

The tissues of the body are routinely subjected to various forms of mechanical vibration, the frequency, amplitude, and duration of which can contribute both positively and negatively to human health. The vocal cords, which are in close proximity to the thyroid, may also supply the thyroid with important mechanical signals that modulate hormone production via mechanical vibrations from phonation. In order to explore the possibility that vibrational stimulation from vocalization can enhance thyroid epithelial cell function, FRTL-5 rat thyroid cells were subjected to either chemical stimulation with thyroid stimulating hormone (TSH), mechanical stimulation with physiological vibrations, or a combination of the two, all in a well-characterized, torsional rheometer-bioreactor. The FRTL-5 cells responded to mechanical stimulation with significantly (p<0.05) increased metabolic activity, significantly (p<0.05) increased ROS production, and increased gene expression of thyroglobulin and sodium-iodide symporter compared to un-stimulated controls, and showed an equivalent or greater response than TSH only stimulated cells. Furthermore, the combination of TSH and oscillatory motion produced a greater response than mechanical or chemical stimulation alone. Taken together, these results suggest that mechanical vibrations could provide stimulatory cues that help maintain thyroid function.

Seizure induced C-Fos mRNA in the rat brain: comparison between young and aging animals.

The molecular mechanisms associated with age-related alterations in the pharmacological and physiological properties of hippocampal and cortical neurons in response to chemically induced seizure are largely unknown. Administration of pentylenetetrazole (PTZ) (50 mg/kg body weight) to rats of various ages evoked tonic-colonic seizures. Using RNA gel blot analysis we found that 1 h after the onset of seizure, the mRNA for the protooncogene c-fos was increased in the hippocampus and cortex of 3-month-old rats. The levels of c-fos mRNA in the hippocampus and cortex of 3-month-old rats returned to control levels by 3 h after PTZ administration. The levels of c-fos mRNA in the hippocampus and cortex of 20-month-old and 30-month-old rats peaked at 3 h and returned to basal levels by 15 h following PTZ treatment. These results suggest that the induction of immediate-early gene expression, as exemplified by c-fos, is not impaired in the aged rat brain. However, the aged rat brain responded more slowly to chemically induced seizure and the levels of c-fos mRNA induction are decreased by about 49% in the cortex and by 27% in the hippocampus of 30-month-old rats, as compared to the levels expressed by 3-month-old rats.

Neural cell adhesion molecule (NCAM) and N-cadherin mRNA during development and aging: selective reduction in the 7.4-kb and 6.7-kb NCAM mRNA levels in the hippocampus of adult and old rats.

By examining the time course, from E15 to 720 days of age, for changes in the prevalence of mRNAs coding for neural cell adhesion molecule (NCAM), N-cadherin and alpha-tubulin in rat hippocampus and forebrain, it was concluded that (i) the NCAM 7.4-, 6.7-, 5.2-, 4.3- and 2.9-kb mRNAs are differentially regulated during development and aging; (ii) the 7.4- and 6.7-kb mRNA are drastically reduced starting from day 21 onward; (iii) the E15- and day-1-specific mRNA of 4.3 kb is replaced with the 5.2-kb mRNA starting with 21 days, thereafter the 5.2-kb message remained relatively constant over the entire life-span studied. Likewise, the 2.9-kb mRNA, which was very abundantly expressed at E15 and early postnatal stages, remained relatively constant between 180 days and 720 days; (iv) postnatal rat brains showed both qualitative and quantitative changes in N-cadherin 4.3- and 4.0-kb transcripts. The 4.3-kb mRNA was relatively abundant at 1 and 21 days postnatal stages, thereafter the signal remained very low over the entire life-span studied. The 4.0-kb message, which was specific for the E15 stage, was replaced with the 4.3-kb message; (v) as expected, the 1.8-kb mRNA coding for embryonic alpha-tubulin decreased dramatically after 1 day, but became stabilized at moderate levels during the subsequent developmental stages. At least for the NCAM gene, the regulation seems to occur post-transcriptionally, possibly at the level of RNA processing while the N-cadherin mRNA expression seems to be transcriptionally regulated.

Evidence that V+ fibronectin, GFAP and S100 beta mRNAs are increased in the hippocampus of aged rats.

In the present study, using RNA gel-blot analysis, we characterized the developmental changes in the prevalence of mRNA coding for fibronectin (FN), glial fibrillary acidic protein (GFAP), neurotrophic protein S100 beta, and beta-actin mRNA in rat hippocampus and forebrain from 1 to 720 days of age. We found that the FN and mRNA containing the V segment (FN-V) was relatively abundant at early postnatal stages, but very few transcripts were detected in adult rats. However, the hybridization signal for the juvenile FN-V mRNA was up to approximately 8-fold increased in some but not all 24-versus 6-month-old rats. Also, GFAP and S100 beta transcripts were faintly expressed at an early developmental stage, then the level of expression steadily increased starting with day 21. The greatest increase averages approximately 1.8-fold for GFAP in 24-month-old rats, and approximately 1.5-fold for S100 beta in 15-month-old versus 6-month-old rats. As all these messages are localized primarily in astrocytes, we conclude that (a) astrocyte might play an active role in aging hippocampus and (b) an increase in S100 beta and GFAP mRNA expression may precede that for FN-V mRNA expression in a hypothetical pathway of molecular events underlying neurodegeneration in the hippocampus of old rats. We also note the considerable variability among the 24-month-old rats, suggesting that aging is an individual process.

Age changes of the isoelectric points of non-histone chromosomal proteins from rat liver in the pH range 5 to 8.

Non-histone chromosomal proteins were extracted from purified nuclei of young (2-3 months) and old (24-28 months) rat liver by a two-phase partition method (chloroform:-isoamyl alcohol, 24:1) after histone depletion with 0.25N HCl. The proteins were subjected to analytical isoelectric focusing in the pH range 5-8. On the densitograms derived from Coomasie brilliant blue R-250 stained gels, there were formally four areas separated having the following pH ranges: I) 5.80-6.10; II) 6.25-6.42; III) 6.80-7.00; IV) 7.20-7.35 for young rats, and I) absent; II) 6.35-6.75; III) 6.80-7.00; IV) 7.12-7.40 for old rats. Hence, the main result is the absence of a group of proteins from old rats having the pH range 5.80-6.10. The factors involved in protein separation by isoelectric focusing, like time-dependent post-translational charge modifications: phosphorylation, acetylation, ADP-ribosylation, deamidation, terminal peptide cleavage, glycosylation, and DNA-like contaminants are discussed.

Brain plasticity: to what extent do aged animals retain the capacity to coordinate gene activity in response to acute challenges.

The ability of the rodent brain to support plasticity-related phenomena declines with increasing age. A decreased coordination of genes implicated in brain plasticity may be one factor contributing to this decline. Synaptic rearrangement that occurs after seizure activity is regarded as a model of brain plasticity. In a rat model of seizure-related brain plasticity, we found that the induction of immediate-early genes, as exemplified by c-fos and tissue plasminogen activator (TPA) is not impaired in the aged rat brain. However, the aged rat brain responded more slowly to chemically induced seizure and the levels of c-fos and TPA mRNAs induction are decreased in the cortex and in the hippocampus of 30-month-old rats, as compared to the levels expressed by 3-month-old rats. In addition, at the peak induction the TPA transcripts were restricted to certain cortical layers of the older rats. Surprisingly, in applying the same experimental paradigm to late genes we found that there was a shift toward earlier times in the maximum expression of growth-related molecule, the microtubule-associated protein 1B (MAP1B) mRNA, which was very evident in 18-month-old rats. Aberrant immunolabeling of MAP1B occurred in cortical layer VI of the aged rats where, unlike in young rats, there was heavy staining of neuronal somata. These results suggest that (i) one consequence of aging, besides decreases in the levels of mRNA, is a progressive loss of coordination in gene activity following the administration of a stimulus; (ii) since c-fos, TPA and MAP1B have been implicated in neuronal plasticity, these findings could explain, in part, the limited plasticity of the aging brain.

Age changes in the H1 group of histones from rat liver.

Histones were obtained from young and old rat livers by extracting them in 0.25 N HCl. They were fractionated on 15% acid urea polyacrylamide gels containing 6.25 M urea and the changes in the ratio of the major histone fractions as a function of age were calculated. Data presented show a significant increase in the amount of H1 degree fraction in the liver of old rats as compared to young rats. This data is discussed and the possible involvement of H1 degree fraction in an increased resistance of old rat liver chromatin to micrococcal nuclease digestion of linker DNA is suggested. Finally, in connection with this increased resistance, some possible consequences in chromatin structure are discussed.

Evidence that the V+ fibronectin mRNA is increased in the hippocampus of aged rats.

In this study we investigated the splicing pattern of fibronectin (FN) mRNA during development and aging by using Northern blot hybridization with probes that either recognize all forms of FN mRNA or that are specific for the different spliced forms (FN-EIIIA, FN-EIIIB, and FN-V). We find that (1) the FNmRNA in the hippocampus of some but not all old rats showed a pattern of splicing similar to that found in the forebrain of 21 day old rats and (2) the hybridization signal for the alternatively spliced FN mRNA containing the EIIIA, EIIIB, and V95 segments was relatively abundant at early postnatal stages but very few transcripts were detected in adult and old rats. However, the hybridization signal for the juvenile FN-V mRNA was markedly increased in some but not all two-year-old rats suggesting that aging is an individual process.

Needle placement with transtympanic electrocochleography.

Electrocochleography (ECoG) is an objective, electrophysiologic test useful in the clinical diagnosis of endolymphatic hydrops, or Meniere's disease. The purpose of this study was to determine if the position of the needle, using transtympanic methodology, gives a variable SP/AP (summating potential/action potential) response. SP/AP ratios were obtained during routine tympanoplasty procedures. After the tympanic membrane remnant was removed using a lateral graft technique, precise needle placement was obtained at the medial and lateral round window niches, as well as on the promontory. SP/AP ratios were obtained in these three needle positions. There was no significant difference in the SP/AP ratio responses despite the location of needle placement. The use of transtympanic electrocochleography can give very good wave form morphology and consistent results. Therefore, if elevated SP/AP ratios do occur, they are thought to be due to a pathologic process of the ear and not needle placement.

A simple spectrophotometric method for the measurement of ribonuclease activity in biological fluids.

We have developed a rapid and sensitive method for detecting ribonuclease (RNAase). The method makes use of a RNA-Pyronine Y complex which has a different absorption spectrum from that of Pyronine Y alone. When the RNA is hydrolyzed by RNAase, the spectrum of the complex changes to that of unbound Pyronine Y. The resultant decrease in absorbance at 572 nm is linear for final RNAase concentrations ranging from 2 to 45 ng/ml. Optimal assay conditions were 11.5 micrograms/ml Pyronine Y, 0.56 mg/ml RNA, 80 mumol/ml Tris-HCl buffer, pH 7.8, and 2-45 ng/ml RNAase. The effect of complex concentration, pH, molarity and temperature upon the rate of the reaction were determined. The assay is applicable to crude cell-free extracts.

Synaptic plasticity is preserved in the temporal cortex of 20-month-old rats.

The molecular mechanisms associated with age-related alterations in the plasticity of the cortical neurons in response to chemically-induced seizure are largely unknown. Administration of pentylenetetrazole (PTZ) (50 mg/kg body weight) to rats of various ages evoked tonic-clonic seizures. Using immunoblotting and in situ hybridization analysis we found that 72 h after the onset of seizure, the mRNA for microtubule-associated protein 1B (MAP1B), a marker of synaptic plasticity, was increased in the cortex of 3-month-old rats. The levels of MAP1B mRNA in the cortex of 3-month-old rats returned to control levels by 10 days after PTZ administration. The levels of MAP1B mRNA in the hippocampus and cortex of 20 months at later times (10 days) and returned nearly to basal levels by 20 days following PTZ treatment. Immunohistochemical analysis revealed that MAP1B-like immunoreactivity was confined to layer II and neuronal processes extending into layer I. In contrast, the staining of MAP1B in the temporal cortex of 20-month-old animals was restricted to neuronal cell bodies of layer II. Since synaptic plasticity is associated mainly with neuronal processes we conclude that synaptic plasticity is reduced in the temporal cortex of 20-month-old rats. Remarkably, the induction of MAP1B in neuronal extensions was not impaired in the temporal cortex of older animals following intense neuronal activity. However, the aged rat brain responded more slowly to chemically-induced seizure although the levels of MAP1B induction are not decreased as compared to the levels expressed by 3-month-old rats.

Dynamics of gene expression for immediate early- and late genes after seizure activity in aged rats.

The ability of the rodent brain to support plasticity-related phenomena declines with increasing age. A decreased coordination of genes implicated in brain plasticity may be one factor contributing to this decline. Synaptic rearrangement that occurs after seizure activity is regarded as a model of brain plasticity. In a rat model of seizure-related brain plasticity, we found that the induction of immediate-early genes, as exemplified by c-fos and tissue plasminogen activator ( tPA), is not impaired in the aged rat brain. However, the aged rat brain responded more slowly to chemically induced seizure, and the levels of c-fos and tPA mRNAs induction are decreased in the cortex and in the hippocampus of 30 month old rats, as compared to the levels expressed by 3 month old rats. In addition, at the peak induction, the TPA transcripts were restricted to certain cortical layers of the older rats. Surprisingly, in applying the same experimental paradigm to late genes, we found that there was a shift toward earlier times in the maximum expression of growth-related molecules, the microtubule-associated protein 1B (MAP1B) mRNA, which was very evident in 18 month old rats. Aberrant immunolabeling of MAP1B occurred in cortical layer VI of the aged rats where, unlike in young rats, there was heavy staining of neuronal somata. These results suggest that (1) one consequence of aging, besides decreases in the levels of mRNA, is a progressive loss of coordination in gene activity following the administration of a stimulus; (2) since c-fos, TPA and MAP1B have been implicated in neuronal plasticity, these findings could explain, in part, the limited plasticity of the aging brain.