Trends in Frailty and Its Association With Mortality:Results From the Longitudinal Aging Study Amsterdam, 1995-2016

The aim of this study was to investigate trends in frailty and its relationship with mortality among older adults aged 64-84 years across a period of 21 years. We used data from 1995 to 2016 from the Longitudinal Aging Study Amsterdam. A total of 7,742 observations of 2,874 respondents in the same age range (64-84 years) across 6 measurement waves were included. Frailty was measured with a 32-item frailty index, with a cutpoint of ≥0.25 to indicate frailty. The outcome measure was 4-year mortality. Generalized estimating equation analyses showed that among older adults aged 64-84 years the 4-year mortality rate declined between 1995 and 2016, while the prevalence of frailty increased. Across all measurement waves, frailty was associated with 4-year mortality (odds ratio = 2.79, 95% confidence interval: 2.39, 3.26). There was no statistically significant interaction effect between frailty and time on 4-year mortality, indicating a stable association between frailty and mortality. In more recent generations of older adults, frailty prevalence rates were higher, while excess mortality rates of frailty remained the same. This is important information for health policy-makers and clinical practitioners, showing that continued efforts are needed to reduce frailty and its negative health consequences

The impact of a history of child abuse on cognitive performance:a cross-sectional study in older patients with a depressive, anxiety, or somatic symptom disorder

Background: Child abuse is a major global burden with an enduring negative impact on mental and physical health. A history of child abuse is consistently associated with worse cognitive performance among adults; data in older age groups are inconclusive. Since affective symptoms and cognitive functioning are interrelated among older persons, a synergistic effect can be assumed in patients with affective symptoms who also have suffered from child abuse. This study examines the association between a history of child abuse and cognitive performance in such patients. Methods: Cross-sectional data were collected from the ‘Routine Outcome Monitoring for Geriatric Psychiatry & Science’ project, including 179 older adults (age 60–88 years) with either a unipolar depressive, any anxiety, or somatic symptom disorder referred to specialized geriatric mental health care. A history of physical, sexual, and psychological abuse, and emotional neglect was assessed with a structured interview. Cognitive functioning was measured with three paper and pencils tests (10-words verbal memory test, Stroop Colour-Word test, Digit Span) and four tests from the computerized Cogstate Test Battery (Detection Test, Identification Test, One Card Learning Test, One Back Test). The association between a history of child abuse and cognitive performance was examined by multiple linear regression analyses adjusted for covariates. Results: Principal component analyses of nine cognitive parameters revealed four cognitive domains, i.e., visual-verbal memory, psychomotor speed, working memory and interference control. A history of child abuse was not associated with any of these cognitive domains. However, when looking at the specific types of child abuse separately, a history of physical abuse and emotional neglect were associated with poorer interference control. A history of physical abuse was additionally associated with better visual-verbal memory. Conclusions: The association between a history of child abuse and cognitive performance differs between the different types of abuse. A history of physical abuse might particularly be a key determinant of cognitive performance in older adults with a depressive, anxiety, or somatic symptom disorder. Future studies on the impact of these disorders on the onset of dementia should take child abuse into account. Trial registration: ROM-GPS is registered at the Dutch Trial Register (NL6704 at www.trialregister.nl)

Impact of childhood trauma on multidimensional frailty in older patients with a unipolar depressive-, anxiety- or somatic symptom

Item does not contain fulltextObjectives: Frailty marks an increased risk for adverse health outcomes. Since childhood trauma is associated with the onset of physical and mental health diseases during the lifespan, we examined the link between childhood trauma and multidimensional frailty. Method: A cross-sectional study embedded in a clinical cohort study (ROM-GPS) of older (>=60 years) patients (n=182) with a unipolar depressive-, anxiety- and/or somatic symptom disorder according to DSM-criteria referred to specialized geriatric mental health care. Frailty was assessed with the Tilburg Frailty Indicator (TFI), comprising a physical, psychological, and social dimension. Physical, sexual and psychological abuse and emotional neglect before the age of 16 years was measured with a structured interview. Results: Of 182 patients, 103 (56.6%) had experienced any childhood trauma and 154 (84.6%) were frail (TFI sum score >=5). Linear regression analyses, adjusted for lifestyle, psychological and physical-health factors, showed that the presence of any type of childhood trauma was not associated with the TFI sum score, however when considered separately, physical abuse was (ß=0.16, p=.037). Regarding the specific frailty dimensions, any childhood trauma was associated with social frailty (ß=0.18, p=.019), with emotional neglect as main contributor. Conclusion: These findings demonstrate a complex link between different types of childhood trauma and multidimensional frailty among older psychiatric patients. Regarding the three dimensions of frailty, social frailty seems most affected by childhood trauma. This may have been underestimated until now and should receive more attention in clinical care and future research.7 p

Transforming data by calculation

Thispaperaddressesthefoundationsofdata-modeltransformation.A catalog of data mappings is presented which includes abstraction and representa- tion relations and associated constraints. These are justified in an algebraic style via the pointfree-transform, a technique whereby predicates are lifted to binary relation terms (of the algebra of programming) in a two-level style encompassing both data and operations. This approach to data calculation, which also includes transformation of recursive data models into “flat” database schemes, is offered as alternative to standard database design from abstract models. The calculus is also used to establish a link between the proposed transformational style and bidi- rectional lenses developed in the context of the classical view-update problem.Fundação para a Ciência e a Tecnologia (FCT

An interactive tool for manipulating logical formulae

Logic is constructive in nature, and in a course on logic a student learns how to manipulate logical formulas. For example, a student has to learn how to simplify a logical formula, how to transform a logical formula into disjunctive normal form (DNF), and how to prove equivalences of logical formulae. Solving logical exercises is often done with pen and paper, but e-learning tools offer great possibilities. In particular for a distance learning university such as the Dutch Open University it is important to support the interactive construction of solutions to logical exercises. Currently all exercises and solutions can be found in our lecture notes for the courses that teach logic

Datatype-generic termination proofs

Datatype-generic programs are programs that are parameterised by a datatype. We review the allegorical foundations of a methodology of designing datatype-generic programs. The notion of F-reductivity, where F parametrises a datatype, is reviewed and a number of its properties are presented. The properties are used to give concise, effective proofs of termination of a number of datatype-generic programming schemas. The paper concludes with a concise proof of the well-foundedness of a datatype-generic occurs-in relation

Intelligente feedback in e-learning

Elearning systemen zijn uitermate geschikt om onderwijsmateriaal via het web te ontsluiten en om de communicatie tussen docent en student bij afstandsonderwijs te faciliteren. We zien dit o.a. in de zgn. Electronische Leer Omgevingen (ELO's). Er zijn echter ook andere vormen van elearning, zoals het gebruik van de computer als intelligente tutor. Deze vorm van elearning, aanvankelijk onder de naam ComputerAided Instruction (CAI), heeft de afgelopen decennia veel minder ingang gevonden. Het is ook veel moeilijker gebleken om de student bij het leren zelf te ondersteunen. Dat vraagt om het kunnen volgen van het leerproces van de student en het kunnen bijsturen waar nodig. In dit artikel beschrijven we de resultaten van een onderzoeksproject1 op het gebied van elearning voor wiskunde, in het bijzonder de lineaire algebra. Hoewel lineaire algebra een typisch wiskundevak is, zijn de resultaten van het onderzoeksproject ingezet in een informaticaopleiding, en zijn de resultaten van het project ook relevant voor andere informaticavakken waarin algebraïsche vaardigheden aan bod komen, zoals semantiek, programmacorrectheid, etc. We beschrijven een strategietaal en een parser waarmee oplossingspaden kunnen worden beschreven en waarmee de stappen van de student gevolgd kunnen worden. Vervolgens kan daarmee automatisch feedback worden gegenereerd tijdens het oplossen van de som en niet alleen achteraf

Non-parametric statistical analysis of spatially distributed functional data

International audienc