Longitudinal associations between late-life depression dimensions and cognitive functioning: a cross-domain latent growth curve analysis.

BACKGROUND: Cognitive impairment and depression often co-occur in older adults, but it is not clear whether depression is a risk factor for cognitive decline, a psychological reaction to cognitive decline, or whether changes in depressive symptoms correlate with changes in cognitive performance over time. The co-morbid manifestation of depression and cognitive impairment may reflect either a causal effect or a common cause, depending on the specific symptoms experienced and the cognitive functions affected. METHOD: The study sample comprised 1506 community-dwelling older adults aged ⩾65 years from the Longitudinal Aging Study Amsterdam (LASA). We conducted cross-domain latent growth curve analyses to examine longitudinal associations between late-life depression dimensions (i.e. depressed affect, positive affect, and somatic symptoms) and specific domains of cognitive functioning (i.e. processing speed, inductive reasoning, immediate recall, and delayed recall). RESULTS: Poorer delayed recall performance at baseline predicted a steeper increase in depressed affect over time. Steeper decline in processing speed correlated with a steeper increase in somatic symptoms of depression over time. CONCLUSIONS: Our findings suggest a prospective association between memory function and depressed affect, whereby older adults may experience an increase in depressed affect in reaction to poor memory function. Somatic symptoms of depression increased concurrently with declining processing speed, which may reflect common neurodegenerative processes. Our findings do not support the hypothesis that depression symptoms may be a risk factor for cognitive decline in the general population. These findings have potential implications for the treatment of late-life depression and for the prognosis of cognitive outcomes.

[Alcohol consumption and depressive symptoms among older adults: results of the Longitudinal Aging Study Amsterdam]. / Alcoholgebruik en depressieve symptomen bij ouderen: Resultaten van de Longitudinal Aging Study Amsterdam.

The aim of this research is to investigate the often assumed relation between alcohol use and depressive symptoms among older men and women. For this study, a subsample of 2119 participants of the Longitudinal Aging Study Amsterdam, aged 65 to 85 years at baseline, was followed over time and visited in their homes in 1992, 1995, 1998 and 2002. Depressive symptoms are assessed with the Centre for Epidemiologic Studies Depression Scale (CES-D). Alcohol use is measured with questions about the frequency and quantities of alcohol use. A relation between depressive symptoms and alcohol use could not be demonstraded in a population based sample of older drinkers. Only older heavily drinking men with higher levels of depressive symptoms, higher levels of anxiety, and more chronic diseases at baseline significantly reduced the number of glasses consumed per week from 26 to 14 in the ten years of follow-up. Heavily drinking women do not reduce the level of alcohol intake during follow-up. Public prevention strategies are needed to make older heavy drinking women and men who are still in relatively good health aware of the potential risks of excessive alcohol use.

[Alcohol consumption among persons aged 55+ in The Netherlands]. / Alcoholgebruik onder 55-plussers in Nederland.

In The Netherlands no detailed information about alcohol consumption among older persons (55 years and older) is available. Therefore we investigated the prevalence and determinants of alcohol consumption with data from the Longitudinal Aging Study Amsterdam. The results show that 13.4% of persons of 55 years and older are heavy drinkers (male >3 glasses per day, female >2 glasses per day). Most heavy drinkers are younger than 75 years of age, and in this age group more female (22.2%) than male (14.8%) are heavy drinkers. 13% of all participants frequently drinks 6 or more glasses in a short period of time (binge drinking). In the age group of 55-65 years alcohol consumption has considerably increased over a period of ten years. This increase is stronger among females than among males. When people grow older alcohol consumption decreases, which seems associated with a decline in physical or psychological health and/or cognitive decline. Heavy and binge drinking is associated with younger age, higher education and income, and may be strongly related to their social lifes.

[A multi-centre study of the reliability, validity and sensitivity to change of the honos65+ in psychiatry for older persons]. / Een multicenterstudie naar betrouwbaarheid, validiteit en gevoeligheid voor verandering van de honos65+ binnen de ouderenpsychiatrie.

BACKGROUND: Within the mental health care services for older persons there is a growing need for insight into and evaluation of the results of clinical treatment. The Health of the Nations Outcome Scales 65+ (honos65+) is a promising instrument for the assessment of mental, social and physical health in older persons, but it is not yet known whether it is valid for older persons in the Netherlands. AIM: To assess the reliability, validity and sensibility to change of the honos65+ when applied to older persons with psychiatric disorders. METHOD: The bio-psycho-social level of functioning of clients aged 60 and over (n=168) receiving mental health care was assessed by means of existing and validated measuring instruments and the results were compared with those obtained with the honos65+. Three months later the population sample was re-assessed in order to test the extent to which the honos65+ was sensitive to change. RESULTS: The reliability and validity of the honos65+ could be ascertained for 168 clients aged 60 and over. After three months 116 clients were re-assessed so that the sensitivity of the honos65+ to change could be noted. CONCLUSION: The honos65+ is a reliable and valid instrument for assessing clients with affective disorders such as depression and anxiety and for detecting changes in clients' problems and functioning. No conclusions could be reached regarding the reliability and validity of the honos65+ when used for clients with other psychiatric disorders because the clinical subgroups were too small for patterns to be detected.

[Effect of changes in physical capacities upon personal social network in aging people]. / Gevolgen van veranderingen in fysiek functioneren voor het persoonlijk relatienetwerk bij het ouder worden.

The aim of the research is to assess whether there is change in the size and composition of older adults' personal network. Furthermore, change in contact frequency and received instrumental support within the relationships is studied. Five relationship types are distinguished: children, other kin, friends, neighbors and acquaintances. Older adults with a decline in physical capacity are compared with those with stable and increased capacities. Furthermore, differences according to (change in) partner status and age are investigated. Data are from the Longitudinal Aging Study Amsterdam, including the first and fourth observation of 1634 older adults living independently. The observation interval is 7 years. A decline in physical capacities is observed for 35% of the older adults, the capacities are stable for 60% and an increase is observed for 5% of the respondents. In general, network size and composition did not change. The frequency of contact within the relationships decreased. Decline was considerable for parent-child relationships, but relatively modest among older adults who faced a moderate to strong physical decline. However, among older adults who did not have a partner at the fourth observation and among the oldest (> 75 years) the frequency of contact with children increased, independently of the degree of physical decline. The decline in contact with neighbours was nearly absent for older adults who faced a moderate to strong physical decline; the contact increased when there was no partner at the fourth observation. The instrumental support received increased within all relationship types, independently of the degree of physical decline. It is concluded that research into determinants of the decline and increase in parent-child contacts is needed and that the meaning of neighbours should receive attention.