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- Brinda, Ethel M., et al.
(författare)
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Health, Social, and Economic Variables Associated with Depression Among Older People in Low and Middle Income Countries : World Health Organization Study on Global AGEing and Adult Health
- 2016
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Ingår i: American Journal of Geriatric Psychiatry. - : Elsevier BV. - 1064-7481. ; 24:12, s. 1196-1208
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Tidskriftsartikel (refereegranskat)abstract
- Objective Although depression among older people is an important public health problem worldwide, systematic studies evaluating its prevalence and determinants in low and middle income countries (LMICs) are sparse. The biopsychosocial model of depression and prevailing socioeconomic hardships for older people in LMICs have provided the impetus to determine the prevalence of geriatric depression; to study its associations with health, social, and economic variables; and to investigate socioeconomic inequalities in depression prevalence in LMICs. Methods The authors accessed the World Health Organization Study on Global AGEing and Adult Health Wave 1 data that studied nationally representative samples from six large LMICs (N = 14,877). A computerized algorithm derived depression diagnoses. The authors assessed hypothesized associations using survey multivariate logistic regression models for each LMIC and pooled their risk estimates by meta-analyses and investigated related socioeconomic inequalities using concentration indices. Results Cross-national prevalence of geriatric depression was 4.7% (95% CI: 1.9%–11.9%). Female gender, illiteracy, poverty, indebtedness, past informal-sector occupation, bereavement, angina, and stroke had significant positive associations, whereas pension support and health insurance showed significant negative associations with geriatric depression. Pro-poor inequality of geriatric depression were documented in five LMICs. Conclusions Socioeconomic factors and related inequalities may predispose, precipitate, or perpetuate depression amongolder people in LMICs. Relative absence of health safety net places socioeconomically disadvantaged older people in LMICs at risk. The need for population-based public health interventions and policies to prevent and to manage geriatric depression effectively in LMICs cannot be overemphasized.
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| 3. |
- Chan, Carol K, et al.
(författare)
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Association of Depressive Symptoms With Postoperative Delirium and CSF Biomarkers for Alzheimer's Disease Among Hip Fracture Patients.
- 2021
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Ingår i: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - : Elsevier BV. - 1545-7214. ; 29:12, s. 1212-1221
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Tidskriftsartikel (refereegranskat)abstract
- While there is growing evidence of an association between depressive symptoms and postoperative delirium, the underlying pathophysiological mechanisms remain unknown. The goal of this study was to explore the association between depression and postoperative delirium in hip fracture patients, and to examine Alzheimer's disease (AD) pathology as a potential underlying mechanism linking depressive symptoms and delirium.Patients 65 years old or older (N = 199) who were undergoing hip fracture repair and enrolled in the study "A Strategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients" completed the 15-item Geriatric Depression Scale (GDS-15) preoperatively. Cerebrospinal fluid (CSF) was obtained during spinal anesthesia and assayed for amyloid-beta (Aβ) 40, 42, total tau (t-tau), and phosphorylated tau (p-tau)181.For every one point increase in GDS-15, there was a 13% increase in odds of postoperative delirium, adjusted for baseline cognition (MMSE), age, sex, race, education and CSF AD biomarkers (OR = 1.13, 95%CI = 1.02-1.25). Both CSF Aβ42/t-tau (β = -1.52, 95%CI = -2.1 to -0.05) and Aβ42/p-tau181 (β = -0.29, 95%CI = -0.48 to -0.09) were inversely associated with higher GDS-15 scores, where lower ratios indicate greater AD pathology. In an analysis to identify the strongest predictors of delirium out of 18 variables, GDS-15 had the highest classification accuracy for postoperative delirium and was a stronger predictor of delirium than both cognition and AD biomarkers.In older adults undergoing hip fracture repair, depressive symptoms were associated with underlying AD pathology and postoperative delirium. Mild baseline depressive symptoms were the strongest predictor of postoperative delirium, and may represent a dementia prodrome.
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| 4. |
- Creese, Byron, et al.
(författare)
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Determining the Association of the 5HTTLPR Polymorphism with Delusions and Hallucinations in Lewy Body Dementias
- 2014
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Ingår i: The American Journal of Geriatric Psychiatry. - : Elsevier BV. - 1545-7214 .- 1064-7481. ; 22:6, s. 580-586
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To determine whether the 5HTTLPR serotonin transporter polymorphism is associated with delusions and hallucinations in people with dementia with Lewy bodies (DLB) and Parkinson disease dementia (PDD). Design: Prospective cohort study. Participants: A total of 187 individuals, recruited from centres in Norway, Sweden, and the United Kingdom were included in this study; 97 with clinically or neuropathologically diagnosed DLB/PDD and 90 cognitively normal individuals as a comparison group. Measurements: All participants with dementia underwent serial evaluation of neuropsychiatric symptoms to assess the presence of persistent delusions and hallucinations using the Columbia University Scale for Psychopathology in Alzheimer disease, the Neuropsychiatric Inventory, or the Present Behavioural Examination. Severity of cognitive impairment was measured using the Mini Mental State Examination (MMSE). Individuals were genotyped for the 5HTTLPR polymorphism. Results: Logistic regression demonstrated that homozygosity for the L/L genotype and lower MMSE were associated with an increased risk for delusions (odds ratio: 11.5 and 1.16, respectively). Neither was significantly associated with hallucinations. Conclusions: This study is the first to demonstrate the 5HTTLPR polymorphism is associated with delusions in Lewy body dementias, with important implications regarding the mechanisms underlying this symptom across the AD/DLB/PDD spectrum. Further studies are warranted to investigate this relationship further and examine treatment opportunities.
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| 6. |
- Cumming, Toby B, et al.
(författare)
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The High Prevalence of Anxiety Disorders After Stroke.
- 2016
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Ingår i: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - : Elsevier BV. - 1545-7214. ; 24:2, s. 154-60
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies indicate that post-stroke anxiety is common and persistent. We aimed to determine whether point prevalence of anxiety after stroke is higher than in the population at large, and whether the profile of anxiety symptoms is different.This case-control study was conducted in Göteborg, Sweden, with stroke patients recruited from the Sahlgrenska University Hospital and a comparison group selected from local population health studies. We included 149 stroke survivors (assessed at 20 months post-stroke) and 745 participants from the general population matched for age and sex. A comprehensive psychiatric interview was conducted, with anxiety and depressive disorders diagnosed according to DSM-III-R criteria.Those in the stroke group were significantly more likely than those in the comparison group to have generalized anxiety disorder (GAD) (27% versus 8%), phobic disorder (24% versus 8%) and obsessive-compulsive disorder (9% versus 2%). Multivariate regression indicated that being in the stroke group, female sex, and having depression were all significant independent associates of having an anxiety disorder. In terms of symptom profile, stroke survivors with GAD were significantly more likely to report vegetative disturbance than those in the comparison group with GAD but less likely to have observable muscle tension or reduced sleep.Point prevalence of anxiety disorders is markedly higher after stroke than in the general population, and this cannot be attributed to higher rates of comorbid depression.
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| 7. |
- Dekhtyar, Serhiy, et al.
(författare)
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A Life-Course Study of Cognitive Reserve in Dementia-From Childhood to Old Age.
- 2015
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Ingår i: The American Journal of Geriatric Psychiatry. - : Elsevier BV. - 1545-7214 .- 1064-7481. ; 23:9, s. 885-896
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Tidskriftsartikel (refereegranskat)abstract
- Objective To test a life-course model of cognitive reserve in dementia and examine if school grades around age 10 years, formal educational attainment, and lifetime occupational complexity affect the risk of dementia in old age. Methods 7,574 men and women from the Uppsala Birth Cohort Multigenerational Study were followed for 21 years. Information on school performance, formal education, and occupational attainment was collected prospectively from elementary school archives and population censuses. Dementia diagnosis was extracted from the two Swedish registers. Discrete-time Cox proportional hazard models were estimated. Results Dementia was diagnosed in 950 individuals (12.5%). Dementia risk was lower among individuals with higher childhood school grades (hazard ratio [HR]: 0.79; 95% confidence interval [CI]: 0.68 to 0.93) and was lower among individuals in data-complex occupations (HR: 0.77; 95% CI: 0.64 to 0.92). Professional/university education predicted lower risk of dementia in minimally adjusted models (HR: 0.74; 95% CI: 0.60 to 0.91), although the effect faded with adjustment for occupational complexity. Lowest risk was found in the group with both higher childhood school performance and high occupational complexity with data (HR: 0.61; 95% CI: 0.50 to 0.75). Importantly, high occupational complexity could not compensate for the effect of low childhood grades. In contrast, dementia risk was reduced in those with higher school grades, irrespective of occupational complexity. Conclusion Higher childhood school performance is protective of dementia risk, particularly when preserved through complex work environments in adulthood, although it will remain protective even in the absence of later-life educational or occupational stimulation.
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| 8. |
- Dekhtyar, S, et al.
(författare)
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Response to Brodziak's Letter to the Editor
- 2015
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Ingår i: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. - : Elsevier BV. - 1545-7214. ; 23:11, s. 1204-1206
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 10. |
- Fredén Klenfeldt, Isak, 1980, et al.
(författare)
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Prevalence of Obsessive-compulsive Disorder in Relation to Depression and Cognition in an Elderly Population
- 2014
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Ingår i: The American journal of geriatric psychiatry. - : Elsevier BV. - 1064-7481. ; 22:3
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Tidskriftsartikel (refereegranskat)abstract
- Objectives We examined the 1-month prevalence of obsessive-compulsive disorder (OCD) and obsessive-compulsive symptoms (OCS) not fulfilling OCD criteria in relation to sex, age, social and mental function, comorbid depression, and cognitive functioning in an elderly nondemented population. Settings and Participants Population-based sample (N = 900), stratified into two age groups: 70-year-olds (335 women and 224 men) and those aged 78 and above (341 women). Measurements Semi-structured interviews. Psychiatric symptoms were assessed with the Comprehensive Psychopathological Rating Scale and Mini-International Neuropsychiatric Interview, mental and social function with the GAF-scale, memory function with the Word Recall Task and general cognition with MMSE. OCD and Depression were diagnosed according to DSM-IV. Results The one-month prevalence of OCD was 2.9%; a further 21% had OCS. Among 70-year-olds, the prevalence of OCD was 1.3% in men and 4.5% in women. Depression was more common among those with OCD (34.6%) than among those with (12.7%) and without (8.0%) OCS. GAF-score was lower among those with OCD (74.8) and OCS (82.9) compared with individuals without obsessions and compulsions (88.2). The association between OCD and GAF-score remained after adjustment for age, sex, and depression. The OCD subgroup with checking behavior had more memory and concentration problems and did worse on Word Recall Task than other groups in our sample. Conclusions We found that OCD and OCS are common among the elderly. Both conditions are related to depression and poorer mental and social functioning. Physicians who meet elderly patients need to be aware of OCD as it is potentially treatable.
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