Components of the metabolic syndrome and depressive symptoms in community-dwelling older people: the Bambuí Cohort Aging Study

ObjectiveHigh as well as low levels of IGF1 have been associated with cardiovascular diseases (CVD). The relationship of IGF1 with (components of) the metabolic syndrome could help to clarify this controversy. The aims of this study were: i) to investigate the association of IGF1 concentration with prevalent (components of) the metabolic syndrome; and ii) to examine the role of (components of) the metabolic syndrome in the relationship between IGF1 and incident CVD during 11 years of follow-up.MethodsData were used from the Longitudinal Aging Study Amsterdam, a cohort study in a representative sample of the Dutch older population (≥65 years). Data were available in 1258 subjects. Metabolic syndrome was determined using the definition of the US National Cholesterol Education Program Adult Treatment Panel III. CVD were ascertained by self-reports and mortality data.ResultsLevels of IGF1 in the fourth quintile were associated with prevalent metabolic syndrome compared with the lowest quintile (odds ratio: 1.59, 95% confidence interval (CI) 1.09–2.33). The middle up to the highest quintile of IGF1 was positively associated with high triglycerides in women. Metabolic syndrome was not a mediator in the U-shaped relationship of IGF1 with CVD. Both subjects without the metabolic syndrome and low IGF1 levels (hazard ratio (HR) 1.75, 95% CI 1.12–2.71) and subjects with the metabolic syndrome and high IGF1 levels (HR 2.28, 95% CI 1.21–4.28) demonstrated increased risks of CVD.ConclusionsIn older people, high-normal IGF1 levels are associated with prevalent metabolic syndrome and high triglycerides. Furthermore, this study suggests the presence of different pathomechanisms for both low and high IGF1 levels and incident CVD.

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Apathy is associated with incident dementia in community-dwelling older people

Neurology ◽

10.1212/wnl.0000000000004767 ◽

2017 ◽

Vol 90 (1) ◽

pp. e82-e89 ◽

Cited By ~ 12

Author(s):

Jan Willem van Dalen ◽

Lennard L. Van Wanrooij ◽

Eric P. Moll van Charante ◽

Edo Richard ◽

Willem A. van Gool

Keyword(s):

Depressive Symptoms ◽

Older People ◽

Cox Regression ◽

Depression Scale ◽

Community Dwelling ◽

Memory Complaints ◽

Incident Dementia ◽

Increased Risk ◽

Community Dwelling Older People

ObjectiveTo assess whether apathy and depressive symptoms are independently associated with incident dementia during 6-year follow-up in a prospective observational population-based cohort study.MethodsParticipants were community-dwelling older people in the Prevention of Dementia by Intensive Vascular Care trial, aged 70–78 years, without dementia at baseline. Apathy and depressive symptoms were measured using the 15-item Geriatric Depression Scale (GDS-15). Dementia during follow-up was established by clinical diagnosis confirmed by an independent outcome adjudication committee. Hazard ratios (HRs) were calculated using Cox regression analyses. Given its potentially strong relation with incipient dementia, the GDS item referring to memory complaints was assessed separately.ResultsDementia occurred in 232/3,427 (6.8%) participants. Apathy symptoms were associated with dementia (HR 1.28, 95% confidence interval [CI] 1.12–1.45; p < 0.001), also after adjustment for age, sex, Mini-Mental State Examination score, disability, and history of stroke or cardiovascular disease (HR 1.21, 95% CI 1.06–1.40; p = 0.007), and in participants without depressive symptoms (HR 1.26, 95% CI 1.06–1.49; p = 0.01). Depressive symptoms were associated with dementia (HR 1.12, 95% CI 1.05–1.19), also without apathy symptoms (HR 1.16, 95% CI 1.03–1.31; p = 0.015), but not after full adjustment or after removing the GDS item on memory complaints.ConclusionsApathy and depressive symptoms are independently associated with incident dementia in community-dwelling older people. Subjective memory complaints may play an important role in the association between depressive symptoms and dementia. Our findings suggest apathy symptoms may be prodromal to dementia and might be used in general practice to identify individuals without cognitive impairment at increased risk of dementia.

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The association between frontal lobe perfusion and depressive symptoms in later life

The British Journal of Psychiatry ◽

10.1192/bjp.2018.288 ◽

2019 ◽

Vol 214 (4) ◽

pp. 230-236 ◽

Cited By ~ 4

Author(s):

Robert Briggs ◽

Daniel Carey ◽

Paul Claffey ◽

Triona McNicholas ◽

Louise Newman ◽

...

Keyword(s):

Blood Pressure ◽

Depressive Symptoms ◽

Older People ◽

Frontal Lobe ◽

Saturation Index ◽

Community Dwelling ◽

Lower Blood Pressure ◽

Lower Blood ◽

Community Dwelling Older People ◽

Clinically Significant

BackgroundDeficits in frontal lobe perfusion have been demonstrated in late-life depression; however, studies to date have generally involved small numbers, used neuroimaging rather than bedside testing and have not controlled for important covariates.AimsWe aimed to examine the association between depressive symptoms and frontal lobe perfusion during standing, in a large cohort of community-dwelling older people.MethodParticipants aged ≥50 years underwent continuous measurement of orthostatic blood pressure by finometry, and frontal lobe perfusion by near-infrared spectroscopy. Depressive symptoms were assessed by the eight-item Centre for Epidemiological Studies Depression Scale. Real-time frontal lobe cerebral oxygenation was measured by the Portalite System, detecting changes in frontal lobe perfusion and reporting a tissue saturation index score.ResultsAlmost 8% (209 out of 2616) had clinically significant depressive symptoms. Multilevel models demonstrated a significantly lower tissue saturation index in participants with depressive symptoms at both 60 and 90 s post-stand, with coefficients of −0.43 (95% CI −0.63 to −0.22) and −0.37 (95% CI −0.57 to −0.16), respectively. Controlling for relevant covariates did not significantly attenuate these associations. After addition of systolic blood pressure this association was no longer significant, suggesting lower blood pressure may modify this relationship.ConclusionsThis study demonstrates that lower frontal lobe perfusion, related to lower values of baseline systolic blood pressure, is associated with clinically significant depressive symptoms in a cohort of community-dwelling older people. Given the recognised longitudinal association between lower blood pressure and depression in older people, this may represent a potential therapeutic target for prevention of incident depression.Declaration of interestNone.

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The ‘Wish to Die’ in later life: prevalence, longitudinal course and mortality. Data from TILDA

Age and Ageing ◽

10.1093/ageing/afab010 ◽

2021 ◽

Author(s):

Robert Briggs ◽

Mark Ward ◽

Rose Anne Kenny

Keyword(s):

Depressive Symptoms ◽

Older People ◽

Later Life ◽

Community Dwelling ◽

Mortality Data ◽

Individual Level ◽

Longitudinal Course ◽

Wish To Die ◽

Community Dwelling Older People

Abstract Background ‘Wish to Die’ (WTD) involves thoughts of or wishes for one’s own death or that one would be better off dead. Objective To examine the prevalence, longitudinal course and mortality-risk of WTD in community-dwelling older people. Design Observational study with 6-year follow-up. Setting The Irish Longitudinal Study on Ageing, a nationally representative cohort of older adults. Subjects In total, 8,174 community-dwelling adults aged ≥50 years. Methods To define WTD, participants were asked: ‘In the last month, have you felt that you would rather be dead?’ Depressive symptoms were measured using the CES-D. Mortality data were compiled by linking administrative death records to individual-level survey data from the study. Results At Wave 1, 3.5% of participants (279/8,174) reported WTD. Both persistent loneliness (OR 5.73 (95% CI 3.41–9.64)) and depressive symptoms (OR 6.12 (95% CI 4.33–8.67)) were independently associated with WTD. Of participants who first reported WTD at Wave 1 or 2, 72% did not report WTD when reassessed after 2 years, and the prevalence of depressive symptoms (−44%) and loneliness (−19%) was more likely to decline in this group at follow-up. Fifteen per cent of participants expressing WTD at Wave 1 died during a 6-year follow-up. Conclusions WTD amongst community-dwelling older people is frequently transient and is strongly linked with the course of depressive symptoms and loneliness. An enhanced focus on improving access to mental health care and addressing social isolation in older people should therefore be a public health priority, particularly in the current context of the Covid-19 pandemic.

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FNIH-defined Sarcopenia Predicts Adverse Outcomes Among Community-Dwelling Older People in Taiwan: Results From I-Lan Longitudinal Aging Study

The Journals of Gerontology Series A ◽

10.1093/gerona/glx148 ◽

2017 ◽

Vol 73 (6) ◽

pp. 828-834 ◽

Cited By ~ 13

Author(s):

Ting-Ching Tang ◽

An-Chun Hwang ◽

Li-Kuo Liu ◽

Wei-Ju Lee ◽

Liang-Yu Chen ◽

...

Keyword(s):

Older People ◽

Adverse Outcomes ◽

Community Dwelling ◽

Aging Study ◽

Longitudinal Aging Study ◽

Community Dwelling Older People

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Medication use in community-dwelling older people: pharmacoepidemiology of psychotropic utilisation

Journal of Primary Health Care ◽

10.1071/hc14269 ◽

2014 ◽

Vol 6 (4) ◽

pp. 269 ◽

Cited By ~ 5

Author(s):

Anna Schäfers ◽

Nataly Martini ◽

Simon Moyes ◽

Karen Hayman ◽

Monica Zolezzi ◽

...

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

New Zealand ◽

Older People ◽

Psychotropic Medication ◽

Medication Use ◽

Community Dwelling ◽

Drug Event ◽

Community Dwelling Older People ◽

Community Dwelling Older Adults

INTRODUCTION: Psychotropic medications have a significant adverse drug event profile, particularly in older adults, and appropriate use is paramount. Patterns of prescribing in community-dwelling older adults in New Zealand remain unknown. AIM: This study aimed to determine the prevalence and the pattern of psychotropic use amongst community-dwelling older people in New Zealand and to identify any association between depressive symptomatology and psychotropic medication use. METHODS: Data were collected on the demographics, medication use and mood status of community-dwelling older adults from two New Zealand studies: the BRIGHT trial, which recruited potentially disabled participants (N=141) and the DeLLITE trial, which recruited potentially depressed participants (N=193). The prevalence and the pattern of psychotropic use were established and the gender, age and level of depression assessed using regression analysis. RESULTS: The use of any psychotropic medication was 28.9% in the BRIGHT trial and 43.5% in the DeLLITE trial. Antidepressants were the most commonly used psychotropic medication in the two studies, followed by hypnotics and sedatives. Psychotropic use was highly correlated with the presence of depressive symptoms in the BRIGHT trial and with female gender in the DeLLITE trial. Age was not associated with psychotropic medication use. In both studies, there is possible underdiagnosed, undertreated and inappropriately treated depression. DISCUSSION: The prevalence of psychotropic medication use is high in community-dwelling older people with disability and very high in community-dwelling older people with depressive symptoms, but varies by gender and level of depression. KEYWORDS: Aged; depression; independent living; New Zealand; psychotropic drugs

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