scholarly journals Stroke, vascular risk factors and depression

2001 ◽  
Vol 178 (1) ◽  
pp. 23-28 ◽  
Author(s):  
R. Stewart ◽  
M. Prince ◽  
M. Richards ◽  
C. Brayne ◽  
A. Mann
Keyword(s):  
Risk Factors ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Geriatric Depression ◽  
Community Based ◽  
Blood Tests ◽  
Mediating Factor ◽  
The Uk

BackgroundStroke, hypertension and diabetes are common in older Caribbean-born populations in the UK who may be at risk of depression secondary to vascular disease.AimsWe examined the association between stroke, vascular risk factors and depression in a community-based Caribbean-born population aged 55–75 years.MethodVascular risk factors were identified by interview, examination and blood tests. Depression was categorised using the Geriatric Depression Scale. Disablement was assessed as a potential mediating factor.ResultsPhysical illness and disablement were strongly associated with depression, independent of disablement. Previous stroke was associated with depression, independent of disablement. No vascular risk factors were associated with depression.ConclusionsThe risk of depression associated with stroke was not explained by disablement. However, the hypothesis that vascular risk factors are important in the genesis of depression was not supported.

scholarly journals Prevalence of dementia in African–Caribbean compared with UK-born White older people: two-stage cross-sectional study

2011 ◽  
Vol 199 (2) ◽  
pp. 119-125 ◽  
Author(s):  
Simon Adelman ◽  
Martin Blanchard ◽  
Greta Rait ◽  
Gerard Leavey ◽  
Gill Livingston
Keyword(s):  
Risk Factors ◽  
Older People ◽  
Vascular Risk Factors ◽  
Country Of Birth ◽  
Vascular Risk ◽  
Cross Sectional ◽  
Caribbean Country ◽  
African Caribbean ◽  
The Uk ◽  
Prevalence Of Dementia

BackgroundPreliminary studies in the UK, all using screening instruments of unknown cultural validity, indicate that there may be an increased prevalence of dementia in African–Caribbean people, possibly related to vascular risk factors and potentially amenable to preventative measures.AimsTo determine the prevalence of dementia in older people of African–Caribbean country of birth compared with their White UK-born counterparts.MethodA total of 218 people of African–Caribbean country of birth and 218 White UK-born people aged ⩾60 years were recruited from five general practices in North London. Those who screened positive for cognitive impairment using a culturally valid instrument were offered a standardised diagnostic interview. Two independent assessors diagnosed dementia according to standard operationalised criteria.ResultsAfrican–Caribbean participants were 2 years younger, and those with dementia nearly 8 years younger than their White counterparts. The prevalence of dementia was significantly higher in the African–Caribbean (9.6%) than the White group (6.9%) after adjustment for the confounders age and socioeconomic status (odds ratio (OR) = 3.1, 95%CI 1.3–7.3, P = 0.012).ConclusionsThere is an increased prevalence of dementia in older people of African–Caribbean country of birth in the UK and at younger ages than in the indigenous White population. These findings have implications for service provision and preventive interventions. Further research is needed to explore the role of vascular risk factors and social adversity in the excess of dementia in this population.

Impact of Comorbidities and Prospective Functional Geriatric Assessment Tools (CF-GA) As an Aide to Understand Outcome, Therapy Tolerance, Side Effects and Clinical Trial Eligibility in Multiple Myeloma (MM) Patients (pts)

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5616-5616
Author(s):  
Alexander Zober ◽  
Mandy Möller ◽  
Sandra-Maria Dold ◽  
Gabriele Ihorst ◽  
Stefanie Hieke ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multiple Myeloma ◽  
Overall Survival ◽  
Research Funding ◽  
Performance Status ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Geriatric Depression ◽  
Timed Up And Go ◽  
Comorbidity Index

Abstract Introduction: Cancer pts present with a highly heterogeneous health status and treatment choices are often numerous. Therefore, careful assessment of individuals' condition is highly relevant. In order to define best possible and tolerable treatment options, novel parameters and metrics for non-disease variables are needed. Albeit impairment in the Karnofsky Performance Status (KPS), Activities of Daily Living (IADL or ADL) and quality of life (QoL) are predictive for outcome in cancer and MM pts, the prognostic variables within a defined and prospectively assessed battery of established functional tests have rarely been delineated nor have their combination with disease-related risk factors or molecular markers been meticulously assessed. Their prognostic value for functional decline and overall survival (OS) has also not been tested and validated prospectively. Methods: We performed this comorbidity and functional geriatric assessment (CF-GA) in consecutive MM pts treated at our center according to our institutional Comprehensive Cancer Center pathway. The GA was prospectively obtained prior to initiation of anti-myeloma treatment and reflected pts' baseline health status rather than being confounded by toxicities induced by therapy. This CF-GA included the IADL, ADL, Timed Up and Go-Test, malnutrition, pain, rating of fitness, SF12-QoL and geriatric depression scale. Moreover, established comorbidity (CM) scores: ß2MG/eGFR (Eur J Haematol. 2009;83:519-27), Kaplan Feinstein (KF), Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI), Charlson Comorbidity Index (CCI) and initial Freiburg Comorbidity Index (iFCI) vs. revised FCI (rFCI) were assessed. This CF-GA was performed as one screening tool to assess pt fitness as well as to predict survival and toxicities in elderly myeloma pts. Results: Characteristics of 131 pts, currently included in this CF-GA, were typical for tertiary centers with a median age of 63 years (40-83), all with symptomatic disease. Their median hemoglobin was 10.8g/dl (7.6-14.7), the eGFR 68ml/min/1.73qm (7-136), the ß2-MG 4.4mg/l (0.8-38.4) and BM infiltration 40% (3-90). The baseline frailty assessment revealed a median KPS of 80% (40-100). The fitness score scaled both by physicians and patients was 4 vs. 3 (1-6), demonstrating that physicians overestimate pts' performance status and objective tests to verify this are essential. Median functional results for the IADL were 5 (1-8), for the ADL 4 (2-6), for pain 2 (0-10), for malnutrition 4 (0-14) and for cognitive deficiency via Mini Mental State Examination 28 (16-30). The median geriatric depression scale was 3 (0-13) and Timed Up and Go-Test 10 (4-30). Median CM scores were substantially different with an iFCI of 0 (0-3), ß2MG/eGFR of 1 (0-2), KF of 1 (0-3), HCT-CI of 2 (0-8), rFCI of 4 (0-9) and CCI of 7 (0-12). Highly valuable CF-GA-tools seem currently the IADL, Timed Up and Go-Test and rFCI. Since CF-GA is a time and man-power consuming procedure, we have presently completed a web account that allows the straightforward assessment of the rFCI for MM pts (https://rfci-score.org). This permits to perform this score in only 1-2 minutes. Moreover, we continue to perform this prospective assessment in more MM pts at our center and within a multicentre approach within the German Study Group Multiple Myeloma(DSMM) and will thereby also assess whether these function deficits and tests change over time. Prior scores to define fit, intermediate and frail pts (Blood. 2015;125:2068-74) will be compared with our risk group definitions and their predictive power for progression free survival, overall survival, side effects, therapy termination/discontinuation and early mortality will be evaluated. Adverse risk groups will allow to test and validate the most significant predictors of survival outcomes. Conclusions: Our CF-GA and rFCI contain easily assessable and reliable tests, which are of value to further test for their discriminative character in MM pts. Moreover, most predictive CF-CA tools need to be determined in prospective multicentre cohorts and need to be included in future clinical trials. We advocate our CF-GA and rFCI to foresee treatment toxicity, facilitate treatment decisions and guide personalized therapies. Timely identification and management of risk factors in MM pts are important considerations in the daily care of older and frail cancer pts, specifically those with MM. Disclosures Zober: Deutsche Krebshilfe: Other: grant. Knop:Celgene Corporation: Consultancy. Einsele:Amgen/Onyx: Consultancy, Honoraria, Speakers Bureau; Novartis: Consultancy, Honoraria, Speakers Bureau; Janssen: Consultancy, Honoraria, Research Funding, Speakers Bureau; Celgene: Consultancy, Honoraria, Research Funding, Speakers Bureau. Engelhardt:Deutsch Krebshilfe: Other: grant.

scholarly journals Risk factors for depression in residents of gerontology center in Sarajevo

2015 ◽  
Vol 5 (1) ◽  
pp. 19-24
Author(s):  
Jasmina Mahmutovic ◽  
Aida Rudić ◽  
Arzija Pašalić ◽  
Fatima Jusupović ◽  
Suada Branković ◽  
...  
Keyword(s):  
Risk Factors ◽  
Marital Status ◽  
Sleep Disturbances ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Geriatric Depression ◽  
Cross Sectional ◽  
Younger Age ◽  
Common Risk Factors

Introduction: Depression is the most common mental problem in elderly and is often under-recognized or is inadequately treated, thus significantly affecting the quality of life of elderly people. The reasons for the occurrence of depression in the elderly are multiple. The most common are neurobiological and psychosocial risk factors as well as physical illness. The aim of this study is to determine the presence of the most common risk factors related to the degree of depression, determined by the geriatric depression scale.Methods: This is cross-sectional, descriptive and analytical study undertaken on the sample of 150 psychologically and physically capable residents of the "The Gerontology Center" in Sarajevo older than 65 years. The following instruments were used for research: the Geriatric Depression Scale (GDS) and the modified questionnaire on risk factors important in the depression development.Results: Women are more depressed than men (p<0.01). Depression severity increases with age (p=0.008). The marital status of respondents was significant factor affecting the GDS scores (p=0.009). GDS score and education are weakly correlated (p=0.07) and more educated are less depressed. Also, independently mobile elderly are less depressed (p<0.0005). GDS scores and presence of depression in younger age are dependent (p=0.004). Depression and subjective sleep disturbances are dependent (p=0.002).Conclusion: The most common risk factors for depression in elderly are gender, age, marital status, history of depression in younger age and mobility.

scholarly journals Current Trends of Geriatric Depression at an Indian Tertiary Care Center

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Akash Rajender ◽  
Krishna Kanwal ◽  
Gaurav R
Keyword(s):  
Risk Factors ◽  
Care Center ◽  
Tertiary Care ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Treatment Compliance ◽  
Elderly Subjects ◽  
Geriatric Depression ◽  
Prevalence Of Depression ◽  
Associated Risk Factors

Background: Aging is a progressive process beginning with life & ending with death. There is a massive growth in elderly population & age associated diseases. Depression is frequently associated with aging, associated comorbidities & treatment compliance in this fragile age group. Aims & Objective: To study prevalence of depression in elderly using Geriatric Depression Scale (GDS) and its associated risk factors. Method: Three hundred elderly (≥60 years) patients were assessed at Mahatma Gandhi Medical College & Hospital, Jaipur in an observational, cross sectional study using Geriatric Depression Scale (GDS). Correlation with associated risk factors were evaluated. Statistical analysis was done using SPSS version 12.0. Results: Prevalence of depression was 29.3% of which 62 (20.67%) were mildly depressed and 26 (8.67%) were severely depressed. Depression was significantly higher in elderly subjects with comorbid chronic disease (p 0.0001), inadequate sleep (p 0.001), absent social participation (p 0.002) and in those who did not engage themselves in day time work or hobbies (p 0.0002). Conclusions: Depression is common in elderly, its undiagnosed & overlooked. Prevention of risk factors & early diagnosis may significantly reduce morbidity, mortality & improve quality of life.

Association of Low Systolic Blood Pressure with Postmortem Amyloid-β and Tau

2020 ◽  
Vol 78 (4) ◽  
pp. 1755-1764
Author(s):  
Shahram Oveisgharan ◽  
Ana W. Capuano ◽  
Alifiya Kapasi ◽  
Aron S. Buchman ◽  
Julie A. Schneider ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Amyloid Β ◽  
Vascular Risk Factors ◽  
Risk Scores ◽  
Vascular Risk ◽  
Community Based ◽  
Cardiovascular Risk Score ◽  
Linear Regressions

Background: Vascular mechanisms may contribute to the accumulation of AD pathology. Objective: We examined whether the burden of vascular risk factors proximate to death is associated with amyloid-β and tau levels or modified their known association. Methods: We examined the brains of 1, 585 participants from two longitudinal community-based studies of older adults. Amyloid-β and tau were quantified by postmortem examination. The burden of vascular risk factors was summarized by calculating the Framingham general cardiovascular risk score (FRS) proximate to death. Using linear regressions, we examined the association of the FRS with the amyloid-β and tau levels and examined if the FRS modified the association of the amyloid-β with tau. Results: On average, participants were nearly 90 years old and two-thirds were women. The FRS was not associated with amyloid-β (Spearman r  = –0.00, p  = 0.918) or tau (r = 0.01, p = 0.701). However, the FRS as a whole (estimate = –0.022, SE = 0.008, p = 0.009), and specifically the systolic blood pressure (SBP) component (estimate = –0.033, SE = 0.012, p = 0.009), modified the association of the amyloid-β with tau. Further analysis showed that the association between amyloid-β and tau was stronger at lower levels of SBP. Conclusion: Late-life vascular risk scores were not related to postmortem levels of amyloid-β or tau. However, lower levels of vascular risk scores and SBP were associated with a stronger association between amyloid-β and tau. These data suggest that vascular risk factors may modify the relation of AD pathology markers to one another.

Abstract 71: Sex and Genetic Predisposition Synergistically Influence Risk of Stroke and Myocardial Infarction in Middle-Aged Persons Without Risk Factors

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Guido J Falcone ◽  
Julian Acosta ◽  
Audrey C Leasure ◽  
Kevin N Vanent ◽  
Rommell B Noche ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Genetic Predisposition ◽  
Genetic Risk ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Uk Biobank ◽  
Middle Aged ◽  
High Genetic Risk ◽  
The Uk

Background and Hypothesis: Driven by aging-related physiological changes, the incidence of stroke and myocardial infarction rises rapidly in persons aged >40 years. A significant proportion of these acute vascular events (AVE) take place in persons without vascular risk factors. We tested the hypothesis that sex and genetic predisposition synergistically increase the risk of AVE in middle-aged persons without vascular risk factors. Methods: We analyzed data from the UK Biobank, a prospective longitudinal study that enrolled persons aged 40 to 69 years. Our analysis was restricted to middle-aged participants, defined as those aged 40 to 60 years. Prevalent and incident cases of stroke (ischemic and hemorrhagic) and myocardial infarction were included. To quantify the genetic predisposition to sustain an AVE, we constructed a polygenic risk score using 68 independent (R 2 <0.1) genetic variants known to associate (p<5x10 -8 ) with AVE. Participants were classified as having low, intermediate or high genetic risk according to tertiles of the score. We used Cox models for association and interaction testing. Results: Of the 502,536 study participants enrolled in the UK Biobank, 303,295 (60%) did not have any vascular risk factors. During the follow-up period, there were 5,746 AVEs, including 1,954 strokes and 3,792 myocardial infarctions. The cumulative risk of AVE was 0.12% (n=352), 0.46% (n = 1,386) and 1.32% (n = 4,008) at ages 40, 50 and 60 years (test-for-trend p<0.001). The risk of AVE was 3 times greater in men than women (HR 3.30, 95%CI 3.08 - 3.53). Compared to persons with low genetic risk, those with intermediate and high genetic risk had a 22% (HR 1.22, 95%CI 1.13 - 1.32) and 52% (HR 1.52, 95%CI 1.41 - 1.65) increase in risk of AVE, respectively. There was significant synergy (interaction) between sex and genetic predisposition: compared to females with low genetic risk, males with high genetic risk had 4 times (HR 3.91, 95%CI 3.58 - 4.26) the risk of AVE (interaction analysis p<0.001). Conclusion: Genetic information constitutes a promising tool to risk stratify middle-aged persons without vascular risk factors. The synergistic effect of sex and genetic predisposition points to specific subgroups that could benefit from aggressive preventive interventions.

Are Vascular Risk Factors Associated With Post-Stroke Depressive Symptoms?

2011 ◽  
Vol 24 (4) ◽  
pp. 215-221 ◽  
Author(s):  
Gayla Tennen ◽  
Nathan Herrmann ◽  
Sandra E. Black ◽  
Karen S. Levy ◽  
Jaclyn Cappell ◽  
...  
Keyword(s):  
Risk Factors ◽  
Depressive Symptoms ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Vascular Risk Factors ◽  
World Health ◽  
Stroke Severity ◽  
Vascular Risk ◽  
Post Stroke ◽  
Health Organization

Objective: Vascular risk factors (VRFs) have been associated with stroke and cognitive impairment, however, the role of VRFs in predicting post-stroke depression (PSD) has not been assessed. The objective of the current study was to determine whether VRFs are associated with the risk of PSD in an acute stroke population. Methods: In this observational study, patients meeting World Health Organization MONICA Project and National Institute of Neurological Disorders and Stroke criteria for stroke were eligible. Patients were assessed for depression, cognition, and stroke severity, and VRF and demographic information were obtained. Results: A total of 102 patients were recruited within 4 months post-stroke. Using a score of ≥16 on the Center for Epidemiological Studies Depression scale to determine depressive symptoms, 38 patients (age 72.1 ± 15.6, 44.7% male) screened positive for depressive symptoms and 64 (age 70.1 ± 13.6, 51.6% male) screened negative. Analysis of VRFs showed that only hypertension ( P = .044) independently predicted the presence of depressive symptoms (χ2 = 4.742, P = .029, Nagelkerke R2 = .062). Conclusions: Hypertension was associated with post-stroke depressive symptoms, while there was no relationship between PSD and other VRFs. Hypertension may have a greater impact than other VRFs on mood following stroke and may have a role in prevention and treatment of PSD.

scholarly journals Midlife vascular risk factors and risk of incident dementia: Longitudinal cohort and Mendelian randomization analyses in the UK Biobank

2021 ◽  
Author(s):  
Rainer Malik ◽  
Marios K. Georgakis ◽  
Julia Neitzel ◽  
Kristiina Rannikmäe ◽  
Michael Ewers ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mendelian Randomization ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Uk Biobank ◽  
Longitudinal Cohort ◽  
Incident Dementia ◽  
The Uk
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