Search

BACKGROUND Suicide is a leading cause of preventable death worldwide, with its peak of maximum incidence in later life. Depression often puts an individual at higher risk for suicidal behaviour. In turn, depression deserves particular interest in old age due to its high prevalence and dramatic impact on health and wellbeing. AIM To gather integrated evidence on the potential risk factors for suicide behaviour development in depressive older adults, and to examine the effects of depression treatment to tackle suicide behaviour in this population. METHODS A systematic review of empirical studies, published from 2000 onwards, was conducted. Suicidal behaviour was addressed considering its varying forms (i.e., wish to die, ideation, attempt, and completed suicide). RESULTS Thirty-five papers were selected for review, comprising both clinical and epidemiological studies. Most of studies focused on suicidal ideation (60%). The studies consistently pointed out that the risk was related to depressive episode severity, psychiatric comorbidity (anxiety or substance use disorders), poorer health status, and loss of functionality. Reduced social support and loneliness were also associated with suicide behaviour in depressive older adults. Finally, the intervention studies showed that suicidal behaviour was a robust predictor of depression treatment response. Reductions in suicidal ideation were moderated by reductions in risk factors for suicide symptoms. CONCLUSION To sum up, common and age-specific risk factors seem to be involved in suicide development in depressive older adults. A major effort should be made to tackle this serious public health concern so as to promote older people to age healthily and well.

This study was supported by the Instituto de Salud Carlos III-FIS research grants (PI16/00187, PI19/00236, PI19/00569, PI19/00685, PI19/00941, PI19/00954, PI19/01027, PI19/01256, PI19/01484, PI20/00229), co-funded by the European Regional Development Fund (ERDF) “A Way to Build Europe”; the Government of the Principality of Asturias (grant ref.: PCTI-2018-2022 IDI/2018/235); Secretaria d'Universitats i Recerca from the Departament d'Economia i Coneixement (ref.: 2017SGR1365 and 2017SGR134), and Generalitat de Catalunya (Government of Catalonia), CERCA Programme., de la Torre-Luque A., Pemau A., Ayad-Ahmed W., Borges G., Fernandez-Sevillano J., Garrido-Torres N., Garrido-Sanchez L., Garriga M., Gonzalez-Ortega I., Gonzalez-Pinto A., Grande I., Guinovart M., Hernandez-Calle D., Jimenez-Treviño L., Lopez-Sola C., Mediavilla R., Perez-Aranda A., Ruiz-Veguilla M., Seijo-Zazo E., Toll A., Perez-Sola V., Ayuso-Mateos J.L.

Objective: to conduct a systematic review and meta-analyses of the effect of socio-behavioral cognitive reserve (CR) proxies on cognitive decline after stroke. Method: three journal search and indexing databases (PubMed, Scopus and Web of Sciences) were crossed to examine the scientific evidence systematically. In addition, meta-analytic techniques, using mixed-effect methods, were carried out to estimate the impact (pooled effect size) of CR proxies on either dementia incidence or cognitive decline after stroke. Results: twenty-two studies were included in the systematic revision, whereas nineteen of them were eligible for the meta-analysis. The findings showed that high education is associated with a decreased rate of post-stroke dementia. Moreover, other CR proxies (e.g., occupation, bilingualism or social interaction) demonstrate a protective effect against non-dementia cognitive decline after stroke, although some inconsistencies were found in the literature. Regarding the meta-analysis, occupational attainment and education) showed a protective effect against post-stroke cognitive impairment diagnosis in comparison with a mixed category of different CR proxies. Second, a main cognitive change effect was found, pointing to greater cognitive change after stroke in those with low vs. high CR. Conclusions: Our findings emphasize that CR may prevent cognitive decline after stroke, but this effect can be modulated by different factors such the CR proxy and individual characteristics such as age or type of lesion. The methodological divergences of the studies (i.e., follow-up intervals, cognitive outcomes) need unification to diminish external sources of variability for predicting rates of cognitive decline after stroke.

We compared the trajectory of activities of daily living (ADL) in a nationally representative sample of older Nigerians with their Spanish peers and identified factors to explain country-specific growth models.Data from two household multistage probability samples were used, comprising older adults from Spain (Compared with Nigerians (µThe rate of increase in disability was faster in older Nigerians living in an economically disadvantaged context.

Internalising disorders are highly prevalent conditions in adolescence and tend to co-occur with externalising disorders. The present study used a symptom network approach to examine the interplay between symptoms of internalising disorders among adolescents with comorbid internalising and externalising disorders. Data comes from the National Comorbidity Survey—Adolescent Supplement, a nationally representative survey of adolescents aged 13 to 18 years. The most central symptoms across the disorders in the network were poor self-esteem and worry. The comorbidity between anxiety and depression increases the probability of having comorbid externalising disorders. Adolescents with both internalising and externalising disorders had the highest rate of health service utilisation. Comorbidity group, lifestyle factors, deficits in cognitive and academic competence and coping skills were significant covariates of the mental health outcomes. Understanding comorbidity profile of internalising and externalising disorders and central symptoms that bridge these disorders could have important clinical implications.

TeV halos are regions of enhanced photon emissivity surrounding pulsars. While multiple sources have been discovered, a self-consistent explanation of their radial profile and spherically-symmetric morphology remains elusive due to the difficulty in confining high-energy electrons and positrons within ~20 pc regions of the interstellar medium. One proposed solution utilizes anisotropic diffusion to confine the electron population within a "tube" that is auspiciously oriented along the line of sight. In this work, we show that while such models may explain a unique source such as Geminga, the phase space of such solutions is very small and they are unable to simultaneously explain the size and approximate radial symmetry of the TeV halo population., 6 pages, 3 figures - Supplemental Material adds 4 pages and 3 figures

This study aimed at identifying the heterogeneous trajectories of emotional dysregulation across childhood and to study the relationship between specific trajectories and adolescent suicide-related behaviour (SRB). Data from the Millennium Cohort Study (N = 13,853 children; 49.07% female, M = 3.13 years at baseline, SD = 0.2) were used to identify the emotional dysregulation trajectories from 3 to 8 years old, using growth mixture modelling. Moreover, 1992 participants (52.86% female) from the initial sample were used to study the relationship between childhood emotional dysregulation trajectory and engagement in both self-harm and suicide attempt at age 17, using logistic regression. Some other time-invariant and proximal (adolescent) risk factors were incorporated into this analysis. Six emotional dysregulation trajectories were identified. Self-harm at age 17 was significantly associated with the history of self-harm and other proximal factors, but not with emotional dysregulation trajectory membership. Childhood trajectories featured by earlier emotional dysregulation were associated with higher risk of lifetime suicide attempt, as well as other proximal factors (concurrent self-harm). This study found differential risk profiles involved in both SRB forms. A relationship between early emotional dysregulation and suicide attempt engagement in adolescence was identified. Early interventions should be developed to deal with SRB risk factors from childhood.

A Galactic cosmic-ray transport model featuring non-homogeneous transport has been developed over the latest years. This setup is aimed at reproducing γ-ray observations in different regions of the Galaxy (with particular focus on the progressive hardening of the hadronic spectrum in the inner Galaxy) and was shown to be compatible with the very-high-energy γ-ray diffuse emission recently detected up to PeV energies. In this work, we extend the results previously presented to test the reliability of that model throughout the whole sky. To this aim, we compare our predictions with detailed longitude and latitude profiles of the diffuse γ-ray emission measured by Fermi-LAT for different energies and compute the expected Galactic ν diffuse emission, comparing it with current limits from the ANTARES collaboration. We emphasize that the possible detection of a Galactic ν component will allow us to break the degeneracy between our model and other scenarios featuring prominent contributions from unresolved sources and TeV halos.

Massive black holes at the centers of galaxies can launch powerful wide-angle winds that, if sustained over time, can unbind the gas from the stellar bulges of galaxies. These winds may be responsible for the observed scaling relation between the masses of the central black holes and the velocity dispersion of stars in galactic bulges. Propagating through the galaxy, the wind should interact with the interstellar medium creating a strong shock, similar to those observed in supernovae explosions, which is able to accelerate charged particles to high energies. In this work we use data from the Fermi Large Area Telescope to search for the γ-ray emission from galaxies with an ultrafast outflow (UFO): a fast (v ∼ 0.1 c), highly ionized outflow, detected in absorption at hard X-rays in several nearby active galactic nuclei (AGN). Adopting a sensitive stacking analysis we are able to detect the average γ-ray emission from these galaxies and exclude that it is due to processes other than UFOs. Moreover, our analysis shows that the γ-ray luminosity scales with the AGN bolometric luminosity and that these outflows transfer ∼0.04% of their mechanical power to γ-rays. Interpreting the observed γ-ray emission as produced by cosmic rays (CRs) accelerated at the shock front, we find that the γ-ray emission may attest to the onset of the wind-host interaction and that these outflows can energize charged particles up to the transition region between galactic and extragalactic CRs., Ajello, M., et al., M.A. and C.K. acknowledge support from NSF and NASA through grants AST-1715256, 80NSSC21K1915, and 80NSSC18K1718. R.D. and D.C. acknowledge the Eugene & Niesje Parker Fellowship Fund, NASA (grants NNX17AG30G, 80NSSC18K1218, and 80NSSC18K1726) and the NSF (grants AST-1714658, AST-1909778). G.C. acknowledges financial support from NASA grants 80NSSC20K0438 and 80NSSC19K095.

Depression is a disabling mental condition that reduces the quality of life regardless of age and circumstances. Late-life depression may be especially impairing due to its relationship with poor physical and mental health. Repeated or prolonged exposures to stressful events deserve a particular interest among late-life depression risk factors. One factor that may help to cope with these stressful situations is the resilience. The objective of the study was to examine the moderating effect of resilience on the relationship between perceived stress (PS) and depression. A total of 1020 community-dwelling older adults aged from 60 to 101 years (M = 68.5, SD = 6.99) completed the Perceived Stress Scale, Hospital Anxiety and Depression Scale, and Brief Resilience Scale. A moderation effect has been tested using PROCESS for SPSS. Depressive symptomatology was positively related to PS (r = .598; p < .001) and inversely related to resilience (r = − .444; p < .001). Moreover, the negative impact of PS on depressive symptoms was buffered for individuals with higher resilience (β = − .014; p < .001). The resilience could be an adaptive strategy to cope with stress and reduce depression in community-dwelling older adults.

Monthly notices of the Royal Astronomical Society 502(4), 5821 - 5838 (2021). doi:10.1093/mnras/stab355, We present a comprehensive study about the phenomenological implications of the theory describing Galactic cosmic ray scattering on to magnetosonic and Alfv��nic fluctuations in the GeV���PeV domain. We compute a set of diffusion coefficients from first principles, for different values of the Alfv��nic Mach number and other relevant parameters associated with both the Galactic halo and the extended disc, taking into account the different damping mechanisms of turbulent fluctuations acting in these environments. We confirm that the scattering rate associated with Alfv��nic turbulence is highly suppressed if the anisotropy of the cascade is taken into account. On the other hand, we highlight that magnetosonic modes play a dominant role in Galactic confinement of cosmic rays up to PeV energies. We implement the diffusion coefficients in the numerical framework of the dragon code, and simulate the equilibrium spectrum of different primary and secondary cosmic ray species. We show that, for reasonable choices of the parameters under consideration, all primary and secondary fluxes at high energy (above a rigidity of |$\simeq 200 \, \mathrm{GV}$|���) are correctly reproduced within our framework, in both normalization and slope., Published by Oxford Univ. Press, Oxford

Background The concept of European psychologisation of depression versus somatisation in non-European populations has been the basis of several studies of cultural psychopathology in the general population. Little is currently known about cross-cultural differences and similarities in late-life depression symptom reporting. We cross-culturally compared symptom reporting in the context of Major Depressive Disorder (MDD) among community-dwelling older adults from Spain and Nigeria. Methods We relied on data from two household multistage probability samples comprising 3,715 persons aged 65 years or older in the Spanish and Nigerian populations. All participants underwent assessments for MDD using the World Mental Health Survey version of the Composite International Diagnostic Interview. Cross-cultural comparison of broad somatic and psychological categories as well as relationship and influence of individual symptoms were analysed using the Symptom Network Analysis approach. Results Current MDD was diagnosed in 232 and 195 older persons from Spain and Nigeria, respectively. The symptom network of the two samples were invariant in terms of global strength, S(GSPAIN , GNIGERIA ) = 7.56, P = .06, with psychological and somatic symptoms demonstrating centrality in both countries. However, country-specific relationships and influence of individual symptoms were found in the network structure of both samples, M(GSPAIN , GNIGERIA ) = 2.95, P Conclusion Broad somatic and psychological symptoms categories contributed to the structural network of older Africans and their peers from the Spanish population. Variations in the relationship and influence of individual symptoms suggests that the functional and "communicative" role of individual symptoms may be differentiated by context specific imperatives. J Am Geriatr Soc 68:-, 2020.

Background The long-term trajectory of depressive symptoms has a heterogeneous pattern. Identifying factors associated with different trajectories and outcomes may have important theoretical and clinical implications. This study explored patterns of depressive symptom trajectory from adolescence to adulthood, and their relationship with subsequent psychiatric disorders. Method A sample of 816 participants (58.8% girls; M = 16.58 years old at baseline, SD = 1.21) from a large community sample were interviewed four times during adolescence and adulthood. Depressive symptoms were also assessed. Symptom trajectory identification was based on latent class mixed modeling. Logistic regression was used for predicting emotional and drug use disorder over age 30. Results Three trajectories of depressive symptoms were identified: "decreasing symptom" (decreasing trajectory of symptoms; 15.1% of participants), "increasing symptom" (initially decreasing pattern of symptoms and then increasing; 6.1% of participants), and "normative symptom" (consistently low symptom levels; 78.8% of participants). Predictors of the increasing symptom trajectory were high level of loneliness and state anxiety, presence of an emotional disorder, and low involvement in physical exercise at baseline. This trajectory membership predicted the development of anxiety disorders over age 30. Predictors of the decreasing symptom class were being female and high level of worry at baseline. Conclusions Long-term trajectories of depressive symptoms are heterogeneous, with each trajectory having different predictors and are associated with different outcomes during adulthood.