Biography

    Dr. Avron (Ron) Spiro received his PhD in Human Development and Family Studies in 1982 from The Pennsylvania State University, specializing in adult development and aging and in developmental methodology. 

    In 1986, he joined the VA Normative Aging Study (NAS), then at the Boston VA Outpatient Clinic, as a research psychologist and methodologist. In that position, he has studied the influences of health and disease on cognitive aging, and conducted longitudinal studies of personality, well-being, and mental health. He also works with the Dental Longitudinal Study (DLS), an ongoing study of dental health among NAS men. In 1998, the VA funded the Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), which incorporated the NAS/DLS, now located at VA Boston Healthcare System in Jamaica Plain.

    In 1993, Dr. Spiro began collaborating with researchers at the VA HSR&D Center of Excellence at the Bedford VA Medical Center, known as the Center for Health Quality, Outcomes, and Economic Research (CHQOER). His work here focuses primarily on mental health, including PTSD and depression, and on patient-reported outcomes, including health-related quality of life.

    In 1987, Dr. Spiro was appointed Assistant Professor of Epidemiology and Biostatistics at the Boston University School of Public Health, and was promoted to Associate Professor in the Department of Epidemiology in 2004.  In 2001, he was appointed as Associate Professor in the Department of Health Policy and Health Services Research at BU’s Goldman School of Dental Medicine, and in 2010 Associate Professor of Psychiatry at BU School of Medicine.  In 2008, he received a Research Career Scientist award from the Clinical Science R&D Service of the Department of Veterans Affairs. In 2011, Dr. Spiro was promoted to Research Professor of Epidemiology and Psychiatry.

    Dr. Spiro has been funded by NIH and VA. Currently, he is PI of a VA grant studying cognition and health, an NIH grant on Lifespan Outcomes of Military Service, and is co-investigator on several projects funded by NIH and VA  studying health, personality, cognition and aging. His current work involves (a) examining the effects of health and disease on cognitive aging, (b) modeling longitudinal changes in personality in relation to health, (c) developing a lifespan approach to health, and (d) studying mental disorders and their impact on health and functioning.

Publications
    1. Verfaellie M, Lafleche G, Spiro A, Tun C, Bousquet K. Chronic Postconcussion Symptoms and Functional Outcomes in OEF/OIF Veterans with Self-Report of Blast Exposure. J Int Neuropsychol Soc. 2013 Jan; 19(1):1-10.
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    2. Potter CM, Kaiser AP, King LA, King DW, Davison EH, Seligowski AV, Brady CB, Spiro A. Distinguishing late-onset stress symptomatology from posttraumatic stress disorder in older combat veterans. Aging Ment Health. 2013; 17(2):173-9.
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    3. Osei-Bonsu PE, Spiro A, Schultz MR, Ryabchenko KA, Smith E, Herz L, Eisen SV. Is DSM-IV criterion A2 associated with PTSD diagnosis and symptom severity? J Trauma Stress. 2012 Aug; 25(4):368-75.
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    4. Madrigano J, Baccarelli A, Mittleman MA, Sparrow D, Spiro A, Vokonas PS, Cantone L, Kubzansky L, Schwartz J. Air Pollution and DNA Methylation: Interaction by Psychological Factors in the VA Normative Aging Study. Am J Epidemiol. 2012 Aug 1; 176(3):224-32.
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    5. Rahilly-Tierney C, Vokonas P, Gaziano JM, Spiro A. Lifestyle Change and High-Density Lipoprotein Change: The US Department of Veterans Affairs Normative Aging Study. Clin Cardiol. 2012; 35(7):437-42.
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    6. Schwartz N, Kaye EK, Nunn ME, Spiro A, Garcia RI. High-fiber foods reduce periodontal disease progression in men aged 65 and older: the veterans affairs normative aging study/dental longitudinal study. J Am Geriatr Soc. 2012 Apr; 60(4):676-83.
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    7. Burridge AB, Hawley KS, Spiro A, Echt KV. Physical and cognitive function in older men: is longitudinal study participation related to better functioning? J Am Geriatr Soc. 2012 Feb; 60(2):396-8.
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    8. Turiano NA, Spiro A, Mroczek DK. Openness to experience and mortality in men: analysis of trait and facets. J Aging Health. 2012 Jun; 24(4):654-72.
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    9. Kaiser AP, Park CL, King LA, King DW, Schuster J, Spiro A, Moore JL, Kaloupek DG, Keane TM. Long-term effects of coping with extreme stress: Longitudinal study of Vietnam-era repatriated prisoners of war. J Trauma Stress. 2011 Dec; 24(6):680-90.
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    10. Peters JL, Kubzansky LD, Ikeda A, Spiro A, Wright RO, Weisskopf MG, Kim D, Sparrow D, Nie LH, Hu H, Schwartz J. Childhood and Adult Socioeconomic Position, Cumulative Lead Levels, and Pessimism in Later Life: The VA Normative Aging Study. Am J Epidemiol. 2011 Dec 15; 174(12):1345-53.
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    11. Goral M, Clark-Cotton M, Spiro A, Obler LK, Verkuilen J, Albert ML. The contribution of set switching and working memory to sentence processing in older adults. Exp Aging Res. 2011 Oct; 37(5):516-38.
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    12. Ikeda A, Schwartz J, Peters JL, Fang S, Spiro A, Sparrow D, Vokonas P, Kubzansky LD. Optimism in Relation to Inflammation and Endothelial Dysfunction in Older Men: The VA Normative Aging Study. Psychosom Med. 2011 Oct; 73(8):664-71.
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    13. Spiro A, Brady CB. Integrating health into cognitive aging: toward a preventive cognitive neuroscience of aging. J Gerontol B Psychol Sci Soc Sci. 2011 Jul; 66 Suppl 1:i17-i25.
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    14. Weuve J, Glymour MM, Hu H, Sparrow D, Spiro A, Vokonas PS, Litonjua AA. Forced expiratory volume in 1 second and cognitive aging in men. J Am Geriatr Soc. 2011 Jul; 59(7):1283-92.
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    15. Eisen SV, Bottonari KA, Glickman ME, Spiro A, Schultz MR, Herz L, Rosenheck R, Rofman ES. The incremental value of self-reported mental health measures in predicting functional outcomes of veterans. J Behav Health Serv Res. 2011 Apr; 38(2):170-90.
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    16. Rahilly-Tierney CR, Spiro A, Vokonas P, Gaziano JM. Relation Between High-Density Lipoprotein Cholesterol and Survival to Age 85 Years in Men (from the VA Normative Aging Study). Am J Cardiol. 2011 Apr 15; 107(8):1173-7.
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    17. Huntington NL, Spetter D, Jones JA, Rich SE, Garcia RI, Spiro A. Development and validation of a measure of pediatric oral health-related quality of life: the POQL. J Public Health Dent. 2011; 71(3):185-93.
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    18. Power MC, Weisskopf MG, Alexeeff SE, Coull BA, Spiro A, Schwartz J. Traffic-related air pollution and cognitive function in a cohort of older men. Environ Health Perspect. 2011 May; 119(5):682-7.
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    19. Echt KV, Smith SL, Burridge AB, Spiro A. Longitudinal changes in hearing sensitivity among men: the Veterans Affairs Normative Aging Study. J Acoust Soc Am. 2010 Oct; 128(4):1992-2002.
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    20. Park SK, Elmarsafawy S, Mukherjee B, Spiro A, Vokonas PS, Nie H, Weisskopf MG, Schwartz J, Hu H. Cumulative lead exposure and age-related hearing loss: the VA Normative Aging Study. Hear Res. 2010 Oct 1; 269(1-2):48-55.
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    21. Obler LK, Rykhlevskaia E, Schnyer D, Clark-Cotton MR, Spiro A, Hyun J, Kim DS, Goral M, Albert ML. Bilateral brain regions associated with naming in older adults. Brain Lang. 2010 Jun; 113(3):113-23.
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    22. Kaye EK, Valencia A, Baba N, Spiro A, Dietrich T, Garcia RI. Tooth loss and periodontal disease predict poor cognitive function in older men. J Am Geriatr Soc. 2010 Apr; 58(4):713-8.
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    23. Cunnion DT, Spiro A, Jones JA, Rich SE, Papageorgiou CP, Tate A, Casamassimo P, Hayes C, Garcia RI. Pediatric oral health-related quality of life improvement after treatment of early childhood caries: a prospective multisite study. J Dent Child (Chic). 2010 Jan-Apr; 77(1):4-11.
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    24. Selim AJ, Berlowitz D, Kazis LE, Rogers W, Wright SM, Qian SX, Rothendler JA, Spiro A, Miller D, Selim BJ, Fincke BG. Comparison of health outcomes for male seniors in the Veterans Health Administration and Medicare Advantage plans. Health Serv Res. 2010 Apr; 45(2):376-96.
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    25. Albert ML, Spiro A, Sayers KJ, Cohen JA, Brady CB, Goral M, Obler LK. Effects of health status on word finding in aging. J Am Geriatr Soc. 2009 Dec; 57(12):2300-5.
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    26. Peters JL, Weisskopf MG, Spiro A, Schwartz J, Sparrow D, Nie H, Hu H, Wright RO, Wright RJ. Interaction of stress, lead burden, and age on cognition in older men: the VA Normative Aging Study. Environ Health Perspect. 2010 Apr; 118(4):505-10.
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    27. Rosen AK, Chatterjee S, Glickman ME, Spiro A, Seal P, Eisen SV. Improving risk adjustment of self-reported mental health outcomes. J Behav Health Serv Res. 2010 Jul; 37(3):291-306.
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    28. van de Rest O, Spiro A, Krall-Kaye E, Geleijnse JM, de Groot LC, Tucker KL. Intakes of (n-3) fatty acids and fatty fish are not associated with cognitive performance and 6-year cognitive change in men participating in the Veterans Affairs Normative Aging Study. J Nutr. 2009 Dec; 139(12):2329-36.
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    29. Selim AJ, Kazis LE, Qian S, Rothendler JA, Spiro A, Rogers W, Haffer SC, Wright SM, Miller D, Selim BJ, Fincke BG. Differences in risk-adjusted mortality between medicaid-eligible patients enrolled in medicare advantage plans and those enrolled in the veterans health administration. J Ambul Care Manage. 2009 Jul-Sep; 32(3):232-40.
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    30. McCall-Hosenfeld JS, Liebschutz JM, Spiro A, Seaver MR. Sexual assault in the military and its impact on sexual satisfaction in women veterans: a proposed model. J Womens Health (Larchmt). 2009 Jun; 18(6):901-9.
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    31. Chatterjee S, Rath ME, Spiro A, Eisen S, Sloan KL, Rosen AK. Gender differences in veterans health administration mental health service use: effects of age and psychiatric diagnosis. Womens Health Issues. 2009 May-Jun; 19(3):176-84.
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    32. Boeninger DK, Shiraishi RW, Aldwin CM, Spiro A. Why do older men report low stress ratings? Findings from the Veterans Affairs Normative Aging Study. Int J Aging Hum Dev. 2009; 68(2):149-70.
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    33. Wright WG, Jones JA, Spiro A, Rich SE, Kressin NR. Use of patient self-report oral health outcome measures in assessment of dental treatment outcomes. J Public Health Dent. 2009; 69(2):95-103.
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    34. Knoops KT, Spiro A, de Groot LC, Kromhout D, van Staveren WA, Tucker KL. Do dietary patterns in older men influence change in homocysteine through folate fortification? The Normative Aging Study. Public Health Nutr. 2009 Oct; 12(10):1760-6.
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    35. Rajan P, Kelsey KT, Schwartz JD, Bellinger DC, Weuve J, Spiro A, Sparrow D, Smith TJ, Nie H, Weisskopf MG, Hu H, Wright RO. Interaction of the delta-aminolevulinic acid dehydratase polymorphism and lead burden on cognitive function: the VA normative aging study. J Occup Environ Med. 2008 Sep; 50(9):1053-61.
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    36. Neupert SD, Mroczek DK, Spiro A. Neuroticism moderates the daily relation between stressors and memory failures. Psychol Aging. 2008 Jun; 23(2):287-96.
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    37. Park SK, O'Neill MS, Vokonas PS, Sparrow D, Spiro A, Tucker KL, Suh H, Hu H, Schwartz J. Traffic-related particles are associated with elevated homocysteine: the VA normative aging study. Am J Respir Crit Care Med. 2008 Aug 1; 178(3):283-9.
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    38. Miller DR, Rogers WH, Kazis LE, Spiro A, Ren XS, Haffer SC. Patients' self-report of diseases in the Medicare Health Outcomes Survey based on comparisons with linked survey and medical data from the Veterans Health Administration. J Ambul Care Manage. 2008 Apr-Jun; 31(2):161-77.
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    39. Kressin NR, Jones JA, Orner MB, Spiro A. A new brief measure of oral quality of life. Prev Chronic Dis. 2008 Apr; 5(2):A43.
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    40. Shen BJ, Avivi YE, Todaro JF, Spiro A, Laurenceau JP, Ward KD, Niaura R. Anxiety characteristics independently and prospectively predict myocardial infarction in men the unique contribution of anxiety among psychologic factors. J Am Coll Cardiol. 2008 Jan 15; 51(2):113-9.
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    41. Rajan P, Kelsey KT, Schwartz JD, Bellinger DC, Weuve J, Sparrow D, Spiro A, Smith TJ, Nie H, Hu H, Wright RO. Lead burden and psychiatric symptoms and the modifying influence of the delta-aminolevulinic acid dehydratase (ALAD) polymorphism: the VA Normative Aging Study. Am J Epidemiol. 2007 Dec 15; 166(12):1400-8.
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    42. Peters JL, Kubzansky L, McNeely E, Schwartz J, Spiro A, Sparrow D, Wright RO, Nie H, Hu H. Stress as a potential modifier of the impact of lead levels on blood pressure: the normative aging study. Environ Health Perspect. 2007 Aug; 115(8):1154-9.
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    43. Eisen SV, Ranganathan G, Seal P, Spiro A. Measuring clinically meaningful change following mental health treatment. J Behav Health Serv Res. 2007 Jul; 34(3):272-89.
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    44. Selim AJ, Kazis LE, Rogers W, Qian SX, Rothendler JA, Spiro A, Ren XS, Miller D, Selim BJ, Fincke BG. Change in health status and mortality as indicators of outcomes: comparison between the Medicare Advantage Program and the Veterans Health Administration. Qual Life Res. 2007 Sep; 16(7):1179-91.
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    45. Mroczek DK, Spiro A. Personality change influences mortality in older men. Psychol Sci. 2007 May; 18(5):371-6.
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    46. King LA, King DW, Vickers K, Davison EH, Spiro A. Assessing late-onset stress symptomatology among aging male combat veterans. Aging Ment Health. 2007 Mar; 11(2):175-91.
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    47. Weisskopf MG, Proctor SP, Wright RO, Schwartz J, Spiro A, Sparrow D, Nie H, Hu H. Cumulative lead exposure and cognitive performance among elderly men. Epidemiology. 2007 Jan; 18(1):59-66.
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    48. Kubzansky LD, Koenen KC, Spiro A, Vokonas PS, Sparrow D. Prospective study of posttraumatic stress disorder symptoms and coronary heart disease in the Normative Aging Study. Arch Gen Psychiatry. 2007 Jan; 64(1):109-16.
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    49. Yancura LA, Aldwin CM, Levenson MR, Spiro A. Coping, affect, and the metabolic syndrome in older men: how does coping get under the skin? J Gerontol B Psychol Sci Soc Sci. 2006 Sep; 61(5):P295-303.
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    50. Zhang J, Niaura R, Dyer JR, Shen BJ, Todaro JF, McCaffery JM, Spiro A, Ward KD. Hostility and urine norepinephrine interact to predict insulin resistance: the VA Normative Aging Study. Psychosom Med. 2006 Sep-Oct; 68(5):718-26.
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    51. Sloan KL, Montez-Rath ME, Spiro A, Christiansen CL, Loveland S, Shokeen P, Herz L, Eisen S, Breckenridge JN, Rosen AK. Development and validation of a psychiatric case-mix system. Med Care. 2006 Jun; 44(6):568-80.
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    52. Neupert SD, Almeida DM, Mroczek DK, Spiro A. Daily stressors and memory failures in a naturalistic setting: findings from the VA Normative Aging Study. Psychol Aging. 2006 Jun; 21(2):424-9.
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    53. Selim AJ, Kazis LE, Rogers W, Qian S, Rothendler JA, Lee A, Ren XS, Haffer SC, Mardon R, Miller D, Spiro A, Selim BJ, Fincke BG. Risk-adjusted mortality as an indicator of outcomes: comparison of the Medicare Advantage Program with the Veterans' Health Administration. Med Care. 2006 Apr; 44(4):359-65.
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    54. Hankin CS, Spiro A, Mansell D, Miller DR, Kazis LE. Mental disorders and medical care utilization of VA ambulatory care patients: the veterans health study. J Ambul Care Manage. 2006 Jan-Mar; 29(1):51-60.
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    55. Mansell D, Penk W, Hankin CS, Lee A, Spiro A, Skinner KM, Hsieh J, Kazis LE. The illness burden of alcohol-related disorders among VA patients: the veterans health study. J Ambul Care Manage. 2006 Jan-Mar; 29(1):61-70.
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    56. Spiro A, Hankin CS, Mansell D, Kazis LE. Posttraumatic stress disorder and health status: the veterans health study. J Ambul Care Manage. 2006 Jan-Mar; 29(1):71-86.
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    57. Mansell D, Spiro A, Lee A, Kazis L. Validation of the primary care alcohol severity measure. J Ambul Care Manage. 2006 Jan-Mar; 29(1):87-97.
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    58. Kinnunen T, Haukkala A, Korhonen T, Quiles ZN, Spiro A, Garvey AJ. Depression and smoking across 25 years of the Normative Aging Study. Int J Psychiatry Med. 2006; 36(4):413-26.
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    59. Brady CB, Spiro A, Gaziano JM. Effects of age and hypertension status on cognition: the Veterans Affairs Normative Aging Study. Neuropsychology. 2005 Nov; 19(6):770-7.
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    60. Zhang J, Niaura R, Todaro JF, McCaffery JM, Shen BJ, Spiro A, Ward KD. Suppressed hostility predicted hypertension incidence among middle-aged men: the normative aging study. J Behav Med. 2005 Oct; 28(5):443-54.
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    61. Tucker KL, Qiao N, Scott T, Rosenberg I, Spiro A. High homocysteine and low B vitamins predict cognitive decline in aging men: the Veterans Affairs Normative Aging Study. Am J Clin Nutr. 2005 Sep; 82(3):627-35.
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    62. Todaro JF, Con A, Niaura R, Spiro A, Ward KD, Roytberg A. Combined effect of the metabolic syndrome and hostility on the incidence of myocardial infarction (the Normative Aging Study). Am J Cardiol. 2005 Jul 15; 96(2):221-6.
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    63. Fincke BG, Clark JA, Linzer M, Spiro A, Miller DR, Lee A, Kazis LE. Assessment of long-term complications due to type 2 diabetes using patient self-report: the diabetes complications index. J Ambul Care Manage. 2005 Jul-Sep; 28(3):262-73.
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    64. Clark JA, Spiro A, Miller DR, Fincke BG, Skinner KM, Kazis LE. Patient-based measures of illness severity in the Veterans Health Study. J Ambul Care Manage. 2005 Jul-Sep; 28(3):274-85.
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    65. Schnurr PP, Lunney CA, Sengupta A, Spiro A. A longitudinal study of retirement in older male veterans. J Consult Clin Psychol. 2005 Jun; 73(3):561-6.
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    66. Miller DR, Clark JA, Rogers WH, Skinner KM, Spiro A, Lee A, Kazis LE. The influence of place of administration on health-related quality-of-life assessments: findings from the Veterans Health Study. J Ambul Care Manage. 2005 Apr-Jun; 28(2):111-24.
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    67. Selim AJ, Fincke G, Berlowitz DR, Miller DR, Qian SX, Lee A, Cong Z, Rogers W, Selim BJ, Ren XS, Spiro A, Kazis LE. Comprehensive health status assessment of centenarians: results from the 1999 large health survey of veteran enrollees. J Gerontol A Biol Sci Med Sci. 2005 Apr; 60(4):515-9.
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    68. Mroczek DK, Spiro A. Change in life satisfaction during adulthood: findings from the veterans affairs normative aging study. J Pers Soc Psychol. 2005 Jan; 88(1):189-202.
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    69. Weisskopf MG, Wright RO, Schwartz J, Spiro A, Sparrow D, Aro A, Hu H. Cumulative lead exposure and prospective change in cognition among elderly men: the VA Normative Aging Study. Am J Epidemiol. 2004 Dec 15; 160(12):1184-93.
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    70. Eisen SV, Normand SL, Belanger AJ, Spiro A, Esch D. The Revised Behavior and Symptom Identification Scale (BASIS-R): reliability and validity. Med Care. 2004 Dec; 42(12):1230-41.
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    71. McArdle JJ, Hamgami F, Jones K, Jolesz F, Kikinis R, Spiro A, Albert MS. Structural modeling of dynamic changes in memory and brain structure using longitudinal data from the normative aging study. J Gerontol B Psychol Sci Soc Sci. 2004 Nov; 59(6):P294-304.
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    72. Connor LT, Spiro A, Obler LK, Albert ML. Change in object naming ability during adulthood. J Gerontol B Psychol Sci Soc Sci. 2004 Sep; 59(5):P203-9.
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    73. Selim AJ, Berlowitz DR, Fincke G, Cong Z, Rogers W, Haffer SC, Ren XS, Lee A, Qian SX, Miller DR, Spiro A, Selim BJ, Kazis LE. The health status of elderly veteran enrollees in the Veterans Health Administration. J Am Geriatr Soc. 2004 Aug; 52(8):1271-6.
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    74. Rogers WH, Kazis LE, Miller DR, Skinner KM, Clark JA, Spiro A, Fincke RG. Comparing the health status of VA and non-VA ambulatory patients: the veterans' health and medical outcomes studies. J Ambul Care Manage. 2004 Jul-Sep; 27(3):249-62.
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    75. Kazis LE, Miller DR, Clark JA, Skinner KM, Lee A, Ren XS, Spiro A, Rogers WH, Ware JE. Improving the response choices on the veterans SF-36 health survey role functioning scales: results from the Veterans Health Study. J Ambul Care Manage. 2004 Jul-Sep; 27(3):263-80.
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    76. Frayne SM, Seaver MR, Loveland S, Christiansen CL, Spiro A, Parker VA, Skinner KM. Burden of medical illness in women with depression and posttraumatic stress disorder. Arch Intern Med. 2004 Jun 28; 164(12):1306-12.
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    77. Charbonneau A, Rosen AK, Owen RR, Spiro A, Ash AS, Miller DR, Kazis L, Kader B, Cunningham F, Berlowitz DR. Monitoring depression care: in search of an accurate quality indicator. Med Care. 2004 Jun; 42(6):522-31.
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    78. Jones JA, Kressin NR, Miller DR, Orner MB, Garcia RI, Spiro A. Comparison of patient-based oral health outcome measures. Qual Life Res. 2004 Jun; 13(5):975-85.
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    79. Kalman D, Lee A, Chan E, Miller DR, Spiro A, Ren XS, Kazis LE. Alcohol dependence, other psychiatric disorders, and health-related quality of life: a replication study in a large random sample of enrollees in the Veterans Health Administration. Am J Drug Alcohol Abuse. 2004 May; 30(2):473-87.
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    80. Skinner KM, Miller DR, Spiro A, Kazis LE. Measurement strategies designed and tested in the Veterans Health Study. J Ambul Care Manage. 2004 Apr-Jun; 27(2):180-9.
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    81. Kazis LE, Miller DR, Skinner KM, Lee A, Ren XS, Clark JA, Rogers WH, Spiro A, Selim A, Linzer M, Payne SM, Mansell D, Fincke RG. Patient-reported measures of health: The Veterans Health Study. J Ambul Care Manage. 2004 Jan-Mar; 27(1):70-83.
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    82. Kazis LE, Lee A, Spiro A, Rogers W, Ren XS, Miller DR, Selim A, Hamed A, Haffer SC. Measurement comparisons of the medical outcomes study and veterans SF-36 health survey. Health Care Financ Rev. 2004; 25(4):43-58.
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    83. Wright RO, Tsaih SW, Schwartz J, Spiro A, McDonald K, Weiss ST, Hu H. Lead exposure biomarkers and mini-mental status exam scores in older men. Epidemiology. 2003 Nov; 14(6):713-8.
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    84. Rhodes D, Spiro A, Aro A, Hu H. Relationship of bone and blood lead levels to psychiatric symptoms: the normative aging study. J Occup Environ Med. 2003 Nov; 45(11):1144-51.
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    85. Mroczek DK, Spiro A. Personality structure and process, variance between and within: integration by means of a developmental framework. J Gerontol B Psychol Sci Soc Sci. 2003 Nov; 58(6):P305-6; author reply P311-2.
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    86. Todaro JF, Shen BJ, Niaura R, Spiro A, Ward KD. Effect of negative emotions on frequency of coronary heart disease (The Normative Aging Study). Am J Cardiol. 2003 Oct 15; 92(8):901-6.
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    87. Charbonneau A, Rosen AK, Ash AS, Owen RR, Kader B, Spiro A, Hankin C, Herz LR, Jo V Pugh M, Kazis L, Miller DR, Berlowitz DR. Measuring the quality of depression care in a large integrated health system. Med Care. 2003 May; 41(5):669-80.
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    88. Mroczek DK, Spiro A. Modeling intraindividual change in personality traits: findings from the normative aging study. J Gerontol B Psychol Sci Soc Sci. 2003 May; 58(3):P153-65.
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    89. Shen BJ, Todaro JF, Niaura R, McCaffery JM, Zhang J, Spiro A, Ward KD. Are metabolic risk factors one unified syndrome? Modeling the structure of the metabolic syndrome X. Am J Epidemiol. 2003 Apr 15; 157(8):701-11.
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    90. Kressin NR, Boehmer U, Nunn ME, Spiro A. Increased preventive practices lead to greater tooth retention. J Dent Res. 2003 Mar; 82(3):223-7.
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    91. Niaura RS, Stroud LR, Todaro J, Ward KD, Spiro A, Aldwin C, Landsberg L, Weiss ST. Associations between repression, general maladjustment, body weight, and body shape in older males: the Normative Aging Study. Int J Behav Med. 2003; 10(3):221-38.
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    92. Jones JA, Orner MB, Spiro A, Kressin NR. Tooth loss and dentures: patients' perspectives. Int Dent J. 2003; 53(5 Suppl):327-34.
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    93. Niaura R, Todaro JF, Stroud L, Spiro A, Ward KD, Weiss S. Hostility, the metabolic syndrome, and incident coronary heart disease. Health Psychol. 2002 Nov; 21(6):588-93.
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    94. Jones JA, Spiro A, Miller DR, Garcia RI, Kressin NR. Need for dental care in older veterans: assessment of patient-based measures. J Am Geriatr Soc. 2002 Jan; 50(1):163-8.
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    95. Kressin NR, Spiro A, Atchison KA, Kazis L, Jones JA. Is depressive symptomatology associated with worse oral functioning and well-being among older adults? J Public Health Dent. 2002; 62(1):5-12.
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    96. Kressin NR, Reisine S, Spiro A, Jones JA. Is negative affectivity associated with oral quality of life? Community Dent Oral Epidemiol. 2001 Dec; 29(6):412-23.
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    97. Boehmer U, Kressin NR, Spiro A, Garcia RI, Kazis L, Miller D, Randall CW, Jones JA. Oral health of ambulatory care patients. Mil Med. 2001 Feb; 166(2):171-8.
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    98. Jones JA, Kressin NR, Spiro A, Randall CW, Miller DR, Hayes C, Kazis L, Garcia RI. Self-reported and clinical oral health in users of VA health care. J Gerontol A Biol Sci Med Sci. 2001 Jan; 56(1):M55-62.
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    99. LoCastro J, Spiro A, Monnelly E, Ciraulo D. Personality, family history, and alcohol use among older men: the VA Normative Aging Study. Alcohol Clin Exp Res. 2000 Apr; 24(4):501-11.
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    100. Hankin CS, Spiro A, Miller DR, Kazis L. Mental disorders and mental health treatment among U.S. Department of Veterans Affairs outpatients: the Veterans Health Study. Am J Psychiatry. 1999 Dec; 156(12):1924-30.
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    101. Huntington NL, Krall EA, Garcia RI, Spiro A. SES and oral health status in an elderly population. Ann N Y Acad Sci. 1999; 896:451-4.
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    102. Clark JA, Spiro A, Fincke G, Miller DR, Kazis LE. Symptom severity of osteoarthritis of the knee: a patient-based measure developed in the veterans health study. J Gerontol A Biol Sci Med Sci. 1998 Sep; 53(5):M351-60.
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    103. Kazis LE, Miller DR, Clark J, Skinner K, Lee A, Rogers W, Spiro A, Payne S, Fincke G, Selim A, Linzer M. Health-related quality of life in patients served by the Department of Veterans Affairs: results from the Veterans Health Study. Arch Intern Med. 1998 Mar 23; 158(6):626-32.
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    104. Fincke BG, Miller DR, Spiro A. The interaction of patient perception of overmedication with drug compliance and side effects. J Gen Intern Med. 1998 Mar; 13(3):182-5.
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    105. Kressin N, Spiro A, Bosse R, Garcia R, Kazis L. Assessing oral health-related quality of life: findings from the normative aging study. Med Care. 1996 May; 34(5):416-27.
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    106. Spiro A, Aldwin CM, Ward KD, Mroczek DK. Personality and the incidence of hypertension among older men: longitudinal findings from the Normative Aging Study. Health Psychol. 1995 Nov; 14(6):563-9.
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    107. Spiro A, Schnurr PP, Aldwin CM. Combat-related posttraumatic stress disorder symptoms in older men. Psychol Aging. 1994 Mar; 9(1):17-26.
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    108. Bossé R, Aldwin CM, Levenson MR, Spiro A, Mroczek DK. Change in social support after retirement: longitudinal findings from the Normative Aging Study. J Gerontol. 1993 Jul; 48(4):P210-7.
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    109. Spiro A, Aldwin CM, Levenson MR, Bossé R. Longitudinal findings from the Normative Aging Study: II. Do emotionality and extraversion predict symptom change? J Gerontol. 1990 Jul; 45(4):P136-44.
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    110. Aldwin CM, Spiro A, Levenson MR, Bossé R. Longitudinal findings from the normative aging study: 1. Does mental health change with age? Psychol Aging. 1989 Sep; 4(3):295-306.
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    111. Aldwin CM, Levenson MR, Spiro A, Bossé R. Does emotionality predict stress? Findings from the normative aging study. J Pers Soc Psychol. 1989 Apr; 56(4):618-24.
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    112. Power MC, Weisskopf MG, Alexeeff SE, Wright RO, Coull BA, Spiro A, Schwartz J. Modification by hemochromatosis gene polymorphisms of the association between traffic-related air pollution and cognition in older men: a cohort study. Environ Health. 2013; 12:16.
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    113. Grashow R, Spiro A, Taylor KM, Newton K, Shrairman R, Landau A, Sparrow D, Hu H, Weisskopf M. Cumulative lead exposure in community-dwelling adults and fine motor function: Comparing standard and novel tasks in the VA Normative Aging Study. Neurotoxicology. 2013 Mar; 35:154-61.
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    114. Piccinin AM, Muniz-Terrera G, Clouston S, Reynolds CA, Thorvaldsson V, Deary IJ, Deeg DJ, Johansson B, Mackinnon A, Spiro A, Starr JM, Skoog I, Hofer SM. Coordinated Analysis of Age, Sex, and Education Effects on Change in MMSE Scores. J Gerontol B Psychol Sci Soc Sci. 2013 May; 68(3):374-90.
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    115. Cahana-Amitay D, Albert ML, Ojo EA, Sayers J, Goral M, Obler LK, Spiro A. Effects of hypertension and diabetes on sentence comprehension in aging. J Gerontol B Psychol Sci Soc Sci. 2013 Jul; 68(4):513-21.
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