Marital Status and Its Effect on Depression in Indonesia: A Case Study of the 2014 Indonesian Family Life Survey

Background: Depression is a mental health disorder that makes the sufferer unmotivated and unproductive. This is caused by some factors such as loneliness, perfectionism, and marital status. Riset Kesehatan Dasar (Riskesdas) in 2018 shows that 6.1 percent of the population aged 15 and above in Indonesia experienced depression. Therefore, this study aims to see how marital status affects depression in Indonesia. Method: This study uses logistic regression, marginal effect, and the Rasch model using data from the Indonesian Family Life Surveys (IFLS) in 2014/2015. Result: Analyses showed that married observations have a lower prevalence of depression compared to those who are not married, divorced, or widowed. Conclusion: Therefore, an increase in divorce cases will increase the prevalence of depression in Indonesia. More effort in educating marriage to young couples is needed to reduce the number of divorces in Indonesia

The Role of Psychological Well-being and Job Satisfaction in Predicting Marital Adjustment among Female Students

Background and Aim:Marital adjustment is a complex phenomenon and is affected by various internal and external factors. Psychological well-being plays a significant role in the well-being of marital relationships. In contrast, social interactions and career circumstances also affect marital adjustment. However, the threefold relationship between psychological well-being, job satisfaction, and marital adjustment has not been studied to this date. Materials and Methods:The present study was a cross-sectional study that was conducted from May to August 2018. In this regard, 141 married female students were selected by voluntary sampling method by call and entered the study process after fulfilling the necessary criteria. The demographic checklist, the Spanier Dyadic Adjustment Scale, the Ryff scale psychological wellbeing Questionnaire, and the Overall Job Satisfaction- Brayfield & Rothe Questionnaire were completed by participants. Data were analyzed using Pearson correlation coefficient and regression analysis. Results:Data analysis showed that psychological well-being and its subscales include autonomy, environment mastery, personal growth, purpose in life, positive relations with others and self-acceptance are a significant predictor of marital adjustment (all p’s<0.01). Findings also showed that job satisfaction has predicted marital adjustment in students (p <0.01, β = 0.246). Also, a significant relationship was observed between the two indices of psychological well-being and job satisfaction (p <0.05). Conclusion:The findings of this study indicate the significant role of psychological well-being and job satisfaction in explaining marital adjustment. These findings can be associated with clinical applications in the integration of preventive and therapeutic interventions in organizational and family therapy settings

The effect of antioxidants on the course and prevention of Alzheimer's disease on the example of vitamin E

Introduction and purpose of the workAlzheimer's disease is the most common cause of dementia. A small proportion of cases have a genetic etiology. Other factors that influence the development of Alzheimer's disease include old age, family history of the disease, head trauma, hypertension in middle age, excessive body weight, diabetes, as well as elevated plasma cholesterol levels. In the course of this disease, there is accumulation of β-amyloid and intracellular neurofibrillary tangles (NETs) phosphorylated tau. Oxidative stress is a significant factor influencing induction in the course of Alzheimer's disease. The aim of this study is to investigate the role of vitamin E on the course and prevention of Alzheimer's disease. State of the knowledgeCurrently, there is no known effective treatment or prevention of Alzheimer's disease. Given the properties of vitamin E, it seems reasonable to conduct research on its possible positive effects in the prevention and treatment of Alzheimer's disease. Numerous studies have been conducted to determine the role of vitamin E supplementation in the course of this disease. Many of them have shown a positive effect of eating a diet rich in vitamin E or taking this vitamin in the form of supplements on slowing the rate of progression of the disease and reducing the risk of its onset. However, there are also studies in which the role of vitamin E has not been confirmed.SummaryDue to its properties, vitamin E can be considered as a means to reduce the risk of developing and progressing Alzheimer’s disease, but studies conducted so far are ambiguous on this issue. Further analysis should be carried out to confirm the efficacy of vitamin E in Alzheimer’s disease

Childhood adversities and bipolar disorder: a neuroimaging focus

Early-life adverse events or childhood adversities (CAs) are stressors and harmful experiences severely impacting on a child's wellbeing and development. Examples of CAs include parental neglect, emotional and physical abuse and bullying. Even though the prevalence of CAs and their psychological effects in both healthy and psychiatric populations is established, only a paucity of studies have investigated the neurobiological firms associated with CAs in bipolar disorder (BD). In particular, the exact neural mechanisms and trajectories of biopsychosocial models integrating both environmental and genetic effects are still debated. Considering the potential impact of CAs on BD, including its clinical manifestations, we reviewed existing literature discussing the association between CAs and brain alterations in BD patients. Results showed that CAs are associated with volume alterations of several grey matter regions including the hippocampus, thalamus, amygdala and frontal cortex. A handful of studies suggest the presence of alterations in the corpus callosum and the pre-fronto-limbic connectivity at rest. Alterations in these regions of the brain of patients with BD are possibly due to the effect of stress produced by CAs, being hippocampus part of the hypothalamus-pituitary-adrenal axis and thalamus together with amygdala filtering sensory information and regulating emotional responses. However, results are mixed possibly due to the heterogeneity of methods and study design. Future neuroimaging studies disentangling between different types of CAs or differentiating between BD sub-types are needed in order to understand the link between CAs and BD

Reduced Sympathetic Response to Head-Up Tilt in Subjects with Mild Cognitive Impairment or Mild Alzheimer's Dementia

Background: Hemodynamic control was compared in patients with mild cognitive impairment (MCI) or mild Alzheimer's dementia (AD) as well as in healthy elderly subjects. Methods: Noninvasive, continuous hemodynamic recordings were obtained from 14 patients and 48 controls during supine rest (tilt of 30 and 70°). Cardiac output, end-diastolic volume, total peripheral resistance, heart rate variability (HRV), systolic blood pressure variability (SBPV), and baroreceptor sensitivity were calculated. Results: At 70° tilt, the HRV indices differed significantly, with higher high-frequency (HF) variability as well as lower low-frequency (LF) variability and LF/HF ratios in the patients. The patients had significantly lower SBPV in the LF range at 30° tilt. Conclusions: The results indicate a poorer sympathetic response to orthostatic stress in MCI and mild AD

New horizons: the management of hypertension in people with dementia

The optimal management of hypertension in people with dementia is uncertain. This review explores if people with dementia experience greater adverse effects from antihypertensive medications, if cognitive function is protected or worsened by controlling blood pressure (BP) and if there are subgroups of people with dementia for whom antihypertensive therapy is more likely to be harmful. Robust evidence is scant, trials of antihypertensive medications have generally excluded those with dementia. Observational data show changes in risk association over the life course, with high BP being a risk factor for cognitive decline in mid-life, while low BP is predictive in later life. It is therefore possible that excessive BP lowering in older people with dementia might harm cognition. From the existing literature, there is no direct evidence of benefit or harm from treating hypertension in people with dementia. So what practical steps can the clinician take? Assess capacity, establish patient preferences when making treatment decisions, use ambulatory monitoring to thoroughly assess BP, individualise and consider deprescribing where side effects (e.g. hypotension) outweigh the benefits. Future research might include pragmatic randomised trials of targeted deprescribing, which include patient-centred outcome measures to help support decision-making and studies to address mechanistic uncertainties

A modified Camel and Cactus Test detects presymptomatic semantic impairment in genetic frontotemporal dementia within the GENFI cohort

Impaired semantic knowledge is a characteristic feature of some forms of frontotemporal dementia (FTD), particularly the sporadic disorder semantic dementia. Less is known about semantic cognition in the genetic forms of FTD caused by mutations in the genes MAPT, C9orf72, and GRN. We developed a modified version of the Camel and Cactus Test (mCCT) to investigate the presence of semantic difficulties in a large genetic FTD cohort from the Genetic FTD Initiative (GENFI) study. Six-hundred-forty-four participants were tested with the mCCT including 67 MAPT mutation carriers (15 symptomatic, and 52 in the presymptomatic period), 165 GRN mutation carriers (33 symptomatic, 132 presymptomatic), and 164 C9orf72 mutation carriers (56 symptomatic, 108 presymptomatic) and 248 mutation-negative members of FTD families who acted as a control group. The presymptomatic mutation carriers were further split into those early and late in the presymptomatic period (more than vs. within 10 years of expected symptom onset). Groups were compared using a linear regression model, adjusting for age and education, with bootstrapping. Performance on the mCCT had a weak negative correlation with age (rho = −0.20) and a weak positive correlation with education (rho = 0.13), with an overall abnormal score (below the 5th percentile of the control population) being below 27 out of a total of 32. All three of the symptomatic mutation groups scored significantly lower than controls: MAPT mean 22.3 (standard deviation 8.0), GRN 24.4 (7.2), C9orf72 23.6 (6.5) and controls 30.2 (1.6). However, in the presymptomatic groups, only the late MAPT and late C9orf72 mutation groups scored lower than controls (28.8 (2.2) and 28.9 (2.5) respectively). Performance on the mCCT correlated strongly with temporal lobe volume in the symptomatic MAPT mutation group (rho > 0.80). In the C9orf72 group, mCCT score correlated with both bilateral temporal lobe volume (rho > 0.31) and bilateral frontal lobe volume (rho > 0.29), whilst in the GRN group mCCT score correlated only with left frontal lobe volume (rho = 0.48). This study provides evidence for presymptomatic impaired semantic knowledge in genetic FTD. The different neuroanatomical associations of the mCCT score may represent distinct cognitive processes causing deficits in different groups: loss of core semantic knowledge associated with temporal lobe atrophy (particularly in the MAPT group), and impaired executive control of semantic information associated with frontal lobe atrophy. Further studies will be helpful to address the longitudinal change in mCCT performance and the exact time at which presymptomatic impairment occurs

An Expert Opinion From the European Society of Hypertension-European Union Geriatric Medicine Society Working Group on the Management of Hypertension in Very Old, Frail Subjects

Non peer reviewe

The future of AD clinical trials with the advent of anti-amyloid therapies: An CTAD Task Force report

BACKGROUND: Aducanumab (ADUHELMTM) was approved for the treatment of Alzheimer\u27s disease (AD) in the US. This approval was supported by an effect on the cerebral amyloid plaque load and evidence of cognitive efficacy to be confirmed in post-marketing trials. Other anti-amyloid antibodies are under investigation in phase III (donanemab, lecanemab, gantenerumab) and have shown preliminary evidence of a cognitive benefit in phase II trials. Although these agents target a small segment of patients with mild cognitive impairment due to AD or mild AD dementia, their advent will change the design of future clinical trials both for anti-amyloid and non-amyloid drugs. These changes will promote the selection of patients in clinical trials by amyloid and tau biomarkers that identify patients with appropriate biology and may follow the treatment response to approved amyloid antibodies. The use of these agents creates the opportunity to test combined drug therapies and to conduct comparative assessments with innovative therapies and newly approved drugs available in clinical practice. Blood-based AD biomarkers should be implemented in research and could facilitate the recruitment into clinical trials. Anti-amyloid antibodies will have positive (e.g., more early diagnosis) and negative impacts (some subjects will be reluctant to participate in trials and risk assignment to placebo) on AD trials in the immediate future. We present the results of the CTAD Task Force on this topic, in Boston, November 6, 2021