The aim of this study was to validate the Dutch version of the Kessler-10 (K10) as well as an ext... more The aim of this study was to validate the Dutch version of the Kessler-10 (K10) as well as an extended version (EK10) in screening for depressive and anxiety disorders in primary care. Data are from 1607 participants (18 through 65 years, 68.8% female) of the Netherlands Study of Depression and Anxiety (NESDA), recruited from 65 general practitioners. Participants completed the K10,
We assessed the prevalence of subthreshold depression and anxiety, and major depressive, dysthymi... more We assessed the prevalence of subthreshold depression and anxiety, and major depressive, dysthymic, and anxiety disorders (panic disorder, agoraphobia, social phobia, and general anxiety disorder) in visually impaired older adults and compared these estimates with those of normally sighted peers. Cross-sectional data were analyzed based on telephone interviews with visually impaired older adults aged ≥ 60 years (n = 615) with a visual acuity of ≥ 0.30 logMAR (20/40 Snellen) in the best eye from outpatient low vision rehabilitation centers, and face-to-face interviews with community-dwelling normally sighted peers (n = 1232). To determine prevalence rates, the normally sighted population was weighted on sex and age to fit the visually impaired population. Logistic regression analyses were used to compare the populations and to correct for confounders. The prevalence of major depressive disorder (5.4%) and anxiety disorders (7.5%), as well as the prevalence of subthreshold depression (32.2%) and subthreshold anxiety (15.6%), were significantly higher in visually impaired older adults compared to their normally sighted peers (P < 0.05). Agoraphobia and social phobia were the most prevalent anxiety disorders in visually impaired older adults. This study shows that depression and anxiety are major public health problems in visually impaired older adults. Research on psychotherapeutic and psychopharmacologic interventions to improve depression and anxiety in this population is warranted. (http://www.trialregister.nl number, NTR3296.).
The aim of this study was to validate the Dutch version of the Kessler-10 (K10) as well as an ext... more The aim of this study was to validate the Dutch version of the Kessler-10 (K10) as well as an extended version (EK10) in screening for depressive and anxiety disorders in primary care. Data are from 1607 participants (18 through 65 years, 68.8% female) of the Netherlands Study of Depression and Anxiety (NESDA), recruited from 65 general practitioners. Participants completed the K10, extended with five additional questions focusing on core anxiety symptoms, and were evaluated with the WHO Composite International Diagnostic Interview (CIDI lifetime version 2.1) to assess DSM-IV disorders (major depressive disorder, dysthymia, generalized anxiety disorder, social phobia, panic disorder, agoraphobia). Reliability (Cronbach's α) of the Dutch K10 was 0.94. Based on Receiver Operating Characteristics (ROC) analysis, the area under the curve (AUC) for the K10 for any depressive and/or anxiety disorder was found to be 0.87. The extended questions on the EK10 significantly improved the detection of anxiety disorders in particular. With a cut-off point of 20, the K10 reached a sensitivity of 0.80 and a specificity of 0.81 for any depressive and/or anxiety disorder. For the EK10, a cut-off point of 20 and/or at least one positive answer on the additional questions provided a sensitivity of 0.90 and a specificity of 0.75 for detecting any depressive and/or anxiety disorder. The Dutch version of the K10 is appropriate for screening depressive disorders in primary care, while the EK10 is preferred in screening for both depressive and anxiety disorders.
ABSTRACT Depressie bij ouderen komt vaak voor, maar wordt nog altijd fors onderbehandeld. In dit ... more ABSTRACT Depressie bij ouderen komt vaak voor, maar wordt nog altijd fors onderbehandeld. In dit artikel wordt nader ingegaan op de oorzaken van deze onderbehandeling en worden adviezen gegeven voor herkenning en diagnostiek. Depressiediagnostiek bij ouderen met ernstige dementie blijft in dit artikel buiten beschouwing.
... When translation is from L2 to L1, the same route is tracked, but in the opposite direction, ... more ... When translation is from L2 to L1, the same route is tracked, but in the opposite direction, starting with access of the L2 word-form representation. Word translation in a concept-mediation structure could occur via the shared meaning representation in conceptual memory. ...
Background: Major Depressive Disorder (MDD) is common among elderly people. However, it appears t... more Background: Major Depressive Disorder (MDD) is common among elderly people. However, it appears that only a minority receives treatment. This study aims to identify and analyse the factors that determine whether elderly people with depressive disorders have contact with health care professionals for mental problems. Method: Cross-sectional analysis of cohort data collected in the Netherlands Study of Depression in Older persons (NESDO) and the Netherlands Study of Depression and Anxiety (NESDA) among 167 respondents aged Z 55 with a depressive disorder as indicated by the CIDI. Contacts for mental health problems during the past six months (TiC-P), and indicators of predisposing, enabling, and objective need factors were assessed by interview. Results: Of the total sample, 70% had contact for mental health problems, almost entirely within primary care (62%). The odds of having contact increased with advancing age; for respondents born in the Netherlands; for those who felt less lonely; and for those with a higher household income. Limitations: Our study is based on base-line interviews and thus has a cross-sectional character. Therefore, causal conclusions cannot be drawn. Furthermore, we studied the respondents' perception whether mental health care was received.
Alzheimer disease (AD) is a complex disorder with a strong heritable component. Amyloid pathology... more Alzheimer disease (AD) is a complex disorder with a strong heritable component. Amyloid pathology, vascular factors, and inflammation are postulated to be involved in its pathogenesis, but causality has not been established unequivocally. To identify heritable traits in middle age that contribute to AD. We used a proven family design, comparing middle-aged offspring with and without a parental history of AD. In such a design, the offspring under study are enriched for risk factors of AD but do not yet have the disease. The Netherlands. Two hundred six offspring of 92 families with a parental history of late-onset AD and 200 offspring of 97 families without a parental history of AD. The APOE epsilon4 genotype, vascular factors, production capacity of pro- and anti-inflammatory cytokines upon stimulation with lipopolysaccharide, and circulating markers of inflammation. All outcome measures were assessed in the offspring only and not in the parental generation. More offspring with a parental history of AD carried APOE epsilon4 than those without a parental history of the disease (47% vs 21%, P < .001). Those with a parental history of AD also had higher systolic blood pressures (P = .006), higher diastolic blood pressures (P < .001), and lower ankle brachial indices (P = .005) when compared with offspring without a family history of dementia. Production capacity of pro-inflammatory cytokines in offspring with a parental history of AD was also different, with higher levels of IL-1beta (interleukin 1beta) (P < .001), IL-1beta to IL-1ra ratio (P < .001), tumor necrosis factor alpha (P = .008), IL-6 (P = .04), and interferon gamma (P = .01). All of these positive associations were independent of APOE epsilon4 genotype. Hypertension and the expression of an innate pro-inflammatory cytokine profile in middle age are early risk factors of AD in old age. For the offspring of affected families, it provides clues for screening and preventive strategies, of which blood pressure control can be implemented directly.
Depressive symptoms frequently accompany schizophrenia. Older patients constitute the fastest gro... more Depressive symptoms frequently accompany schizophrenia. Older patients constitute the fastest growing segment of the schizophrenia population. With regard to the risk factors associated with depression, it is uncertain to which extent older schizophrenia patients differ from their age peers in the community. We assessed self-reported depressive symptoms in an epidemiological sample of older Dutch community-living patients with schizophrenia or schizoaffective disorder (N=99; mean age 67years). Demographic, clinical and social variables were evaluated for their predictive value on the level of depressive symptoms. A comparison group, proportionally matched for age and gender, was recruited from a community study. In the schizophrenia group, 47.5% reported depressive symptoms at a level indicating clinically relevant depression, in contrast to 12.1% in their age peers (odds ratio 6.55; 95% CI, 3.19-13.48; p<0.001). This difference could not be explained by differential exposure to ...
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2009
Late onset disorders are often associated with cerebral disfunctioning and cognitive impairment i... more Late onset disorders are often associated with cerebral disfunctioning and cognitive impairment in elderly patients. It is unknown whether the age of onset affects cognition in patients with bipolar disorder. The authors compare cognition and clinical characteristics of early- and late-onset bipolar patients in a stable and euthymic condition. One hundred and nineteen older patients (age >60) with an early- (<40 years) or late-onset bipolar disorder and a group of 78 comparison subjects were extensively tested for cognitive functioning. Bipolar subjects scored lower on most cognitive measures. The late-onset patients were more impaired in psychomotor performance and mental flexibility than the early-onset patients. These differences could not be explained by differences in exposure to cerebrovascular risk factors. Older patients with bipolar disorder have substantial cognitive impairments. Late onset bipolar disorder is associated with more severe cognitive impairment than ear...
Journal of geriatric psychiatry and neurology, Jan 26, 2014
To examine whether persons who experienced adverse childhood events or recent negative life event... more To examine whether persons who experienced adverse childhood events or recent negative life events have a worse cognitive performance and faster cognitive decline and the role of depression and apolipoprotein E-∊4 in this relationship. The community-based sample consisted of 10-year follow-up data of 1312 persons participating in the Longitudinal Aging Study Amsterdam (age range 65-85 years). Persons who experienced adverse childhood events showed a faster 10-year decline in processing speed but only when depressive symptoms were experienced. Persons with more recent negative life events showed slower processing speed at baseline but no faster decline. Childhood adversity may cause biological or psychological vulnerability, which is associated with both depressive symptoms and cognitive decline in later life. The accumulation of recent negative life events did not affect cognitive functioning over a longer time period.
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2009
High-cortisol levels in depressed persons could possibly give rise to the metabolic syndrome. Thi... more High-cortisol levels in depressed persons could possibly give rise to the metabolic syndrome. This study investigated cross-sectionally whether depression and high-cortisol levels increased the odds of metabolic syndrome in an older community-based sample. In 1,212 participants, aged > or =65 years, enrolled in the Longitudinal Aging Study Amsterdam, depression (major [1-month diagnosis] or subthreshold [no 1-month diagnosis, but symptoms]), metabolic syndrome (modified Adult Treatment Panel III criteria), and free cortisol index (total serum cortisol/cortisol binding globulin) were assessed. Major depression was not associated with the metabolic syndrome (odds ratio [OR] = 1.16, 95% confidence interval [CI] = 0.54-2.49), but subthreshold depression was associated with a decreased odds (OR = 0.55, 95% CI = 0.37-0.82). Persons with higher levels of free cortisol index showed a higher odds of metabolic syndrome (OR per standard deviation increase = 1.21, 95% CI = 1.06-1.39). As per...
OBJECTIVES: (1) To assess the prevalence and the consequences of chronic verbal aggression, physi... more OBJECTIVES: (1) To assess the prevalence and the consequences of chronic verbal aggression, physical aggression, financial mistreatment, and neglect in a community-based sample;
Late-life depression and pain more often co-occur than can be explained by chance. Determinants o... more Late-life depression and pain more often co-occur than can be explained by chance. Determinants of pain in late-life depression are unknown, even though knowledge on possible determinants of pain in depression is important for clinical practice. Therefore, the objectives of the present study were 1) to describe pain characteristics of depressed older adults and a nondepressed comparison group, and 2) to explore physical, lifestyle, psychological, and social determinants of acute and chronic pain intensity, disability, and multisite pain in depressed older adults. Data from the Netherlands Study of Depression in Older Persons cohort, consisting of 378 depressed persons, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria, and 132 nondepressed persons aged 60 years and older, were used in a cross-sectional design. Pain characteristics were measured by the Chronic Graded Pain Scale. Multiple linear regression analyses were performed to explore the contribution of physical, lifestyle, psychological, and social determinants to outcomes pain intensity, disability, and the number of pain locations. Depressed older adults more often reported chronic pain and experienced their pain as more intense and disabling compared to nondepressed older adults. Adjusted for demographic, physical, and lifestyle characteristics, multinomial logistic regression analyses showed increased odds ratios (OR) for depression in acute pain (OR 3.010; P=0.005) and chronic pain (OR 4.544, P&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). In addition, linear regression analyses showed that acute and chronic pain intensity, disability, and multisite pain were associated with several biopsychosocial determinants, of which anxiety was most pronounced. Further research could focus on the temporal relationship between anxiety, late-life depression, and pain.
A consistent finding is that elderly people obtain higher scores on social desirability (SD) scal... more A consistent finding is that elderly people obtain higher scores on social desirability (SD) scales than younger ones. It is usually assumed that elderly people are more eager to present themselves in a favourable way. Hence, especially in survey-research among the elderly, it is common practice to include SD-scales to correct for spurious relationships. In this article it is argued that the assumptions underlying such practice are doubtful, because SD-scores may be affected by a variety of factors but the tendency to present oneself favourably. Two such factors related to the questionanswering process are discussed in more detail. Empirical support is provided that these factors may explain the relationship between the score on a SD-scale and age. It is argued that using SD-scales to correct for relationships between variables, may lead to erroneous results.
To examine the association of employment status and characteristics with prevalent and incident m... more To examine the association of employment status and characteristics with prevalent and incident memory complaints (MC) in 55-64-year-olds.
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2014
Transient cognitive impairment during electroconvulsive therapy (ECT) can be a reason to disconti... more Transient cognitive impairment during electroconvulsive therapy (ECT) can be a reason to discontinue ECT in depressed elderly patients. We hypothesized that both white matter hyperintensities and medial temporal lobe atrophy contribute to transient cognitive impairment during ECT. In 81 elderly patients with depression, magnetic resonance images (MRI) were recorded before ECT. We rated white matter hyperintensities (WMH) with the Age-Related White Matter Changes scale (ARWMC). Cognitive impairment during ECT was measured weekly with the Mini Mental State Examination (MMSE), 2 days after each session. The mean MMSE score at baseline for all patients was 25.5 points, the lowest MMSE score during ECT was 23.3 points, and the mean MMSE score after ECT was 26.3 points. Stratification for the ECT method showed no significant difference in the lowest MMSE scores of patients with or without WMH, receiving unilateral ECT (22.5 points versus 23.9 points). There was a difference in the lowest ...
Longitudinal data were used from a large, community-based random from a large, community-based ra... more Longitudinal data were used from a large, community-based random from a large, community-based random sample ( sample (n n¼3107) of older men and women 3107) of older men and women (55^85 years) inThe Netherlands, with a (55^85 years) inThe Netherlands, with a follow-up period of 7.5 years. Anxiety follow-up period of 7.5 years. Anxiety disorders were assessed according to disorders
The American Journal of Geriatric Psychiatry, 2015
Objectives: Investigating whether cognitive functioning is associated with the perception of one'... more Objectives: Investigating whether cognitive functioning is associated with the perception of one's sexuality in old age. Design: Cross-sectional analysis, using observation cycle 2005/2006 of the population-based prospective cohort of the Longitudinal Aging Study Amsterdam. Setting: Municipal registries in three Dutch regions. Participants: 1,908 older adults (mean [standard deviation] age: 71 [8.87] years; 54% women). Measurements: Sexuality and intimacy were assessed using four questions. Four cognitive domains were assessed: general cognitive functioning (MinieMental State Examination), memory performance (Auditory Verbal Learning Test), processing speed (Coding , and fluid intelligence (Raven's Coloured Progressive Matrices). Multinomial regression analysis was used, with sexuality as outcome. The interaction effect between gender and sexuality was also tested. Results: Lower fluid intelligence was associated with perceiving sexuality as unimportant; lower general cognitive functioning was associated with perceiving sexuality as unimportant; and lower immediate memory recall was associated with evaluating sexual life as unpleasant. Associations were also found between lower fluid intelligence, processing speed, and general cognitive functioning, and agreeing with sexuality no longer being important. Lower processing speed, general cognitive functioning, and delayed memory recall were associated with disagreeing with a remaining need for intimacy when getting older. Finally, the association between fluid intelligence and perceiving sexuality as important, and the association between immediate memory recall score and evaluating sexual life as pleasant, was only significant in women. The association between lower general cognitive functioning and perceiving sexuality as unimportant seemed stronger in women compared with men. Conclusions: Higher cognitive functioning was associated with the way in which older people perceive their current sexuality. (Am J Geriatr Psychiatry 2013; -:-e-)
Journal of the American Medical Directors Association, Jan 27, 2015
Late-life depression and physical frailty are supposed to be reciprocally associated, however, lo... more Late-life depression and physical frailty are supposed to be reciprocally associated, however, longitudinal studies are lacking. This study examines whether physical frailty predicts a higher incidence of depression, as well as a less favorable course of depression. A population-based cohort study of 888 people aged 65 years and over with follow-up measures at 3, 6, and 9 years. Cox proportional hazards models adjusted for age, sex, education, smoking, alcohol usage, and global cognitive functioning were applied to calculate the incidence of depressed mood in those nondepressed at baseline (n = 699) and remission in those with depressed mood at baseline (n = 189). Depressed mood onset or remission was defined as crossing the cut-off score of 20 points on the Center for Epidemiological Studies-Depression Scale combined with a relevant change in this score. Physical frailty was based on the presence of ≥3 out of 5 components (ie, weight loss, weakness, slowness, exhaustion, and low ph...
Objective: Depression among older adults is associated with both disability and somatic disease. ... more Objective: Depression among older adults is associated with both disability and somatic disease. We aimed to further understand this complicated relationship and to study the possible modifying effect of increasing age. Design: Cross sectional survey. Setting: Outpatient and inpatient clinics of regional facilities for mental health care and primary care. Participants: Elderly people, 60 years and older, 378 persons meeting DSM-IV criteria for a depressive disorder and 132 non-depressed comparisons. Measurements: Depression diagnoses were assessed with the CIDI version 2.1. Disability was assessed with the WHO Disability Assessment Schedule (WHODAS). Social-demographic information and somatic diseases were assessed by self-report measurements. Results: Disability, in general and on all its subscales, was strongly related to depression. Presence of somatic disease did not contribute independently to variance in depression. The relationship was stronger for people of 60-69 years old than for those older than 70 years. Important aspects of disability that contributed to depression were disability in participation, self-care and social activities. Limitations: Results are based on cross sectional data. No inferences about causal relationships can be drawn. Conclusion: Disability, especially disability regarding participation, self-care, or social activities is strongly related to late-life depression. Somatic diseases in itself are less of a risk for depression, except that somatic diseases are related to disability.
The aim of this study was to validate the Dutch version of the Kessler-10 (K10) as well as an ext... more The aim of this study was to validate the Dutch version of the Kessler-10 (K10) as well as an extended version (EK10) in screening for depressive and anxiety disorders in primary care. Data are from 1607 participants (18 through 65 years, 68.8% female) of the Netherlands Study of Depression and Anxiety (NESDA), recruited from 65 general practitioners. Participants completed the K10,
We assessed the prevalence of subthreshold depression and anxiety, and major depressive, dysthymi... more We assessed the prevalence of subthreshold depression and anxiety, and major depressive, dysthymic, and anxiety disorders (panic disorder, agoraphobia, social phobia, and general anxiety disorder) in visually impaired older adults and compared these estimates with those of normally sighted peers. Cross-sectional data were analyzed based on telephone interviews with visually impaired older adults aged ≥ 60 years (n = 615) with a visual acuity of ≥ 0.30 logMAR (20/40 Snellen) in the best eye from outpatient low vision rehabilitation centers, and face-to-face interviews with community-dwelling normally sighted peers (n = 1232). To determine prevalence rates, the normally sighted population was weighted on sex and age to fit the visually impaired population. Logistic regression analyses were used to compare the populations and to correct for confounders. The prevalence of major depressive disorder (5.4%) and anxiety disorders (7.5%), as well as the prevalence of subthreshold depression (32.2%) and subthreshold anxiety (15.6%), were significantly higher in visually impaired older adults compared to their normally sighted peers (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Agoraphobia and social phobia were the most prevalent anxiety disorders in visually impaired older adults. This study shows that depression and anxiety are major public health problems in visually impaired older adults. Research on psychotherapeutic and psychopharmacologic interventions to improve depression and anxiety in this population is warranted. (http://www.trialregister.nl number, NTR3296.).
The aim of this study was to validate the Dutch version of the Kessler-10 (K10) as well as an ext... more The aim of this study was to validate the Dutch version of the Kessler-10 (K10) as well as an extended version (EK10) in screening for depressive and anxiety disorders in primary care. Data are from 1607 participants (18 through 65 years, 68.8% female) of the Netherlands Study of Depression and Anxiety (NESDA), recruited from 65 general practitioners. Participants completed the K10, extended with five additional questions focusing on core anxiety symptoms, and were evaluated with the WHO Composite International Diagnostic Interview (CIDI lifetime version 2.1) to assess DSM-IV disorders (major depressive disorder, dysthymia, generalized anxiety disorder, social phobia, panic disorder, agoraphobia). Reliability (Cronbach's α) of the Dutch K10 was 0.94. Based on Receiver Operating Characteristics (ROC) analysis, the area under the curve (AUC) for the K10 for any depressive and/or anxiety disorder was found to be 0.87. The extended questions on the EK10 significantly improved the detection of anxiety disorders in particular. With a cut-off point of 20, the K10 reached a sensitivity of 0.80 and a specificity of 0.81 for any depressive and/or anxiety disorder. For the EK10, a cut-off point of 20 and/or at least one positive answer on the additional questions provided a sensitivity of 0.90 and a specificity of 0.75 for detecting any depressive and/or anxiety disorder. The Dutch version of the K10 is appropriate for screening depressive disorders in primary care, while the EK10 is preferred in screening for both depressive and anxiety disorders.
ABSTRACT Depressie bij ouderen komt vaak voor, maar wordt nog altijd fors onderbehandeld. In dit ... more ABSTRACT Depressie bij ouderen komt vaak voor, maar wordt nog altijd fors onderbehandeld. In dit artikel wordt nader ingegaan op de oorzaken van deze onderbehandeling en worden adviezen gegeven voor herkenning en diagnostiek. Depressiediagnostiek bij ouderen met ernstige dementie blijft in dit artikel buiten beschouwing.
... When translation is from L2 to L1, the same route is tracked, but in the opposite direction, ... more ... When translation is from L2 to L1, the same route is tracked, but in the opposite direction, starting with access of the L2 word-form representation. Word translation in a concept-mediation structure could occur via the shared meaning representation in conceptual memory. ...
Background: Major Depressive Disorder (MDD) is common among elderly people. However, it appears t... more Background: Major Depressive Disorder (MDD) is common among elderly people. However, it appears that only a minority receives treatment. This study aims to identify and analyse the factors that determine whether elderly people with depressive disorders have contact with health care professionals for mental problems. Method: Cross-sectional analysis of cohort data collected in the Netherlands Study of Depression in Older persons (NESDO) and the Netherlands Study of Depression and Anxiety (NESDA) among 167 respondents aged Z 55 with a depressive disorder as indicated by the CIDI. Contacts for mental health problems during the past six months (TiC-P), and indicators of predisposing, enabling, and objective need factors were assessed by interview. Results: Of the total sample, 70% had contact for mental health problems, almost entirely within primary care (62%). The odds of having contact increased with advancing age; for respondents born in the Netherlands; for those who felt less lonely; and for those with a higher household income. Limitations: Our study is based on base-line interviews and thus has a cross-sectional character. Therefore, causal conclusions cannot be drawn. Furthermore, we studied the respondents' perception whether mental health care was received.
Alzheimer disease (AD) is a complex disorder with a strong heritable component. Amyloid pathology... more Alzheimer disease (AD) is a complex disorder with a strong heritable component. Amyloid pathology, vascular factors, and inflammation are postulated to be involved in its pathogenesis, but causality has not been established unequivocally. To identify heritable traits in middle age that contribute to AD. We used a proven family design, comparing middle-aged offspring with and without a parental history of AD. In such a design, the offspring under study are enriched for risk factors of AD but do not yet have the disease. The Netherlands. Two hundred six offspring of 92 families with a parental history of late-onset AD and 200 offspring of 97 families without a parental history of AD. The APOE epsilon4 genotype, vascular factors, production capacity of pro- and anti-inflammatory cytokines upon stimulation with lipopolysaccharide, and circulating markers of inflammation. All outcome measures were assessed in the offspring only and not in the parental generation. More offspring with a parental history of AD carried APOE epsilon4 than those without a parental history of the disease (47% vs 21%, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001). Those with a parental history of AD also had higher systolic blood pressures (P = .006), higher diastolic blood pressures (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001), and lower ankle brachial indices (P = .005) when compared with offspring without a family history of dementia. Production capacity of pro-inflammatory cytokines in offspring with a parental history of AD was also different, with higher levels of IL-1beta (interleukin 1beta) (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001), IL-1beta to IL-1ra ratio (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; .001), tumor necrosis factor alpha (P = .008), IL-6 (P = .04), and interferon gamma (P = .01). All of these positive associations were independent of APOE epsilon4 genotype. Hypertension and the expression of an innate pro-inflammatory cytokine profile in middle age are early risk factors of AD in old age. For the offspring of affected families, it provides clues for screening and preventive strategies, of which blood pressure control can be implemented directly.
Depressive symptoms frequently accompany schizophrenia. Older patients constitute the fastest gro... more Depressive symptoms frequently accompany schizophrenia. Older patients constitute the fastest growing segment of the schizophrenia population. With regard to the risk factors associated with depression, it is uncertain to which extent older schizophrenia patients differ from their age peers in the community. We assessed self-reported depressive symptoms in an epidemiological sample of older Dutch community-living patients with schizophrenia or schizoaffective disorder (N=99; mean age 67years). Demographic, clinical and social variables were evaluated for their predictive value on the level of depressive symptoms. A comparison group, proportionally matched for age and gender, was recruited from a community study. In the schizophrenia group, 47.5% reported depressive symptoms at a level indicating clinically relevant depression, in contrast to 12.1% in their age peers (odds ratio 6.55; 95% CI, 3.19-13.48; p<0.001). This difference could not be explained by differential exposure to ...
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2009
Late onset disorders are often associated with cerebral disfunctioning and cognitive impairment i... more Late onset disorders are often associated with cerebral disfunctioning and cognitive impairment in elderly patients. It is unknown whether the age of onset affects cognition in patients with bipolar disorder. The authors compare cognition and clinical characteristics of early- and late-onset bipolar patients in a stable and euthymic condition. One hundred and nineteen older patients (age >60) with an early- (<40 years) or late-onset bipolar disorder and a group of 78 comparison subjects were extensively tested for cognitive functioning. Bipolar subjects scored lower on most cognitive measures. The late-onset patients were more impaired in psychomotor performance and mental flexibility than the early-onset patients. These differences could not be explained by differences in exposure to cerebrovascular risk factors. Older patients with bipolar disorder have substantial cognitive impairments. Late onset bipolar disorder is associated with more severe cognitive impairment than ear...
Journal of geriatric psychiatry and neurology, Jan 26, 2014
To examine whether persons who experienced adverse childhood events or recent negative life event... more To examine whether persons who experienced adverse childhood events or recent negative life events have a worse cognitive performance and faster cognitive decline and the role of depression and apolipoprotein E-∊4 in this relationship. The community-based sample consisted of 10-year follow-up data of 1312 persons participating in the Longitudinal Aging Study Amsterdam (age range 65-85 years). Persons who experienced adverse childhood events showed a faster 10-year decline in processing speed but only when depressive symptoms were experienced. Persons with more recent negative life events showed slower processing speed at baseline but no faster decline. Childhood adversity may cause biological or psychological vulnerability, which is associated with both depressive symptoms and cognitive decline in later life. The accumulation of recent negative life events did not affect cognitive functioning over a longer time period.
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2009
High-cortisol levels in depressed persons could possibly give rise to the metabolic syndrome. Thi... more High-cortisol levels in depressed persons could possibly give rise to the metabolic syndrome. This study investigated cross-sectionally whether depression and high-cortisol levels increased the odds of metabolic syndrome in an older community-based sample. In 1,212 participants, aged > or =65 years, enrolled in the Longitudinal Aging Study Amsterdam, depression (major [1-month diagnosis] or subthreshold [no 1-month diagnosis, but symptoms]), metabolic syndrome (modified Adult Treatment Panel III criteria), and free cortisol index (total serum cortisol/cortisol binding globulin) were assessed. Major depression was not associated with the metabolic syndrome (odds ratio [OR] = 1.16, 95% confidence interval [CI] = 0.54-2.49), but subthreshold depression was associated with a decreased odds (OR = 0.55, 95% CI = 0.37-0.82). Persons with higher levels of free cortisol index showed a higher odds of metabolic syndrome (OR per standard deviation increase = 1.21, 95% CI = 1.06-1.39). As per...
OBJECTIVES: (1) To assess the prevalence and the consequences of chronic verbal aggression, physi... more OBJECTIVES: (1) To assess the prevalence and the consequences of chronic verbal aggression, physical aggression, financial mistreatment, and neglect in a community-based sample;
Late-life depression and pain more often co-occur than can be explained by chance. Determinants o... more Late-life depression and pain more often co-occur than can be explained by chance. Determinants of pain in late-life depression are unknown, even though knowledge on possible determinants of pain in depression is important for clinical practice. Therefore, the objectives of the present study were 1) to describe pain characteristics of depressed older adults and a nondepressed comparison group, and 2) to explore physical, lifestyle, psychological, and social determinants of acute and chronic pain intensity, disability, and multisite pain in depressed older adults. Data from the Netherlands Study of Depression in Older Persons cohort, consisting of 378 depressed persons, diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria, and 132 nondepressed persons aged 60 years and older, were used in a cross-sectional design. Pain characteristics were measured by the Chronic Graded Pain Scale. Multiple linear regression analyses were performed to explore the contribution of physical, lifestyle, psychological, and social determinants to outcomes pain intensity, disability, and the number of pain locations. Depressed older adults more often reported chronic pain and experienced their pain as more intense and disabling compared to nondepressed older adults. Adjusted for demographic, physical, and lifestyle characteristics, multinomial logistic regression analyses showed increased odds ratios (OR) for depression in acute pain (OR 3.010; P=0.005) and chronic pain (OR 4.544, P&amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). In addition, linear regression analyses showed that acute and chronic pain intensity, disability, and multisite pain were associated with several biopsychosocial determinants, of which anxiety was most pronounced. Further research could focus on the temporal relationship between anxiety, late-life depression, and pain.
A consistent finding is that elderly people obtain higher scores on social desirability (SD) scal... more A consistent finding is that elderly people obtain higher scores on social desirability (SD) scales than younger ones. It is usually assumed that elderly people are more eager to present themselves in a favourable way. Hence, especially in survey-research among the elderly, it is common practice to include SD-scales to correct for spurious relationships. In this article it is argued that the assumptions underlying such practice are doubtful, because SD-scores may be affected by a variety of factors but the tendency to present oneself favourably. Two such factors related to the questionanswering process are discussed in more detail. Empirical support is provided that these factors may explain the relationship between the score on a SD-scale and age. It is argued that using SD-scales to correct for relationships between variables, may lead to erroneous results.
To examine the association of employment status and characteristics with prevalent and incident m... more To examine the association of employment status and characteristics with prevalent and incident memory complaints (MC) in 55-64-year-olds.
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2014
Transient cognitive impairment during electroconvulsive therapy (ECT) can be a reason to disconti... more Transient cognitive impairment during electroconvulsive therapy (ECT) can be a reason to discontinue ECT in depressed elderly patients. We hypothesized that both white matter hyperintensities and medial temporal lobe atrophy contribute to transient cognitive impairment during ECT. In 81 elderly patients with depression, magnetic resonance images (MRI) were recorded before ECT. We rated white matter hyperintensities (WMH) with the Age-Related White Matter Changes scale (ARWMC). Cognitive impairment during ECT was measured weekly with the Mini Mental State Examination (MMSE), 2 days after each session. The mean MMSE score at baseline for all patients was 25.5 points, the lowest MMSE score during ECT was 23.3 points, and the mean MMSE score after ECT was 26.3 points. Stratification for the ECT method showed no significant difference in the lowest MMSE scores of patients with or without WMH, receiving unilateral ECT (22.5 points versus 23.9 points). There was a difference in the lowest ...
Longitudinal data were used from a large, community-based random from a large, community-based ra... more Longitudinal data were used from a large, community-based random from a large, community-based random sample ( sample (n n¼3107) of older men and women 3107) of older men and women (55^85 years) inThe Netherlands, with a (55^85 years) inThe Netherlands, with a follow-up period of 7.5 years. Anxiety follow-up period of 7.5 years. Anxiety disorders were assessed according to disorders
The American Journal of Geriatric Psychiatry, 2015
Objectives: Investigating whether cognitive functioning is associated with the perception of one'... more Objectives: Investigating whether cognitive functioning is associated with the perception of one's sexuality in old age. Design: Cross-sectional analysis, using observation cycle 2005/2006 of the population-based prospective cohort of the Longitudinal Aging Study Amsterdam. Setting: Municipal registries in three Dutch regions. Participants: 1,908 older adults (mean [standard deviation] age: 71 [8.87] years; 54% women). Measurements: Sexuality and intimacy were assessed using four questions. Four cognitive domains were assessed: general cognitive functioning (MinieMental State Examination), memory performance (Auditory Verbal Learning Test), processing speed (Coding , and fluid intelligence (Raven's Coloured Progressive Matrices). Multinomial regression analysis was used, with sexuality as outcome. The interaction effect between gender and sexuality was also tested. Results: Lower fluid intelligence was associated with perceiving sexuality as unimportant; lower general cognitive functioning was associated with perceiving sexuality as unimportant; and lower immediate memory recall was associated with evaluating sexual life as unpleasant. Associations were also found between lower fluid intelligence, processing speed, and general cognitive functioning, and agreeing with sexuality no longer being important. Lower processing speed, general cognitive functioning, and delayed memory recall were associated with disagreeing with a remaining need for intimacy when getting older. Finally, the association between fluid intelligence and perceiving sexuality as important, and the association between immediate memory recall score and evaluating sexual life as pleasant, was only significant in women. The association between lower general cognitive functioning and perceiving sexuality as unimportant seemed stronger in women compared with men. Conclusions: Higher cognitive functioning was associated with the way in which older people perceive their current sexuality. (Am J Geriatr Psychiatry 2013; -:-e-)
Journal of the American Medical Directors Association, Jan 27, 2015
Late-life depression and physical frailty are supposed to be reciprocally associated, however, lo... more Late-life depression and physical frailty are supposed to be reciprocally associated, however, longitudinal studies are lacking. This study examines whether physical frailty predicts a higher incidence of depression, as well as a less favorable course of depression. A population-based cohort study of 888 people aged 65 years and over with follow-up measures at 3, 6, and 9 years. Cox proportional hazards models adjusted for age, sex, education, smoking, alcohol usage, and global cognitive functioning were applied to calculate the incidence of depressed mood in those nondepressed at baseline (n = 699) and remission in those with depressed mood at baseline (n = 189). Depressed mood onset or remission was defined as crossing the cut-off score of 20 points on the Center for Epidemiological Studies-Depression Scale combined with a relevant change in this score. Physical frailty was based on the presence of ≥3 out of 5 components (ie, weight loss, weakness, slowness, exhaustion, and low ph...
Objective: Depression among older adults is associated with both disability and somatic disease. ... more Objective: Depression among older adults is associated with both disability and somatic disease. We aimed to further understand this complicated relationship and to study the possible modifying effect of increasing age. Design: Cross sectional survey. Setting: Outpatient and inpatient clinics of regional facilities for mental health care and primary care. Participants: Elderly people, 60 years and older, 378 persons meeting DSM-IV criteria for a depressive disorder and 132 non-depressed comparisons. Measurements: Depression diagnoses were assessed with the CIDI version 2.1. Disability was assessed with the WHO Disability Assessment Schedule (WHODAS). Social-demographic information and somatic diseases were assessed by self-report measurements. Results: Disability, in general and on all its subscales, was strongly related to depression. Presence of somatic disease did not contribute independently to variance in depression. The relationship was stronger for people of 60-69 years old than for those older than 70 years. Important aspects of disability that contributed to depression were disability in participation, self-care and social activities. Limitations: Results are based on cross sectional data. No inferences about causal relationships can be drawn. Conclusion: Disability, especially disability regarding participation, self-care, or social activities is strongly related to late-life depression. Somatic diseases in itself are less of a risk for depression, except that somatic diseases are related to disability.
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Papers by Hannie Comijs