The Epidemiology of Depressive Symptoms and Poor Sleep: Findings from the English Longitudinal Study of Ageing (ELSA)

PURPOSE: The reasons for the comorbidity between depressed mood and poor sleep are not well understood. METHOD: Participants were 5172 adults aged 50 years and older from the English Longitudinal Study of Ageing. Sleep was measured via self-report and depressive symptoms using the Centre for Epidemiological Studies Depression scale. RESULTS: Greater depressive symptoms and sleep complaints were associated with female sex, non-cohabitation, relative poverty, smoking, infrequent physical activity, infrequent alcohol consumption, higher body mass index (BMI), diagnosis of hypertension, coronary heart disease, diabetes/high blood glucose, pulmonary disease, arthritis, and higher levels of fibrinogen and C-reactive protein (all p < 0.05). At a 4-year follow-up, depressive symptoms and sleep complaints were both predicted by baseline depressive symptoms and sleep complaints, relative poverty, smoking, physical inactivity, BMI, and arthritis (all p < 0.05). CONCLUSION: Depressive symptoms and sleep complaints share a range of correlates cross-sectionally and prospectively. These findings highlight the common comorbidity between depressive symptoms and sleep complaints underscoring the need for further research to understand their combined detrimental effect on long-term health and wellbeing

Being stressed and active!? An analysis of different aspects of the relationship between physical activity, individual perceived stress, and individual health

Die sportwissenschaftliche Forschung zeigt deutlich, dass Sport und körperliche Aktivität positive Effekte für die Gesundheit haben, im Gegensatz dazu aber erlebter Stress negative Folgen hat. Es stellt sich die Frage, welche Rollen und Effekte Sport im Stress-Gesundheit Kontext spielen kann. In drei Studien wurde der Moderatoreffekt von Sport auf den Zusammenhang zwischen Stress und Beschwerden sowie der Effekt von erlebtem Stress auf die Sportaktivität selbst untersucht

Determinants of adverse health outcomes in late-life depression:the role of vitamin D and frailty

Older persons with a depression are at risk for vitamin D deficiency and physical health problems. Karen van den Berg studied the relationship between late-life depression, vitamin D, physical frailty and mortality.Among depressed older persons, vitamin D levels did not predict the course of depression. Lower vitamin D levels were associated with an increased risk to become physically frail or die. Specific depression characteristics did not influence the mortality risk, but physical frailty lead to a higher mortality risk. Two years later, vitamin D levels on average were decreased. This decrease was related to a worsening of physical frailty but not to the course of the depressive disorder. In depressed older persons, vitamin D supplementation might have a beneficial effect on the negative somatic health consequences associated with depression. Thus far, few studies, however, have focused on the effect of vitamin D on negative somatic health consequences besides the effect on depression.In clinical practice, adverse somatic health consequences of depression should be assessed and addressed in the treatment plan, since they negatively affect the prognosis. Since low vitamin D levels are common in depressed older persons, we recommend to actively strive for vitamin D supplementation in these population, even though a direct effect of vitamin D on depression is unlikely and the evidence for a link with adverse health consequences is still limited

Lighten UP! A community-based group intervention to promote psychological well-being in older adults

Objectives: Aging is often characterized by declines in physical and mental health and increased risk for depression and social isolation. A protective factor that has been found to effectively moderate these phenomena is psychological well-being. The aim of his study was to pilot test a novel group intervention (Lighten UP! program) for the promotion of psychological well-being in older adults living in the community. Methods: Lighten UP! is an eight-week program consisting of 90-minute group session designed to teach participants to identify and savor positive experiences across multiple domains of eudaimonic well-being. It was delivered to a sample of 103 men and women aged 60 or over, that were assessed pre- and post-intervention with Ryff's Psychological Well-being Scale (PWB), Life Satisfaction scale, Geriatric Depression Scale, Symptom Questionnaire, and items measuring sleep complaints and social well-being. Results: At the end of the eight weeks, participants reported significantly increased PWB, life satisfaction, and social well-being along with lower levels of depression and fewer physical symptoms and sleep complaints. These gains were particularly robust for individuals with lower pre-program levels of PWB. Conclusions: This pilot investigation suggests the feasibility of a short group program for enhancing well-being in older adults. Future controlled investigations with long-term follow-up assessment are needed to confirm the effectiveness and sustained benefits of the Lighten UP! program. © 2015 Taylor &amp; Franci

Quality of Life 3 and 12 Months Following Acute Pulmonary Embolism: Analysis From a Prospective Multicenter Cohort Study

BACKGROUND Few data are available on the long-term course and predictors of quality of life (QoL) following acute pulmonary embolism (PE). RESEARCH QUESTION What are the kinetics and determinants of disease-specific and generic health-related QoL 3 and 12 months following an acute PE? STUDY DESIGN AND METHODS The Follow-up after Acute Pulmonary Embolism (FOCUS) study prospectively followed up consecutive adult patients with objectively diagnosed PE. Patients were considered for study who completed the Pulmonary Embolism Quality of Life (PEmb-QoL) questionnaire at predefined visits 3 and 12 months following PE. The course of disease-specific QoL as assessed using the PEmb-QoL and the impact of baseline characteristics using multivariable mixed effects linear regression were studied; also assessed was the course of generic QoL as evaluated by using the EuroQoL Group 5-Dimension 5-Level utility index and the EuroQoL Visual Analog Scale. RESULTS In 620 patients (44% women; median age, 62 years), overall disease-specific QoL improved from 3 to 12 months, with a decrease in the median PEmb-QoL score from 19.4% to 13.0% and a mean individual change of -4.3% (95% CI, -3.2 to -5.5). Female sex, cardiopulmonary disease, and higher BMI were associated with worse QoL at both 3 and 12 months. Over time, the association with BMI became weaker, whereas older age and previous VTE were associated with worsening QoL. Generic QoL also improved: the mean ± SD EuroQoL Group 5-Dimension 5-Level utility index increased from 0.85 ± 0.22 to 0.87 ± 0.20 and the visual analog scale from 72.9 ± 18.8 to 74.4 ± 19.1. INTERPRETATION In a large cohort of survivors of acute PE, the change of QoL was quantified between months 3 and 12 following diagnosis, and factors independently associated with lower QoL and slower recovery of QoL were identified. This information may facilitate the planning and interpretation of clinical trials assessing QoL and help guide patient management. CLINICAL TRIAL REGISTRATION German Clinical Trials Registry (Deutsches Register Klinischer Studien: www.drks.de); No.: DRKS00005939

Uncovering mnestic problems in help-seeking individuals reporting subjective cognitive complaints

In individuals with subjective cognitive impairments (SCI) the risk for the development of a neurodegenerative disease is assumed to be increased. However, it is not clear which factors contribute to the expression of SCI: Is it related to the cognitive resources already challenged, or is the psycho-affective state of more relevance? Using a novel online assessment combining self-report questionnaires and neuropsychological psychometric tests, significant predictors for the level of complaints were identified in two samples of elderly individuals: Help-seekers (HS, n = 48) consulting a memory clinic and a matched sample of non-help-seekers (nHS, n = 48). Based on the results of the online assessment, the SCI level was found to be significantly determined by the psycho-affective state (depressive mood) in the nHS group, whereas cognitive performance (cued recall) was the main predictor in the HS group. The predictive value of recall performance, however, is more-strongly expressed in memory tests which reduce the impact of compensatory strategies (face–name-association vs. word lists). Our results indicate that the problem-focused behavior of help-seeking individuals is also associated with a higher sensitivity for cognitive deficits—which can be uncovered with an appropriate psychometric test. Considering these factors, the conversion risk in individuals with SCI can probably be determined more reliably