Search

Objective: To investigate whether maternal common mental disorders (CMD) in the postnatal period are prospectively associated with child development at 2.5 and 3.5 years in a rural low‐income African setting. Methods: This study was nested within the C‐MaMiE (Child outcomes in relation to Maternal Mental health in Ethiopia) population‐based cohort in Butajira, Ethiopia, and conducted from 2005 to 2006. The sample comprised of 496 women who had recently given birth to living, singleton babies with recorded birth weight measurements, who were 15 to 44 years of age, and residing in six rural sub‐districts. Postnatal CMD measurements were ascertained 2 months after delivery. Language, cognitive, and motor development were obtained from the child 2.5 and 3.5 years after birth using a locally adapted version of the Bayley Scales of Infant Development (3rd Ed). Maternal CMD symptoms were measured using a locally validated WHO Self‐Reporting Questionnaire. A linear mixed‐effects regression model was used to analyze the relationship between postnatal CMD and child development. Results: After adjusting for confounders, there was no evidence for an association between postnatal CMD and overall child development or the cognitive sub‐domain in the preschool period. There was no evidence of effect modification by levels of social support, socioeconomic status, stunting, or sex of the child. Conclusions: Previous studies from predominantly urban and peri‐urban settings in middle‐income countries have established a relationship between maternal CMD and child development, which contrasts with the findings from this study. The risk and protective factors for child development may differ in areas characterized by high social adversity and food insecurity. More studies are needed to investigate maternal CMD's impact on child development in low‐resource and rural areas. [ABSTRACT FROM AUTHOR]

Background: Depression happens commonly in cancer patients. However, there is limited literature on uterine cancer. In this study, we aimed to evaluate the association between uterine cancer and depression as well as the moderating effect of age and hormone replacement therapy (HRT).Methods: This was a population-based study using Taiwan's National Health Insurance Research Database. We conducted a matched cohort study and identified 6526 patients with uterine cancer and 65 260 controls. We adopted the competing risk analysis model as the statistical method and adjusted for potential confounding factors.Results: From 1997 to 2008, 71 786 patients were included (6526 patients with uterine cancer and 65 260 controls). In the study, uterine cancer was not linked to depression. However, when we stratified the different age groups, those cancer patients aged <40 and 40 to 49 years showed significant higher risk of developing depression (subdistribution hazard ratio 1.64 and 1.41, respectively). In addition, among uterine cancer patients, 4602 patients had never used HRT and 1921 patients were prescribed HRT. The analysis of time-dependent Cox model showed that, compared with no use of HRT, patients with cumulative doses ≥168 DDD had significant lower risk of depression (hazard ratio 0.49, 95% confidence interval = 0.26-0.92).Conclusions: An increased risk of depression among younger uterine cancer patients was observed. Our preliminary finding suggests a possible protective factor for developing depression after HRT usage. [ABSTRACT FROM AUTHOR]

Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The study aims to investigate whether longitudinal data on the structure of the mini mental state examination (MMSE) collected in an older Brazilian cohort support factorial invariance over time. Design: Analysis of 10-year data from a community-based cohort study was performed. Setting: The study took place in Bambuí, Brazil. Participants: The study sample comprised 1558 (89.4%) of all eligible 1742 elderly residents. Measurements: A standard Brazilian version of the MMSE was used. Results: A five-factor solution (developed on the baseline of the cohort) either with no constraints or with loadings constrained to equality across time provided a reasonable fit for the MMSE. A comparison between both models suggested that the model with no constraints was superior. However, the five absolute goodness-of-fit indices suggest that the fully constrained model was also adequate and did not differ substantively from the model without any restriction. Conclusion: The structure of the MMSE remained relatively unchanged across the 10 measurement times, thus providing evidence for the good construct validity of the scale across time. [ABSTRACT FROM AUTHOR]

The Clinical Interview Schedule - Revised (CIS-R) has been widely adopted across cultures to assess common mental disorders. We assessed the factorial validity of the CIS-R across ethnic minority groups, using data from a nationally representative survey conducted in England in 2000. The sample comprised White British ( n = 837), Irish ( n = 733), Black Caribbean ( n = 694), Bangladeshi ( n = 650), Indian ( n = 643) and Pakistani ( n = 724) respondents. Ordered logistic regression determined the reporting of CIS-R symptoms. Principal components analysis (PCA) determined the underlying construct of the CIS-R in White British participants. These factor solutions were then assessed for 'best fit' using confirmatory factor analyses (CFAs) across all ethnic groups. In ordered logistic regression analyses, there was heterogeneity in the reporting of worries, phobias, panic and somatic symptoms across ethnic minority groups relative to the White British group. 'Best' fit solutions confirmed through CFA were models where all symptoms were allowed to vary across ethnic groups, or models where an underlying 'depression-anxiety' construct was held invariant while 'somatic symptoms' were permitted to vary across groups, although differences between models assessed were slight. In conclusion, there may be benefits in assessing the functioning of certain CIS-R items within specific cultural contexts to ensure adequate face validity of the CIS-R. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aims The study aims to evaluate the impact of perinatal common mental disorders ( CMDs) on child mortality up to 3.5 years in a demographic surveillance site at Butajira, Ethiopia. Methods One thousand sixty-five eligible women were assessed for CMD in the third trimester of pregnancy and at 2 months post-delivery using the Self- Reporting Questionnaire. We derived a four-level categorical exposure variable for the course of perinatal CMD. The outcome measure was child death recorded from 1 month after the postnatal assessment up to 3.5 years. Potential confounders and mediators were evaluated. Results The cumulative child mortality rates were 62.6/1000 at 1 year and 82.5/1000 at 3.5 years, respectively. Exposure to perinatal CMD did not significantly affect child survival at 3.5 years, with results showing fully adjusted hazard ratio ( HR) and 95% confidence interval (95% CI) of 1.85 (0.43, 7.88) for CMD in pregnancy only, 1.47 (0.14, 15.66) for CMD in postnatal period only and 0.41 (0.02, 7.38) for persistent CMD (both in pregnancy and postnatal). Only using soap less frequently than daily ( HR 5.67, 95% CI 1.58-20.30) and episode of malaria in pregnancy ( HR 5.02, 95% CI 2.15-11.72) were associated with child mortality in multivariable analysis. Conclusions Maternal health, health behaviours and family structure appear to be the most important factors affecting post-neonatal child mortality in this Ethiopian birth cohort, with little evidence for an effect of maternal perinatal CMD. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Although engagement in productive activities is associated with favourable outcomes with respect to the health and well-being of older individuals, the association between such activities and depression in older populations remains relatively unexplored. The purpose of this study was to evaluate the association among five productive activities (paid work, formal volunteering, caregiving, informal helping and caring for grandchildren) with depression in older adults in 14 European countries. METHODS: This cross-sectional study used the first two waves of data collected by the Survey of Health, Ageing and Retirement in Europe and analysed a total sample of 7238 relatively healthy community residents aged 60 years and older from 14 European countries. The Survey of Health, Ageing and Retirement in Europe excluded potential participants with a past history of depression, cognitive impairment and physical limitations. Depression was categorised using the EURO-D instrument, and associations with participating in productive activities were investigated. RESULTS: Depression was less prevalent among those individuals who were employed or self-employed and those who participated in formal volunteering or informal helping, whereas caregiving was associated with a higher risk of depression. Caring for grandchildren was not associated positively or negatively with depression. Formal volunteering and caregiving remained associated with depression after adjustment for age, sex, marital status, education, economic status, country and presence of long-term illness. CONCLUSIONS: Availability of formal volunteering may be important in reducing depression risk, whereas caregiving is associated with a higher risk of depression in older European adults. Further research is required to clarify the direction of causation and evaluate interventions. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives To investigate long-term prospective associations between a range of measurements of hypertensive status in midlife and cognitive impairment 20 years later. Design Cohort study. Setting Two areas ( Southall and Brent) of northwest London. Participants Survey samples of a multiethnic population ( European, African Caribbean, South Asian) aged 40 to 67 were followed up 20 years later. Measurements Comprehensive cardiovascular assessments were performed at baseline, including measurements of resting blood pressure ( BP) and, in a subsample, ambulatory BP. At follow-up, a battery of cognitive assessments was administered, and a composite outcome was derived, with impairment defined as the lowest 10% within each ethnic group. Logistic regression models were used to investigate associations with prior measures of hypertensive status. Results In 1,484 participants at follow-up, cognitive impairment showed significant U-shaped associations with baseline diastolic BP ( DBP) and mean arterial pressure ( MAP; strongest for those aged ≥50 at baseline), independent of a range of covariates, but no associations were found with systolic BP or pulse pressure. Cognitive impairment was also associated with antihypertensive medication use and higher evening ambulatory DBP at baseline. No substantial differences in strengths of association were found between ethnic groups. Conclusion Low and high DBP and MAP were associated with cognitive impairment 20 years later. Higher evening DBP on ambulatory monitoring was also associated with greater risk. [ABSTRACT FROM AUTHOR]

This study investigates the association of sleep duration with risk of all-cause mortality among elderly Brazilians using data from a 9-year population-based cohort study and applying a multivariable longitudinal categorical and continuous analysis using Cox's proportional hazards models. This analysis used data from the Bambui Health and Ageing Study (BHAS), conducted in Bambuí city (approximately 15 000 inhabitants) in southeastern Brazil. The study population comprised 1512 (86.8%) of all eligible 1742 elderly residents. In multivariable analysis, using sleep duration as categorical variable and controlling for multiple measures of sociodemographic and health status, those who slept 9 h or more per night were found to be at higher risk of mortality than those who slept 7 h [hazard ratio (HR): 1.53; 95% confidence interval (CI): 1.12-2.09]. Excluding those whose deaths occurred within 2 years after entry, this association remained significant (HR: 1.56; 95% CI: 1.12-2.18). In analyses using sleep duration as a continuous variable, a linear correlation was found between sleep duration and mortality in all adjusted models in the whole sample (HR: 1.08; 95% CI: 1.02-1.15) and following exclusion of those whose deaths occurred within 2 years after entry (HR: 1.13; 95% CI: 1.06-1.21). Both linear and quadratic terms were significant, reflecting a predicted relationship, with mortality predominantly increasing in association with long sleep duration but with the addition of a slight decrease in association with shorter sleep duration. In conclusion, long rather than short sleep duration was associated principally with all-cause mortality in this sample. It is therefore reasonable to suggest that clinicians should be aware of the potential adverse prognosis associated with prolonged sleep. [ABSTRACT FROM AUTHOR]

Objective The prevalence rate of depression among patients with Parkinson's disease (PD) has been estimated at 25%, although prevalence figures range between 7–76%. Relatively few studies on PD and depression are based on random samples in the general population. Some depressive symptoms can also be understood as symptoms of parkinsonism, and the current study aims to describe which ‘overlap’ symptoms can be identified in a community sample. Methods Data are employed from the EURODEP collaboration. Nine study centres, from eight western European countries, provided data on depression (most GMS-AGECAT), depressive symptoms (EURO-D items and anxiety), parkinsonism (self-report of PD or clinical signs of PD), functional disability and dementia diagnosis. Results Data were complete for 16 313 respondents, aged 65 and older; 306 (1.9%) reported or had signs of parkinsonism. The rate of depression was about twice as high among respondents with parkinsonism (unadjusted Odds Ratio 2.44, 95% Confidence Interval 1.88–3.17), also among those without functional disability. ‘Overlap’ symptoms between parkinsonism and depression, were represented by motivation and concentration problems, appetite problems and especially the symptom of fatigue (energy loss). However, principal component analysis showed that these ‘overlap’ symptoms loaded on different factors of the EURO-D scale. Conclusions As among clinical patients with PD, depression is highly common in community dwelling older people with parkinsonism, even among those without functional disability. Although fatigue did not strongly relate to motivational symptoms, both types of ‘overlap’ symptoms possibly trigger a final common pathway towards a full depressive syndrome. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

We evaluated the psychometric properties of the 12-item interviewer-administered screener version of the World Health Organization Disability Assessment Schedule – version II (WHODAS II) among older people living in seven low- and middle-income countries. Principal component analysis (PCA), confirmatory factor analysis (CFA) and Mokken analyses were carried out to test for unidimensionality, hierarchical structure, and measurement invariance across 10/66 Dementia Research Group sites. PCA generated a one-factor solution in most sites. In CFA, the two-factor solution generated in Dominican Republic fitted better for all sites other than rural China. The two factors were not easily interpretable, and may have been an artefact of differing item difficulties. Strong internal consistency and high factor loadings for the one-factor solution supported unidimensionality. Furthermore, the WHODAS II was found to be a ‘strong’ Mokken scale. Measurement invariance was supported by the similarity of factor loadings across sites, and by the high between-site correlations in item difficulties. The Mokken results strongly support that the WHODAS II 12-item screener is a unidimensional and hierarchical scale confirming to item response theory (IRT) principles, at least at the monotone homogeneity model level. More work is needed to assess the generalizability of our findings to different populations. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The reported prevalence of late-life depressive symptoms varies widely between studies, a finding that might be attributed to cultural as well as methodological factors. The EURO-D scale was developed to allow valid comparison of prevalence and risk associations between European countries. This study used Confirmatory Factor Analysis (CFA) and Rasch models to assess whether the goal of measurement invariance had been achieved; using EURO-D scale data collected in 10 European countries as part of the Survey of Health, Ageing and Retirement in Europe (SHARE) (n = 22,777). The results suggested a two-factor solution (Affective Suffering and Motivation) after Principal Component Analysis (PCA) in 9 of the 10 countries. With CFA, in all countries, the two-factor solution had better overall goodness-of-fit than the one-factor solution. However, only the Affective Suffering subscale was equivalent across countries, while the Motivation subscale was not. The Rasch model indicated that the EURO-D was a hierarchical scale. While the calibration pattern was similar across countries, between countries agreement in item calibrations was stronger for the items loading on the affective suffering than the motivation factor. In conclusion, there is evidence to support the EURO-D as either a uni-dimensional or bi-dimensional scale measure of depressive symptoms in late-life across European countries. The Affective Suffering sub-component had more robust cross-cultural validity than the Motivation sub-component. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background Few population-based studies have examined the whole range of subthreshold syndromes and disorders of anxiety and depression in older people. Aims To investigate the co-occurrence of anxiety and depressive syndromes in older people. Associations between these conditions and personal and environmental factors are examined. Method MRC CFAS included 13, 004, age 65 years and above, who completed the initial screening interview. A stratified random subsample of 2, 640 participated in the assessment interview where the Geriatric Mental State Examination (GMS) was administered. The AGECAT diagnostic system was used to generate subthreshold and disorder-level of anxiety and depression as well as the combination of these into eight syndromes categories plus a group without any of the syndromes categories. Prevalences, unadjusted and adjusted odds ratios are calculated for the syndrome categories in relation to cross-sectional personal and environmental factors, and odds ratios of subthreshold and disorders level are estimated. Results The overall prevalence of anxiety and depressive disorders are 3.1% and 9.7% respectively. The overall prevalence of either anxiety or depressive disorder (anxiety disorder with subthreshold depression, mixed anxiety and depressive disorder with subthreshold anxiety) where they overlapped is 8.4%. The highest Odds Ratios unadjusted and adjusted for age and gender, of anxiety and depressive disorders and significant for trend are found for increasing disability. Disability has a strong relationship with all the co-morbid syndrome categories. In all analyses women showed significant higher estimates than men. Conclusions Our study demonstrated high estimates where anxiety and depression occurred in parallel both as disorders and as subthreshold syndromes. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background Knowledge about co-occurrence of the most frequent chronic pain symptoms with psychiatric morbidity in older people is very limited. Objective To study the association of psychiatric morbidity and painful physical conditions in people aged 60 years and over. Method Population-based random sample of 7,040 household residents, aged 60 years and over, in Brazil. Results The overall prevalence of pain conditions is 76%. Age-sex specific prevalence of chronic pain conditions such as back pain, joint, abdominal, chest, headaches, reported by respondents ranged from 11.6% up to 51.1%. In logistic regression models, chest pain, head pain, back pain, joint pain and abdominal pain emerged as predictors of psychiatric morbidity. The odds of psychiatric morbidity are also affected by income, ethnicity, origin (urban/rural), and marital status. Conclusion The association of chronic painful conditions and psychiatric morbidity in late life is statistically strong in this surveyed population. Copyright © 2007 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective To standardize the EURO-D scale as a method for detecting depression in Spanish older people. Methods In a first phase, a sample of 1080 community older people was assessed with the GMS-AGECAT by lay interviewers. In a second phase, all the probable cases and a similar number of randomly selected probable non-cases were assessed using DSM-III-R diagnosis by psychiatrists. To test reliability, internal consistency with the Cronbach alpha coefficient and test–retest reliability (Kappa value) were obtained. Validity, sensitivity and specificity, predictive values, Receiver Operating Characteristic (ROC) curve, and Specific Likelihood Ratios (SSLR) were calculated. Results A high internal consistency was obtained in both phases of the study (α = 0.75; α = 0.79, respectively). Test–retest reliability was acceptable (weighted kappa = 0.60). For the prediction of DSM-III-R diagnosis validity coefficients (cut-off point 3/4) were: sensitivity 91.8%, specificity 76.6% and area under the ROC curve 0.92 [95% Confidence Intervals (0.89–0.95)]. Illiteracy and cognitive difficulties had a small negative effect on the performance of the scale. Conclusions The EURO-D scale is a reliable and valid instrument for detecting probable cases of depression in older people in Spain. Illiteracy and cognitive difficulties should be considered when interpreting the results. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

We isolated and characterized 60 novel microsatellite markers from the closely related oldfield mouse ( Peromyscus polionotus) and deer mouse ( Peromyscus maniculatus) for studies of conservation, ecological, quantitative and population genetics. We assessed all 60 markers in a wild population of Peromyscus polionotus rhoadsi ( N = 20) from central Florida and found an average of nine alleles per marker and an observed heterozygosity ( HO) of 0.66 (range = 0.00–1.00). These polymorphic markers contribute to the growing number of genomic resources for Peromyscus, an emerging model system for ecological and evolutionary research. [ABSTRACT FROM AUTHOR]

Background No previous attempt has been made to synthesise information on mortality and neurosis in older people. Our objective was to estimate the influence on mortality of various types of neurosis in the older population. Methods Data sources were: Medline; Embase; and personal files. Studies were considered if they included a majority of persons aged 65 and over at baseline either drawn from a total community sample or drawn from a random sample from the community. Studies which sampled from a larger age range were also included if it was possible to retrieve results about those aged 65 and over. Samples from health care facilities were excluded. Effect sizes were extracted from the papers and if they were not included in the published papers effect sizes were calculated if possible. No attempt was made to contact authors for missing data. Results We found seven reports (six of which used a neurosis diagnosis and one which used a symptom scale). Using Fisher's method we found an increase in mortality which was not significant (p = 0.08). Conclusion There have been few studies, and the evidence is weakly in favour of an increased mortality risk. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Populations of paddlefish have been adversely affected by dams that can block their movements. Unlike high-head dams that preclude fish passage (unless they are equipped with fishways), the dams on the upper Mississippi River are typically low-head dams with bottom release gates that may allow fish passage under certain conditions. We evaluated the relation of dam head and river discharge to the passage of radio-tagged paddlefish through dams in the upper Mississippi River. Radio transmitters were surgically implanted into 71 paddlefish from Navigation Pools 5A and 8 of the upper Mississippi River and from two tributary rivers during fall 1994 through fall 1996. We tracked paddlefish through September 1997 and documented 53 passages through dams, 20 upstream and 33 downstream. Passages occurred mostly during spring (71%) but also occurred sporadically during summer and fall (29%). Spring passages varied among years in response to hydrologic conditions. We evaluated patterns in upstream and downstream passages with Cox proportional hazard regression models. Model results indicated that dam head height strongly affected the upstream passage of paddlefish but not the downstream passage. Several paddlefish, however, passed upstream through a dam during periods when the minimum head at the dam was substantial (≥1 m). In these cases, we hypothesize that paddlefish moved upstream through the lock chamber. [ABSTRACT FROM AUTHOR]

We describe polymerase chain reaction (PCR) primers and conditions to amplify 11 microsatellite DNA loci isolated from the oldfield mouse ( Peromyscus polionotus subgriseus). These were tested for amplification using nine species and subspecies maintained at the Peromyscus Genetic Stock Center, with an average success rate of 65% and two loci amplifying in all species. Polymorphism was tested within the P. polionotus subgriseus and the recently obtained P. maniculatus sonorensis colonies. P. p. subgriseus had modest numbers of alleles per locus (1-4), whereas P. m. sonorensis had many alleles per locus (5-10) and high expected heterozygosities (0.625-0.878). [ABSTRACT FROM AUTHOR]

Lake sturgeon , which are now protected from harvest, are considered rare in the upper Mississippi River and little information is available on the remaining populations. Transmitters were implanted into 31 lake sturgeon from two sites in the upper Mississippi River to describe their habitats and movement. The areas surrounding the tagging sites were core areas for both groups of lake sturgeon based on the high use (about 50% of locations by group) and frequent return to these areas by many of the tagged fish. Core areas contained sites with unique hydraulic characteristics, such that depositional substrates were common yet flow was present; these areas probably provide important feeding habitat for lake sturgeon. Minimal geographical overlap in range occurred between groups, suggesting that river reaches and associated core areas were unique to groups or substocks of fish. Lake sturgeon exhibited complex movement behaviors and had ranges of 3-198 km (median, 56 km) during the study. Tagged fish moved both downstream and upstream through upper Mississippi River navigation dams. However, dams appeared to be intermittent barriers to upstream passage because upstream passage events (10 fish, 19 passages) were fewer than downstream events (13 fish, 35 passages). Extensive use of the Wisconsin River by one group of lake sturgeon tagged in the upper Mississippi River has implications regarding management of a threatened population that transcends regulatory boundaries. Our study indicates that lake sturgeon in the upper Mississippi River system share many movement and habitat use characteristics with populations in other systems. However, significant data gaps preclude development of cogent management strategies, including information on population numbers and dynamics, identification of spawning areas, relations between groups, and assessment of the effects of commercial navigation. [ABSTRACT FROM AUTHOR]

Objective To provide a computerised method of diagnosing organic brain syndrome from history data without the use of mental state data. Methods Interview dataset from participants in a community study of the incidence of dementia was used to form a training sample and validation sample. The algorithm was developed on the training sample and tested on the validation sample. Results Performance in the training and validation samples was very similar. The algorithm shows monotonically increasing probability of being diagnosed with dementia as a function of the proposed level of diagnostic confidence. At the proposed cut point it has sensitivity 94% and specificity 84% for detecting concurrent psychiatrist's diagnosis of dementia. Conclusions The method provides a good agreement with psychiatrist's diagnosis, and the results in the validation sample show little shrinkage. The method will prove useful in studies where it has proved impossible to collect mental state information on all the study particpants. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background No recent attempt has been made to synthesise information on mortality and dementia despite the theoretical and practical interest in the topic. Our objective was to estimate the influence on mortality of cognitive impairment and dementia. Methods Data sources were Medline, Embase, personal files and colleagues' records. Studies were considered if they included a majority of persons aged 65 and over at baseline either drawn from a total community sample or drawn from a random sample from the community. Samples from health care facilities were excluded. The search located 68 community studies. Effect sizes were extracted from the studies and if they were not included in the published studies, effect sizes were calculated where possible: this was possible for 23 studies of cognitive impairment and 32 of dementia. No attempt was made to contact authors for missing data. Results For the studies of cognitive impairment Fisher's method (a vote counting method), gave a p -value (from eight studies) of 0.00001. For studies of dementia, age-adjusted confidence intervals (CI) were pooled (odds ratio (OR) 2.63 with 95% CI 2.17 to 3.21 from six studies). Conclusions Levels of cognitive impairment commonly found in community studies give rise to an increased risk of mortality, and this appears to be true even for quite mild levels of impairment. The analysis confirms the increased risk of mortality for dementia, but reveals a dearth of information on the causes of the excess mortality and on possible effect modification by age, dementia subtype or other variables. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background No recent attempt has been made to synthesize information on mortality and depression despite the theoretical and practical interest in the topic. Our objective was to estimate in the older population the influence on mortality of depression and depressive symptoms. Methods Data sources were: Medline, Embase, personal files and colleagues' records. Studies were considered if they included a majority of persons aged ≥ 65 years at baseline either drawn from a total community sample or drawn from a random sample from the community. Samples from healthcare facilities were excluded. Effect sizes were extracted from the papers; if they were not included in the published papers, effect sizes were calculated if possible. No attempt was made to contact authors for missing data. Results We found 21 reports on 23 cohorts using depression diagnosis. For 15 of these, odds ratios were pooled using the Greenland method based on confidence intervals (CIs), giving an estimated odds ratio for mortality with depression of 1.73 (95% CI 1.53 to 1.95). A fixed effects meta-regression of these studies suggested that longer follow-up predicted smaller effect sizes (log odds ratios -0.096 per year (95% CI -0.179 to -0.014)). There is a weak suggestion of a reduced effect of depression on mortality for women. We were unable to pool effect sizes from the 17 studies using symptom totals and scales, or from eight studies of specific symptoms. Conclusions The studies show that diagnosed depression in community-resident older people is associated with increased mortality. The picture for sex differences is still unclear. Copyright © 2001 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The computer diagnosis AGECAT applied to data from the Geriatric Mental State is shown to agree closely with cases of dementia and depression selected by the 'pervasive illness' (Gurland et al., 1983) and DSM III methods (American Psychiatric Association, 1980). AGECAT select more borderline cases of depression than either of the other two methods, but also designates two levels of mild or subcases for both depression and dementia. [ABSTRACT FROM AUTHOR]

One thousand and seventy resident in the community in Liverpool aged 65 and over were interviewed using the GMS AGECAT package. Various suggested risk factors for Alzheimer's disease were examined. Our results are in line with the conclusions drawn from earlier case-control studies; most of the factors are not associated with a change in risk. An important new result was the finding that a history of headache or dizziness led to a reduced risk of subsequent dementia. This finding is consistent with that of Heyman et al. (1984), although it was not statistically significant in their smaller study. [ABSTRACT FROM AUTHOR]

In 1982/83 a random community sample of 1070 people aged 65 years and over resident in Liverpool, Great Britain was identified. GMS data from this sample were analysed using the AGFCAT computer diagnostic program and reliable and valid rates tot hit different mental illnesses were determined. One hundred and seventy-nine subjects have died during the first three years of follow-up in the longitudinal study and form the basis of the mortality data presented here. The results demonstrate a significant relationship between mortality rates and mental disorder and we discuss these finding for different diagnostic categories as well as using the ability of the AGECAF system to look at case level. [ABSTRACT FROM AUTHOR]

The development and preliminary validation of a new self-report questionnaire for screening individuals at risk of developing an eating disorder (SCANS) is described. This instrument was derived from the functional-analytic model of anorexia nervosa, previously outlined by the first author (Slade, 1982). Forty items were created to measure five hypothesized, antecedent conditions, and this questionnaire was then administered to 722 control subjects and 40 eating disorder patients. Two principal component analyses were carried out on successive samples of control subjects (368 validation and 354 cross-validation), which yielded virtually identical solutions. Using scales empirically derived form the first component analysis, the eating disorder groups, anorexia nervosa and bulimia nervosa patients, differed significantly on all five scales from controls. Moreover, normal individuals identified as being theoretically at high risk of an eating disorder were found to score significantly higher than controls on all measures derived from the Eating Attitudes Test (EAT). Further studies and reports are planned. [ABSTRACT FROM AUTHOR]

The preliminary development and validation of a new self-report questionnaire (the NPQ) for measuring neurotic perfectionism in the eating-disorder population is described. The 42-item instrument demonstration satisfactory internal consistency. All test items correlated significantly with both SCANS P and SCANS D (subscales of the SCANS [Slade & Dewey, 1986]), thus indicating neurotic perfectionism according to Slade, Newton, Butler, and Murphy (1991), and discriminated well between controls and eating disorder patents. NPQ scores demonstrated significant group differences on comparison of neurotic perfectionists with normal and non-perfectionists (defined by the SCANS) and with subjects who scored above the EAT-26 (Garner, Olmsted, Bohr, & Garfinkel, 1982) subscale cut-offs when compared with those who scored below. [ABSTRACT FROM AUTHOR]

The present study was concerned with the identification of individuals at risk of developing an eating disorder. Two sets of hypothesized risk factors were examined: general ‘dissatisfaction and loss of control’ combined with ‘perfectionism’ (as measured by the SCANS questionnaire) and ‘body dissatisfaction’ (as measured by the Body Satisfaction Scale, or BSS). Subjects scoring above the critical cut-off points on the SCANS were found to score significantly higher on all of the measures derived from the Eating Attitudes Test (EAT) and, on interview, on measures of ‘food avoidance’ and ‘preoccupation with weight’ when compared with subjects who scored below the SCANS cut-offs. Subjects who showed significant body dissatisfaction did not differ on as many factors concerning abnormal eating attitudes and behaviors compared with individuals who were more satisfied with their body image. Of 38 subjects interviewed, five were judged to exhibit a ‘partial syndrome’ of anorexia nervosa. [ABSTRACT FROM AUTHOR]

Depressive illness in the elderly may be the result of a physical illness, the cause of secondary physical problems. coincidental to physical illness or the result of an aetiological factor common to both conditions. Analysis of a cross-sectional community sample of 396 elderly people showed depression to be significantly linked to presence of headaches, dyspnoea, and malignant disease known to the patient. It was not linked with heart disease nor arthritis per se, although those on anti-arthritic or analgesic medication were significantly more depressed. The subjective description of physical health given by the patient also correlated strongly with depression. Depressive illness is sometimes unrecognized and frequently untreated with a consequent reduction in quality of life for many patients. Clinicians must be aware of the possibility that depression may coexist with physical illness, and that both conditions may need appropriate treatment. Further analysis of the above sample, controlling for physical illness and the additive effect of the variables concerned, showed depression to be positively correlated with adverse social factors such as non going out because of physical disability, feeling lonely, having a shopper and having hearing difficulties. The home help service was identified as a probable protective factor, implying the importance of this service in supporting the emotional as well as the physical needs of its clients. [ABSTRACT FROM AUTHOR]

Problem drinking and patterns of alcohol consumption are examined as part of a follow-up study of 1070 elderly subjects randomly selected from Liverpool general practitioner lists. Using a community version of the Geriatric Mental State Examination, the prevalence of current drinking problems was found to be 9.4/1000 subjects aged 65 and over. At follow-up three years later, one-third were drinking moderately and a similar proportion whose health had seriously deteriorated were abstinent. Detailed examination of drinking patterns reveals a decline with age in the number of subjects drinking regularly. This decline is accompanied by a trend towards reduction in alcohol consumption with age which is less marked for women. Nearly one-fifth of both males and females who are drinking regularly are exceeding recommended sensible limits of alcohol consumption. [ABSTRACT FROM AUTHOR]

Presents an article that focused on the development and testing of diagnostic and screening tests for dementia. Discussion on the relevance of reliability or validity study on a screening or diagnostic test; Details of random sampling and the use of correlational measures.

Presents a letter to the editor about cases of dementia in centenarians.

Presents a letter to the editor about dementia case registers.