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Several lines of evidence have indicated that depression might be a prodromal symptom of Alzheimer's disease (AD). This systematic review and meta-analysis investigated the cross-sectional association between amyloid-beta, one of the key pathologies defining AD, and depression or depressive symptoms in older adults without dementia. A systematic search in PubMed yielded 689 peer-reviewed articles. After full-text screening, nine CSF studies, 11 PET studies, and five plasma studies were included. No association between amyloid-beta and depression or depressive symptoms were found using cerebrospinal fluid (CSF) (0.15; 95% CI: -0.08; 0.37), positron emission topography (PET) (Cohen's d: 0.09; 95% CI: -0.05; 0.24), or plasma (-0.01; 95% CI: -0.23; 0.22). However, subgroup analyses revealed an association in plasma studies of individuals with cognitive impairment. A trend of an association was found in the studies using CSF and PET. This systematic review and meta-analysis suggested that depressive symptoms may be part of the prodromal stage of dementia.

BACKGROUND: The current study aimed to assess if the relation between depression and dementia could be explained by allostatic load (AL) profiles, as well as assessing their risk on incident all-cause dementia, Alzheimer's disease (AD), and non-AD dementias.METHODS: The study included individuals without dementia at baseline from the population-based AGES-Reykjavik Study. Depressive symptoms assessed with the Geriatric Depression Scale-15 and AL markers were collected at baseline. Latent profile analysis (LPA) was performed on the AL markers. Incident dementia was measured during 12-years of follow-up. Cox regressions adjusted for AL profiles were performed to evaluate if AL could explain the relation between depressive symptoms and incident dementia. Additional Cox regressions exploring the interaction with depressive symptoms and AL profiles were also performed.RESULTS: LPA revealed four profiles based on AL factors: 'Low cardiovascular dysregulation' (43 %), 'Average' (42 % prevalence), 'High cardiovascular dysregulation' (11 %), and 'Multisystem dysregulation' (4 %). Cox regression analyses found an increased risk for dementia in the 'Multisystem dysregulation' group (HR 1.72; 95 % CI 1.26-2.33), as well as for AD (HR 1.75; 95 % CI: 1.12-2.71) and non-AD dementias (HR 1.87; 95 % CI: 1.23-2.84). AL profiles did not mediate the risk of all-cause dementia with depressive symptoms; however, there was evidence of additive interaction with depressive symptoms and the 'Multisystem dysregulation' profile and all-cause dementia (RERI 0.15; 95 % CI 0.03-0.26).CONCLUSION: AL profiles and depressive symptoms were independently related to dementia. Individuals with multisystem dysregulation could be more susceptible to the negative effects of depressive symptomology on incident dementia.

RIVM rapport:In 2016, the number of people who were tested at a Dutch STI clinic for a sexually transmitted infection (STI) increased, after a decrease in 2015. The percentage of people diagnosed with an STI has also increased, to 18.4 percent in 2016. It is estimated that the number of STI consultations at the general practitioner has decreased slightly. Chlamydia remains the most common STI in heterosexuals. Gonorrhoea is more common than chlamydia in men who have sex with men (MSM). STI clinics offer high-risk groups the opportunity for free STI testing. In 2016, a total of 143,139 consultations were registered at the STI clinics, an increase of 5 percent compared to 2015. The percentage of detected STIs varied per municipal health centre (GGD), ranging from 12.8 to 20.9 percent. Most STIs were detected in people infected with HIV, followed by people who had been notified for an STI. Chlamydia In 2016, 14.5 percent of STI clinic attendees were infected with chlamydia (20,698 diagnoses; an increase of 11 percent compared to the previous year). This increase can be explained in part because, since 2015, STI clinics more strictly prioritise people with a high risk of STI. The biggest increase was seen in heterosexual men (from 16.1 in 2015 to 18.0 percent in 2016). In women, the percentage of chlamydia diagnoses increased from 14.2 to 15.4. In MSM, the percentage has been stable around 10 percent for years. Gonorrhoea The number of gonorrhoea diagnoses at the STI clinics has risen in the past year with 13 percent, to 6,092 infections. The percentage of positive tests in heterosexual men (1.7 percent) and women (1.4 percent) remained stable, compared to previous years. In MSM, the percentage has increased from 10.7 percent in 2015 to 11.3 percent in 2016. The STI clinics have not yet found cases of gonorrhoea resistant to the first option antibiotic, Ceftriaxone. The number of gonorrhoea infections diagnosed by general practitioners in 2015 saw a slight decline among women, but a, Het aantal mensen dat zich bij een Centrum Seksuele Gezondheid (CSG) heeft laten testen op een seksueel overdraagbare aandoening (soa) is, na een daling in 2015, in 2016 weer toegenomen. Het percentage bij wie een soa werd vastgesteld is ook gestegen, tot 18,4 procent in 2016. Naar schatting is het aantal soa-consulten bij huisartsen licht gedaald. Chlamydia blijft de meest voorkomende soa onder heteroseksuelen. Onder mannen die seks hebben met mannen (MSM) werd vaker gonorroe dan chlamydia gevonden. De CSG's bieden hoog-risicogroepen de mogelijkheid om zich gratis te laten testen op soa's. In totaal zijn er in 2016 143.139 consulten geregistreerd bij de CSG's, een stijging van 5 procent ten opzichte van 2015. Het percentage gevonden soa's varieerde tussen de GGD-en; van 12,8 tot 20,9. De meeste soa's zijn gevonden bij mensen met hiv, gevolgd door mensen die waren gewaarschuwd voor een soa. Chlamydia In 2016 had 14,5 procent van de CSG-bezoekers een chlamydia-infectie (20.698 diagnoses; een toename van 11 procent ten opzichte van het jaar ervoor). Deze stijging is mogelijk deels te verklaren doordat GGD-en sinds 2015 eerder voorrang verlenen aan personen met hoog risico op soa. De grootste toename was te zien bij heteroseksuele mannen (van 16,1 in 2015 naar 18,0 procent in 2016). Bij vrouwen nam het percentage vastgestelde chlamydia toe van 14,2 naar 15,4. Onder MSM ligt dit percentage al jaren rond 10 procent. Gonorroe Het aantal gonorroe-diagnoses bij de CSG is het afgelopen jaar met 13 procent toegenomen tot 6.092 infecties. Het percentage positieven onder heteroseksuele mannen (1,7 procent) en vrouwen (1,4 procent) bleef stabiel ten opzichte van voorgaande jaren. Onder MSM is het percentage toegenomen van 10,7 procent in 2015 naar 11,3 procent in 2016. Bij CSG-bezoekers is nog steeds geen gonorroe resistent gevonden tegen het 'eerstekeus' antibioticum ceftriaxon. Het aantal gonorroe-infecties gediagnosticeerd door huisartsen in 2015 nam licht af onder vrouwen, m