Category Archive for: ‘Mental health’
Physical activity and APOE4 genotype related to cognitive decline
In elderly men of the FINE study a decrease in average physical activity over time was associated with a greater cognitive decline than in those maintaining physical activity. APOE4 carriers with a low level of physical activity are particularly at high risk of cognitive decline.
Lower activity related to cognitive decline
A decrease in the duration of daily activity of more than 60 min per day over 10 years follow-up was associated with an almost 3-fold greater cognitive decline compared to those who maintained their regular activity. A decrease in average intensity of exercise of a half standard deviation was associated with almost a 4 times greater cognitive decline in elderly men from The Netherlands and Italy. [glossary_exclude]
APOE4 modifies the relation of physical activity with cognitive decline
In elderly men from Zutphen, a low (<1 hour/day) compared to a high (>1 hour/day) duration of physical activity was associated with a 2-fold greater cognitive decline. This decline was twice as great in APOE4 carriers.
Cognitive decline associated with mortality
Elderly men from Finland, The Netherlands and Italy (the FINE study) whose cognition declined in the preceding 5 years, had a 2-fold greater risk of dying in the subsequent 5 years. The mortality risk of the men whose cognition improved between 1990 and 1995 was not different from those whose cognition remained stable.
Many factors predict survival
At the start of the mortality follow-up in 1995, the survivors in 2000 were younger, had a better cognitive function, were more physically active and were less disabled. They also had a lower prevalence of heart attacks and cancer than those who died during the 5-year mortality follow-up period.
Disability and depressive symptoms related to all-cause mortality
Self-rated health, disability and depressive symptoms were independent from each other, and were associated with all-cause mortality in elderly men from Finland, The Netherlands and Italy (the FINE study). After adjustment for the prevalence of chronic diseases severity of disability and depressive symptoms remained related to all-cause mortality.
Combinations of measures also associated with all-cause mortality
For the combination of disability and self-rated health a 3-fold greater mortality risk was observed for men who had severe disability and a poor self-rated health compared to the reference group. Men with severe disability in the two highest categories of depressive symptoms had also a 3-fold higher mortality risk.
These results suggest that for adequate prognosis of mortality and for developing intervention strategies information is needed on other and different health outcomes.
Cardiovascular risk factors associated with disability.
Elderly men from Zutphen were divided at baseline in those with a high cardiovascular risk, defined as 2 or more of the following traditional cardiovascular risk factors: obesity, smoking, hypertension, hypercholesterolemia and diabetes and a low-risk group with less than 2 risk factors. Men at baseline with a high cardiovascular risk had compared to those with a low risk a 2-fold or greater risk of functional disabilities after 5, 10 or 15 years. These results suggest that elevated cardiovascular risk factor might prevent or postpone disability.
Design of the study
In the Zutphen Elderly Study, traditional cardiovascular risk factors measured in 1985 were evaluated in relation to information on self-reported disabilities collected in 1990, 1995 and 2000.
Optimism associated with a lower risk of depression
In the Zutphen Elderly Study a high level of optimism in 1985 was associated with a 77% lower risk of depressive symptoms in either 1990, 1995 or 2000. Men free of depressive symptoms in 1990 had a 63% lower cumulative 10-year incidence of depressive symptoms. These results suggest that optimistic elderly men are at a lower risk to develop depressive symptoms.
Measuring optimism and depression
Dispositional optimism was assessed with a 4-item questionnaire of the Central Bureau of Statistics in The Netherlands and depressive symptoms with the 20-items validated Zung self-rating depression scale.
Omega-3 fatty acids associated with lower risk of depressive symptoms
A cross-sectional analysis of the Zutphen Elderly Study showed that men with an average daily intake of the fish fatty acids EPA-DHA (407 mg per day), followed for 10 years, had a 54% lower risk of depressive symptoms compared to those with an average daily intake of 21 mg/d. An explanation for this association might be that low levels of EPA-DHA are associated with low levels of neurotransmitters and with markers of inflammation and endothelial dysfunction.
B-vitamins not related to depressive symptoms
Major depression is associated with with lower blood levels of B-vitamins. The B-vitamins folate, vitamin B6 and B12 are involved in the production of neurotransmitters and low levels are associated with depression. However, in a cross-sectional analysis the intake of B-vitamins was not related to depressive symptoms in the Zutphen Elderly Study.
Moderate physical activity inversely associated with depression
At least mild physical activities (2 kcal/kg/hour, so f.i. for a 70 kg person that would be 140 kcal/hour) were inversely related to depressive symptoms in the baseline survey of the Finland, Italy, Netherlands Elderly study. One unit of moderate physical activity (30 min per day of walking, cycling, gardening and sports) at baseline was associated with a 3% lower risk of depressive symptoms 5 years later.
Moderate alcohol intake inversely related to depression but not to smoking
Moderate alcohol intake (less than 31 gram per day, equal to 3 glasses/d) entry was related to a 65% lower risk of depressive symptoms 5 years later, but the prevalence of smoking did not predict depressive symptoms.
- Kamphuis et al. Med Sci Sports Exerc 2007;39:1693-9
- Bots et al. Int J Geriatr Psychiatry 2008;23:478-84
Poor lung function associated with depression
Data from the Finnish and Italian cohorts showed that poor lung function in men aged 50-69 was associated with subsequent depressive symptoms 15-30 years later. This association was stronger in men with chronic diseases than in those without.
Decline in serum cholesterol predictor of depression
Among elderly men from Finland, The Netherlands and Italy, a 5-year decline in total serum cholesterol level was a predictor of depressive symptoms 5 years later. Men with two or more cardiovascular risk factors at entry (obesity, smoking, hypertension, hypercholesterolaemia, or diabetes) had no higher future risk of depression in the Zutphen Elderly Study.
- Giltay et al Am J Geriatr Psychiatry 2008;16:874-82
- Bots et al. Int J Geriatr Psychiatry 2008;23:478-84
- Giltay et al. Psychosomatic Med 2010;72:53-60
Living together associated with lower cognitive decline
In elderly men from Finland, The Netherlands and Italy information was collected on marital status and living situation in 1985 and again in 1990. This was related to cognitive decline during the next 10 years. Men who were married or who lived with others (with spouse, children, others or in a nursing home) in both 1985 and 1990, had the smallest subsequent 10-year cognitive decline.
The influence of marriage
Elderly men who lost a partner and those who were unmarried in the two examination rounds had a 2 times greater cognitive decline compared with those who were married in both years. Men who started to live alone between 1985 and 1990, had a cognitive decline 2 times greater and those who lived alone in both years had a cognitive decline 3.5 times greater than that of men who lived with others in both years.
Fish consumption related to lower cognitive decline.
In the Zutphen Elderly Study fish consumers had significantly less cognitive decline after 5 years than non-users. Similar results were obtained for the intake of the omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid).
Fish consumption related to lower cognitive decline
In the Zutphen Elderly Study fish consumers had less cognitive decline than non-users after 3 years of follow-up. However, this association was not statistically significant. After extending the follow-up period to 5 years this association became statistically significant.
Moderate intake fatty acids EPA-DHA associated with lower cognitive decline
An average difference in consumption of 380 mg of EPA-DHA per day was associated with a significant difference in cognitive decline after 5 years of follow-up. These results suggest that a moderate intake of EPA-DHA may postpone cognitive decline.